Open Access Open Badges Study protocol

Early signaling, referral, and treatment of adolescent chronic pain: a study protocol

Jessica S Voerman1*, Sylvia Remerie2, L Esther de Graaf1, Petra van de Looij-Jansen3, Tessa Westendorp2, Ina van Elderen4, Frouwkje de Waart3, Jan Passchier5, Anke Dommisse van Berkel3 and Cora de Klerk1

Author Affiliations

1 Department of Medical Psychology and Psychotherapy, Erasmus MC University Medical Hospital, PO Box 2040, Rotterdam, CA, 3000, the Netherlands

2 Rijndam rehabilitation centre, PO Box 23181, Rotterdam, KD, 3001, the Netherlands

3 Municipal Public Health Services Rotterdam-Rijnmond, PO Box 70032, Rotterdam, LP, 3000, the Netherlands

4 Centre for Youth and Family Rijnmond, PO Box 3074, Rotterdam, AB, 3003, the Netherlands

5 Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Van der Boechorstraat 1, Amsterdam, BT, 1081, the Netherlands

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BMC Pediatrics 2012, 12:66  doi:10.1186/1471-2431-12-66

Published: 11 June 2012



Chronic pain is prevalent among young people and negatively influences their quality of life. Furthermore, chronic pain in adolescence may persist into adulthood. Therefore, it is important early on to promote the self-management skills of adolescents with chronic pain by improving signaling, referral, and treatment of these youngsters. In this study protocol we describe the designs of two complementary studies: a signaling study and an intervention study.

Methods and design

The signaling study evaluates the Pain Barometer, a self-assessed signaling instrument for chronic pain in adolescents. To evaluate the feasibility of the Pain Barometer, the experiences of youth-health care nurses will be evaluated in semi-structured interviews. Also, we will explore the frequencies of referral per health-care provider. The intervention study evaluates Move It Now, a guided self-help intervention via the Internet for teenagers with chronic pain. This intervention uses cognitive behavioural techniques, including relaxation exercises and positive thinking. The objective of the intervention is to improve the ability of adolescents to cope with pain. The efficacy of Move It Now will be examined in a randomized controlled trial, in which 60 adolescents will be randomly assigned to an experimental condition or a waiting list control condition.


If the Pain Barometer is proven to be feasible and Move It Now appears to be efficacious, a health care pathway can be created to provide the best tailored treatment promptly to adolescents with chronic pain. Move It Now can be easily implemented throughout the Netherlands, as the intervention is Internet based.

Trial registration

Dutch Trial Register NTR1926

Chronic pain; Adolescents; Signaling; Referral; Treatment; Internet intervention