The aim of my research is to improve health outcomes in children and adolescents with life-threatening and chronic illnesses and their families by enhancing healthcare delivered through digital health technologies (DHT). More specifically, my research focuses on the use of DHTs to: (1) assess, using electronic patient reported outcome measures, and manage procedural and disease-related pain; and (2) deliver innovative disease self- management/transitional care and peer support programs to these at-risk populations.

My research program builds upon my original doctoral and post-doctoral research where I developed and tested an electronic pain diary and an internet-based disease self-management program using juvenile idiopathic arthritis as a prototypical model of childhood chronic illness. My current positions as a clinician scientist in the Research Institute and nurse practitioner in the chronic pain program at The Hospital for Sick Children, as well as professor at the University of Toronto, have enabled my ability to conduct innovative research. I am one of the few nurse-clinician scientists in Canada. In this role, I am committed to conducting high- quality, patient-oriented clinical research across paediatric populations and geographic borders. My clinical background and research experience have allowed me to be a model for non-physician clinician scientists across Canada and internationally. By dedicating the majority of my time to research, while engaging in clinical service, I am able to ensure that my research is methodologically rigorous, clinically relevant and integrated into everyday clinical care in a timely manner.

My research program seeks to:

• improve clinical outcomes and reduce the burden of illness on patients, families and the healthcare system


• lead to the development of new Canadian-based intellectual property (ie, electronic clinical decision-making support systems and internet/smartphone electronic patient-reported outcomes, self- management and peer support programs)


• provide a fertile training environment to build Canada’s capacity of health service researchers in e-health, m-health, pain, and disease management and transitional care.

In my upcoming lecture at 2019 TRANSORM Conference, I will describe how my work applies a user-centred design approach to developing and evaluating DHTs. I will specifically discuss three novel applications:

1. Teens Taking Charge: Managing Juvenile Arthritis Online— this web-based program was evaluated in a multicentre randomised controlled trial (RCT). Adolescents who were randomised to the intervention group demonstrated significant reductions in pain intensity and interference and improvements in aspects of health-related quality of life (HRQL) compared with education control. These health improvements were maintained up to 12 months after program completion.


2. iPeer2Peer—a Skype-based peer mentoring program that has been evaluated in pilot RCTs in adolescents with arthritis and chronic pain, respectively. Both trials identified significant improvements in self-management and adaptive coping.


3. Pain Squad and Pain Squad+—smartphone applications to track pain and provide ‘just-in-time’ pain management advice to youth with cancer, respectively. A prospective study of Pain Squad (N=99) found evidence of test–retest reliability, construct validity and responsiveness. A pre-post study of Pain Squad+ (N=40) in youth with cancer demonstrated significant reductions in pain intensity and interference as well as improvements in aspects of HRQL after 28 days of app use.

 At the end of this lecture, participants will understand the importance of applying a user-centred design framework and have access to digital resources to promote disease self-management in young people in their practice. They will also recognise key opportunities and challenges of using digital health technologies to promote self- management in clinical practice.

Dr Jennifer Stinson is a professor and the Mary Jo Haddad Nursing Chair in Child Health and a senior scientist in the Child Health Evaluative Sciences research program at The Hospital for Sick Children in Toronto.

Q&A: Invited speaker Helen Slater will present on the use of digital tools as implementation enablers to support the re-imagining of musculoskeletal pain care.

What projects are you working on to improve the level of pain physiotherapy care?

Our research focus for over a decade has been exploring how we can support meaningful improvements in musculoskeletal pain care across the whole of health. How can we achieve this? How can consumers and clinicians work together to improve pain outcomes? How can we support capacity building of the health workforce to support improved pain care? How can we enable implementation of right pain care at the clinical interface and upstream through service delivery? How can policy leverage improved pain outcomes downstream?

Can you tell us a bit about what you will be addressing in your presentation?

In this presentation, we will examine the use of digital tools as implementation enablers to support the re-imagining of musculoskeletal pain care in Australia. A specific focus will be on our research with young people experiencing musculoskeletal pain.

Real-world examples will include initiatives that show how we can strengthen our capacity to support the implementation of ‘right’ musculoskeletal pain care across the whole of health: supporting people with musculoskeletal pain and their clinicians, enabling provision of ‘right’ pain care service delivery, and informing evidence-based musculoskeletal health policy.

What do you hope attendees of your presentation come away with?

While musculoskeletal pain presents many challenges, there are also exciting opportunities to drive musculoskeletal pain care transformation. The intention of this presentation is to provide delegates with an understanding of some of these opportunities and show how, as both individuals and as a profession, we, in partnership with others, can support this critical reform.

Helen Slater, FACP, is a professor and clinical researcher at Curtin University in Western Australia. Helen’s career has focused on strategic capacity-building initiatives in musculoskeletal pain and health that have real world impact.