Partnerships for Prevention: A plan for managing student stress, anxiety, and pain through interactive media.

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Pain, anxiety and stress are incidental to everyone’s daily life. For children and teens, learning how to navigate these challenges is critical to establishing a sustained healthy lifestyle, yet little is done to directly address these challenges in the typical school setting. Lacking the skills to manage stress, anxiety and everyday pains of bumps and bruses is often disrupting to all aspects of children’s lives, placing them at risk of falling behind in school, sports, extracurricular activities, and healthy social interactions. While millions of children struggle, some children are clinically referred. For example, the CDC estimates that 2.6 million children in the US aged 6-17 years have diagnosed anxiety, and studies show that the number of children affected is increasing. In the worst case, failing to address pain, anxiety and stress can lead to substance abuse involving opioids and tragedy. Our hypothesis is that attitudes toward pain, anxiety and stress can be influenced by narrative-based educational stories for children in late elementary and middle school, helping to set up healthy behaviors now and for later in life. Within a story, we plan to combine examples of situational experiences that show the reader they are not alone in what they feel with illustrations of the fundamental biology underlying the physiology and neural mechanisms of stress, anxiety and pain. The stories will then reveal research-backed non-pharmacological-based pain relief and coping strategies (e.g., mindfulness, stretching, strengthening, relaxation, ice packs, etc.) and how they can serve as the first line of defense, helping individuals to listen to their bodies to understand what they can control and when to seek medical advice. This integrated approach will be addressed by developing a collection of narrative-based interactive ebook apps using an iOS/Android platform that we invented called BiblioTech™ Adaptive Reader™. BiblioTech is a user-centered format that lets readers craft their own story by choosing where the characters go and what they learn by interacting with a branched build-your-own adventure, complete with interactive graphics, games, a digital notebook, and embedded video. With Adaptive Reader™ technology, the reader can shift the text to be easier or more challenging, allowing for changes in vocabulary and sentence structure while leaving the same learning goals intact. Digital note-taking engages the reader in scenarios and embedded assessments where the reader demonstrates what they have learned, guiding where the story goes next. Short videos will also be produced to complement the ebooks and to serve as an added resource. This combined approach of apps, ebooks and videos serves both the student and the teacher, broadening the utility across grades and individual reading proficiencies. Aligned curriculum will be developed for biology and health sciences, along with teacher professional development workshops. Assessments and evaluations will be conducted at various stages of development with late elementary and middle school students at suburban, urban and independent schools. Students and teachers will be engaged in the development of story arcs.