Headstrong Intervention for Recurrent Pediatric Headache

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Recurrent pediatric headache is a chronic pain syndrome affecting more than two million American children and often resulting in significant functional disability and debilitation. Moreover, this syndrome represents a substantial cost to the patient's family and the health care system. The goal of the present study is to evaluate the efficacy of a new cost-effective approach to the treatment of recurrent pediatric headache that allows children to learn how to self-manage their headaches via a CD-ROM program (called "HeadstrongTM"). This grant proposal is being submitted in response to PA-01-115, which called for research seeking to identify and refine innovative and effective treament strategies for specific pain conditions. A randomized trial will be used to evaluate the effectiveness of the Headstrong TM intervention. One-hundred and eight (108) pediatric patients, ages 7-12 years, with a diagnosed recurrent migraine, muscle-contraction, or chronic daily headache syndrome will be enrolled in the study. After enrollment, each patient's baseline headache frequency, duration, and intensity will be assesed for one month using headache diaries. During this one-month baseline period, we will also collect data_to examine headache-related disability and health- related quality of life. After baseline, patients will be randomly assigned to the standard medical care plus Headstrong TM intervention or the standard medical care plus Education condition (also a CD-ROM program with information about recurrent headaches, such as types, etiology, and triggers). Both groups will work through modules in their respective programs over the co._se of one month. Dependent measures will then continue to be collected at one-month post-treatment and three-, six-, and twelve-month post-treatment follow-up. The primary study outcome will be headache_ frequency, duration, and intensity as measured by daily headache diaries. Secondary endpoints will include ,headache-related disability outcomes and quality of life. _ .....