A randomized controlled trial on long-term effectiveness of a psychosocial aftercare program following paediatric chronic pain treatment: Who benefits the most?

BACKGROUND: For paediatric chronic pain patients, intensive interdisciplinary pain treatment (IIPT) is a well-established treatment. The treatment's short-term effectiveness can be improved by an additive psychosocial aftercare (PAC). However, neither the program's long-term effectiveness nor the patients in particular need have been investigated yet. METHODS: This study aimed at determining the long-term effects of PAC and detecting predictors of treatment outcome within a multicentre randomized controlled trial measured at five time points up to 12 months after discharge. At inpatient admission to IIPT, patients (N = 419, 14.3 years of age, 72.3% female) were randomly assigned to intervention or control group. After IIPT discharge, the intervention group received PAC, whereas the control group received treatment as usual (TAU). Patient-reported outcomes included pain and emotional characteristics. Clinicians assessed potential psychosocial risk factors and their prognosis of treatment outcome. Statistical analyses included mixed-models and univariable logistic regressions. RESULTS: Data at the 12-month follow-up (n = 288) showed a significant benefit of PAC compared with TAU; the majority (59.0%) of patients in the PAC-group reported no chronic pain compared to 29.2% of TAU-patients (p < 0.001). Patients with a single parent specifically benefited from PAC compared to TAU. Clinicians were able to make a reliable prognosis of treatment outcome, but did not successfully predict which patients would benefit the most from PAC. CONCLUSIONS: Study results suggest that PAC is highly effective irrespective of patient characteristics, but particularly for patients with single parents. Its broad implementation could help to improve the long-term outcomes of youth with severely disabling chronic pain. SIGNIFICANCE: A psychosocial aftercare following paediatric IIPT leads to significantly better pain and emotional outcomes compared to treatment as usual up to 12 months after discharge, especially for patients with single parents.

Impact of Crisis Communication Strategies on People’s Attitudes toward Behavioral Guidelines Regarding COVID-19 and on Their Trust in Local Officials

Situational Crisis Communication Theory (SCCT) guides responses of corporations in crises. We tested how COVID-19 related crisis communication strategies affect trust in mayors and the acceptance of behavioral measures. A total of 561 participants (53% female) with a mean age of 50 years took part in an online experiment in which we systematically manipulated the mayor’s crisis communication strategy (deny crisis, diminish role in crisis, rebuild relationship after taking responsibility, bolster reputation, no response) and pre-crisis reputation (good past crisis management, bad past crisis management). Age, gender, and education served as covariates. We also tested the predictive power of personal concern regarding the COVID-19 pandemic, as well as internal and external control convictions. In our preregistered analysis, we found that crisis communication strategies had no significant effect on participants’ ratings of behavioral measures, but they affected participants’ trust in the mayor. The deny crisis strategy resulted in the most unfavorable ratings, while the effects of the other strategies were moderated by the mayor’s pre-crisis reputation. Additional exploratory analyses showed that individual concern and trust were important predictors for the acceptance of behavioral measures. Even though we did not find any effects of communication strategies on behavioral measures, our results support SCCT’s utility in guiding communication strategy during a pandemic.