Arthur Zhang*, University of California at Irvine, Irvine, United States Sergio Gago*, University of California at Irvine, Irvine, United States Ariana Martinez, University of California at Irvine, Irvine, United States Michelle Fortier, University of California at Irvine, Irvine, United States Track: Research Presentation Topic: Mobile & Tablet Health Applications Presentation Type: Rapid-Fire Presentation Submission Type: Single Presentation Building: Sheraton Maui Resort Room: C - Napili Date: 2014-11-13 11:50 AM – 12:35 PM Last modified: 2014-09-22

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Background: Approximately 12,000 children are diagnosed with cancer in the United States each year and the majority of these children will experience moderate to severe pain and disabling symptoms such as fatigue and nausea during the course of their illness. Survivors of childhood cancer are also at high-risk for long-term chronic pain. Although parents and children report that pain is a significant concern, pain assessment throughout cancer treatment is not performed systematically and existing data suggest cancer pain and symptoms are seriously undermanaged. Without accurate data, physicians are unable to intervene appropriately. Additional barriers to treatment include misunderstandings regarding the use of analgesia in children (i.e., fears of addiction) and lack of understanding of how pain is expressed by children. This is particularly relevant to the management of symptoms in a home setting by parents, who have been shown to significantly undertreat children’s pain. To date, interventions targeting pain and symptom management in the home settings of children suffering from cancer are seriously lacking.

Objective: Affective communication such as encouragement, confidence and friendship can be easily transmitted by a therapist. However, previous studies have suggested that affective communication for supporting tasks can also be transmitted by a virtual embodied agent. The goal of this study is to evaluate the feasibility and acceptability of a newly developed mobile application – PainBuddy – as a serious game to help children with cancer convey the extent of their discomfort and connect them to their doctors, who can monitor patients in real time.

Methods: This project involves the development of an animated avatar-based tablet application called PainBuddy, which will help pediatric oncology patients to communicate their pain by making an animated and interactive diary report. Animated characters will interact with these children and ask the needed questions for the diary, providing support and encouragement. The animated characters being developed have been chosen by children through three rounds of surveys at the Children’s Hospital of Orange County. Specifically, the PainBuddy program will include three characters: a penguin, a panda and an elephant. As an additional technique to motivate and engage children, bonus coins will be awarded for completing entries, and children can use these coins to virtually purchase outfits and accessories to customize their avatars. The diary report being implemented is based on a validated pain and symptom assessment protocol. The information collected by PainBuddy will be stored and encrypted on a dedicated server that will allow physicians to monitor and respond to pain and symptoms in real time. In addition, the program will send real time data to health care providers when pre-configured symptom alerts are activated. PainBuddy will also include a messaging platform to improve the communication between patients and providers. PainBuddy will provide training to reduce stress and anxiety in children by adding a skills-training component. Finally, using a randomized controlled trial design, we will examine the efficacy of PainBuddy in managing pain and symptoms in children suffering from cancer.

Results: The research is in progress. A first prototype of PainBuddy has been achieved for mobile devices.

Conclusions: Virtual characters could improve home-based therapy for children suffering from cancer.

The goal of the present presentation is to give an overview of the functionality and application of PainBuddy in clinical and research settings for this purpose. Directions for future development and generic issues will be discussed.