WHI - WIRELESS HEADACHE INTERVENTION
Contact:  anna.huguet@iwk.nshealth.ca
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   The percentages of adults with an active headache disorder are 46% for headache in general, 11% for migraine, 42% for tension-type headache and 3% for chronic daily headache. Using the World Health Organization's ranking of causes of disability, headache disorders are among the 20 most disabling conditions for both men and women and is ranked number 12 among women.

Given the importance of these problems, it is reasonable to suggest that more resources are necessary to meet the challenges of treating headache disorders as soon as possible and preventing more serious problems. They often begin in childhood, adolescence, or during the second decade of life. The traditional medical treatment, which is the most practical first-line treatment option in primary care, is, by itself, often not appropriate to relieve and prevent headache. There is evidence to guide clinical practice. Psychological therapies are effective interventions; biofeedback, relaxation/self hypnosis, and other integrated cognitive-behavior therapy approaches are well-known empirically supported alternatives. However, the majority of people with headache disorders do not receive such interventions because of the lack of availability of clinicians to teach the skills required. With emerging interactive and communication technologies (e-health), especially the internet, new media for the delivery of psychological interventions are now available.

The awareness of the potential of use of information and communication technology (ICT) to deliver self-help psychological treatment has grown among researchers in the field of headache. There is emerging evidence of the effectiveness of the Internet to deliver interventions based on the principles of Cognitive-Behavioral therapy (CBT).

However, too few rigorous studies have been conducted to endorse their widespread use. In addition, few studies have been conducted using smartphone technology as a medium of delivering internet-based treatments and monitoring their effectiveness (electronic pain diaries) despite the fact that smartphones can offer some additional benefits. In particular, Smarphones allow for easy monitoring of headache and other critical events. Even more important, Smartphone-based approaches could deliver personalized prompts of strategies to the headache sufferer at the time of the headache. Prompting in real time is likely to increase use of strategies and may increase effectiveness of the treatment. The overarching, long-term objective of this project is to prevent and reduce pain and suffering in young people with primary headache disorders by improving the accessibility to psychological treatment for headache. This goal will be accomplished by implementing the latest generation of ICT.

Specifically, our objectives over the three-year study period are to: (1) develop a Smartphone-based CBT to treat 14-28 year old people with tension-type headache and/or migraine; (2) evaluate its system usability and feasibility, and (3) provide preliminary data on the efficacy of this treatment. In order to achieve our goals, the project is divided into three phases. We will develop a phone technology-based CBT treatment for headache using a iterative design approach (Phase #1), we will conduct usability testing through in-lab usability evaluation methods with real users (Phase #2), and we will conduct a pilot feasibility study with tension-type headache and/or migraine sufferers (Phase #3). We will use mixed methods approach including quantitative and qualitative methods for evaluating this program.

The use and further development of ICT will play a key role in the delivery of health care interventions making them more accessible and acceptable, especially in health psychology. There is some beginning evidence that individuals with headache can receive valuable help through the use of ICT leading to improved health outcomes. However, we need to ascertain whether psychological interventions can be more easily and effectively delivered through ready available technological alternatives like the Smartphones.