First responders, such as paramedics and firefighters, encounter duty-related traumatic exposures, which can lead to post-traumatic stress (PTS). Although social support protects against PTS, we know little about how first responders’ families, spouses/partners, friends, and care-partners (i.e., ‘trusted others’) provide social support. This narrative review explores support behaviors, coping strategies, and resources trusted others use to support first responders. A structured literature search yielded 24 articles. We used House’s (1981) conceptual framework to inform our analysis. We identified three main themes: providing support, finding support, and support needs. Additionally, we describe trusted others’ self-reported preparedness, coping strategies, and barriers to providing social support. We found that trusted others provided different types of support: (a) emotional (fostering a safe space, giving autonomy over recovery, facilitating coping mechanisms, prioritizing first responders’ emotional needs); (b) instrumental (prioritizing first responders’ practical needs, handling household tasks, supporting recovery); (c) appraisal (active monitoring, verbal reassurance, positive reframing), and (d) informational (seeking informal learning). In their role, trusted others sought formal (organizational) and informal (peer and personal) support and resources, alongside intrapersonal and interpersonal coping strategies. Identified barriers include inadequate communication skills, maladaptive coping, and disempowering beliefs. Thus, we offer practical, treatment, and social support recommendations.

Resource and geographic barriers are the commonly cited constraints preventing the uptake of psychological treatment for chronic pain management. For adults, there is some evidence to support the use of information and communication technology (ICT) as a mode of treatment delivery. However, mixed findings have been reported for the effectiveness and acceptability of psychological interventions delivered using information and communication technology for children and adolescents. This is a protocol for a review that aims to (i) evaluate the effectiveness of psychological interventions delivered using information and communication technology for children and adolescents with chronic pain and (ii) identify the intervention components and usability factors in technology-based treatments associated with behaviour change. We will conduct a systematic review to evaluate the effectiveness of psychological interventions for paediatric chronic pain delivered using ICT. We plan to directly compare ICT-based, psychological interventions with active control, treatment as usual or waiting list control conditions. This systematic review will be reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance. Published and unpublished randomised controlled trials will be included and the literature search will comprise Ovid MEDLINE, Ovid Embase, PsycINFO and the Cochrane Library on Wiley, including CENTRAL and Cochrane Database of Systematic Reviews. Grey literature including theses, dissertations, technical and research reports will also be examined. Two review authors will independently conduct study selection, relevant data extraction and assessment of methodological quality. Risk of bias in included studies will be assessed using the Cochrane Collaboration risk of bias tool criteria. Two qualified coders will independently code behaviour change techniques according to the behaviour change taxonomy (v1) of 93 hierarchically clustered techniques and a novel coding scheme for mode of delivery and usability factors. A quantitative synthesis will be conducted if appropriate. The findings of this review may offer insight for healthcare professionals working in chronic pain services and to researchers involved in designing and evaluating information and communication technology-based interventions. PROSPERO CRD42016017657

Background: Barriers to uptake of psychological treatment for chronic pain management include access and resource issues. Technology-based interventions for pain management are a more accessible treatment approach. The internet can be an effective mode of delivery of psychological treatment for chronic conditions. Research in this area has largely focused on adolescents with chronic pain. Little is known about the acceptability of technology-based delivery of psychological treatment for early school age children with chronic pain Aim(s): The aim of this study is to create an evidence-based, theoretically informed online intervention (Feeling Better) designed to enhance adaptive coping in children with chronic pain and their parents or carers. We describe our experience of using a systematic approach to the development of a complex, web-based intervention which aims to improve symptoms and physical functioning in children with chronic pain by modifying pain related beliefs and coping strategies. Method(s): The intervention development process included: (1) a systematic review of empirical literature which focused on the efficacy of information and communication technology-based delivery of psychological treatment for chronic pain in children; (2) selection of a theoretical framework and behaviour change techniques that demonstrate evidence of effectiveness in improving coping behaviours including pain related beliefs, pain catastrophizing and self-efficacy for managing pain (3) development of intervention prototype materials for user testing (4) a qualitative study using a participative research process approach to engage children with chronic pain and their parents in the generation, analysis and interpretation of responses to questions on support needs, coping preferences and the acceptability of technology-based treatment (5) refinement of prototype materials and a second phase of user testing to obtain end-user and expert feedback on programme adaptation and (6) development of the final intervention. Results: Key stakeholders made a significant contribution in each phase of intervention development and user testing. This was an iterative process which resulted in the final intervention. The Feeling Better intervention has eight sessions and includes an introduction to chronic pain, goal setting, relaxation training, exercise and activity pacing. Sessions are designed to cover areas of pain management which were identified as most challenging and most important to stakeholders Conclusions: It is feasible to create an evidence-based and theory driven online self-management intervention to support children with chronic pain and their parents. Service users can be involved in the design and conduct of research in a meaningful way. An exploratory trial to test the feasibility of acceptability of Feeling Better is underway.