Christine T. Chambers, Ph.D.

• BSc, MA, PhD
• Professor at Dalhousie University

Background The need for partnership between knowledge producers and knowledge users to foster effective implementation is well-established in the implementation science literature. While many theories, models, and frameworks (TMF) have been developed to guide knowledge mobilization (KM) activities, seldom do these frameworks inform approaches for e...

Objectives: To report the 3-year follow-up results of the "Caring Intensively" study, which examined children's psychological and behavioral responses after PICU hospitalization. Design: Prospective mixed methods, concurrent triangulation design. In the quantitative arm, study group (SG) and comparison group (CG) children and their parents were...

Objective Youth with juvenile idiopathic arthritis (JIA) experience elevated rates of internalizing symptoms, although more research is required to understand this phenomenon. Perfectionism, a multidimensional personality trait that involves dimensions such as striving for flawlessness (self-oriented perfectionism) and feeling that others demand pe...

Teachers have limited access to training in in-class interventions for disruptive classroom behaviour (DCB). The goal of the current study was to understand the needs of end-users and stakeholders for teacher-implemented in-class interventions for DCB and their perspectives on eLearning about behaviour management. The needs assessment involved a mi...

Disruptive classroom behaviour (DCB) is highly prevalent and is associated with poor outcomes. Although effective, in-class interventions exist for disruptive behaviour, several barriers prevent teachers from using them. The current systematic review and meta-analysis take a unique approach to the literature by focusing on teacher-implemented in-cl...

An eLearning professional development (PD) program, ASSIST for Disruptive Classroom Behaviour, was developed using an iterative user-centred design approach. This program was designed to support teachers in the implementation of teacher-implemented in-class interventions for disruptive classroom behaviour (DCB). The objective of the current study w...

Objective Although juvenile idiopathic arthritis (JIA) is often associated with pain, this experience does not necessitate negative outcomes (eg, depression, functional impairment). Little research has explored youth and parent resilience resources (ie, stable traits) and mechanisms (ie, dynamic processes) in this context, and studies have focused...

Background: To evaluate the effects of a web-based, personalized avatar intervention conveying the concept of community immunity (herd immunity) on risk perception (perceptions of the risk of infection spreading (to self, family, community, and vulnerable individuals)) and other cognitive and emotional responses across 4 vaccine–preventable disease...

Chronic pain, defined as persistent or recurring pain or pain lasting longer than 3 months, is a common childhood problem. The objective of this study was to conduct an updated systematic review and meta-analysis on the prevalence of chronic pain (ie, overall, headache, abdominal pain, back pain, musculoskeletal pain, multisite/general pain, and ot...

Background: Patient engagement is an approach that is expected or required to be part of a project, initiative or network by many research funding organizations. Solutions for Kids in Pain (SKIP) is a national knowledge mobilization network in Canada that was competitively funded and built on a foundation of engaging with patients (children and you...

Quantitative sensory testing (QST) refers to a group of noninvasive psychophysical tests that examine responses to a range of calibrated mechanical and thermal stimuli. Quantitative sensory testing has been used extensively in adult pain research and has more recently been applied to pediatric pain research. The aims of this scoping review were to...

Introduction Everyday pains are experienced frequently by young children. Parent responses shape how young children learn about and experience pain. However, research on everyday pains in toddlers and preschoolers is scarce, and no self-report measures of parent responses to their child's pain exist for this age group. Objectives The objective of...

Background Knowledge mobilization (KM) is essential to close the longstanding evidence to practice gap in pediatric pain management. Engaging various partners (i.e., those with expertise in a given topic area) in KM is best practice; however, little is known about how different partners engage and collaborate on KM activities. This mixed-methods st...

In the traditional clinical research model, patients are typically involved only as participants. However, there has been a shift in recent years highlighting the value and contributions that patients bring as members of the research team, across the clinical research lifecycle. It is becoming increasingly evident that to develop research that is b...

Introduction: Adolescence is a developmental stage that often coincides with increasing sleep problems. Focus groups were conducted to inform development of an adolescent eHealth sleep intervention by exploring opinions about (1) healthy sleep practices, and (2) using an eHealth intervention. Methods: Adolescents 14-18 years old experiencing sym...

Objective Families and children are not consistently included in pediatric pain management decisions. Shared decision making (SDM) is a collaborative process where health care professionals (HCPs) and families exchange information about treatment options along with families’ preferences to make an optimal health decision. SDM is recommended and ben...

Children remember their memories of pain long after the painful experience is over. Those memories predict higher levels of future pain intensity. Young children’s memories can be reframed to be less distressing. Parents and the way they reminisce about past events with their children play a key role in the formation of pain memories. A novel paren...

Background Pain is one of the most frequently reported experiences amongst children with Juvenile Idiopathic Arthritis (JIA); however, the management of JIA pain remains challenging. As pain is a multidimensional experience that is influenced by biological, psychological, and social factors, the key to effective pain management lies in understandin...

Teething in infants is a natural process that is associated with a variety of signs and symptoms. Many teething pain management strategies exist, yet there is a lack of research investigating which strategies are used by parents and whether they are evidence based. Using an established social media initiative, this study sought to better understand...

Unlabelled: Chronic pain in youth is often associated with social conflict, depression, and suicidality. The Interpersonal Theory of Suicide posits that there are psychosocial factors, such as peer victimization and lack of fear of pain, that may also influence suicidality. Objectives: The objective of this study was to determine if depressive s...

This review identified psychosocial factors associated with pain in children with juvenile idiopathic arthritis.

This review identified psychosocial factors associated with pain in children with juvenile idiopathic arthritis.

This review identified psychosocial factors associated with pain in children with juvenile idiopathic arthritis.

This review identified psychosocial factors associated with pain in children with juvenile idiopathic arthritis.

This review identified psychosocial factors associated with pain in children with juvenile idiopathic arthritis.

This review identified psychosocial factors associated with pain in children with juvenile idiopathic arthritis.

Background: Pain is one of the most frequently reported experiences amongst children with Juvenile Idiopathic Arthritis (JIA); however, the management of JIA pain continues to be a challenge. As pain is a multidimensional experience that is influenced by biological, psychological, and social factors, the key to effective pain management lies in und...

Background: Routine needle procedures can be distressing for parents and children. Mindfulness interventions may be helpful for parents and children but have not been examined for pediatric needle procedures despite showing benefits in the context of pediatric chronic pain and in lab-based pain tasks. Methods: This preregistered (NCT03941717) tw...

Needle procedures are among the most common causes of pain and distress for individuals seeking healthcare. While needle pain is especially problematic for children needle pain and associated fear also has significant impact on adults and can lead to avoidance of appropriate medical care. Currently there is not a standard definition of needle pain....

Pain catastrophizing is understood as a negative cognitive and emotional response to pain. Researchers, advocates and patients have reported stigmatizing effects of the term in clinical settings and the media. We conducted an international study to investigate patient perspectives on the term pain catastrophizing. Open-ended electronic patient and...

Background Patient engagement (PE) in research refers to partnering with people with lived experience (e.g., patients, caregivers, family) as collaborators in the research process. Although PE is increasingly being recognized as an important aspect of health research, the current state of PE amongst pain research trainees in Canada is unclear. Aim...

Objective Children with juvenile idiopathic arthritis (JIA) are faced with a complex medical journey requiring consistent adherence to treatments to achieve disease management. Parents are intimately involved in JIA treatments; however, little is known about their experiences in this role. This is relevant as many treatments necessitate procedural...

Background: Caregiver hesitancy for their children to receive the COVID-19 vaccine remains due to concerns regarding safety and efficacy, but also due to fear of vaccine administration-related pain and distress. Study objectives were to determine caregivers’ perceptions regarding both their personal and child’s COVID-19 vaccine administration-relat...

Objectives: Theoretical models suggest that anxiety, pain intensity, and pain catastrophizing are implicated in a cycle that leads to heightened fear of cancer recurrence (FCR). However, these relationships have not been empirically examined. The objective of this study was to examine the relationships between anxiety symptoms, pain intensity, pai...

Purpose The purpose of this study was to explore parent-nurse pain management communication during a child's discharge process following pediatric outpatient surgery. Design and methods Thirty-two clinical encounters at discharge between parents (N = 40) and nurses (N = 25) at BC Children's Hospital were audio recorded and transcribed verbatim. Co...

Most adolescents identify their best friend as their main source of social support. Adolescents with chronic pain (ACP) report the loss of friendships due to pain. Friendships protect against loneliness and depression, yet adolescents with pain experience increased levels of loneliness and depression compared to peers. This longitudinal study exami...

Introduction: The Pain Coping Questionnaire (PCQ) has support for its validity and reliability as a tool to understand how a child copes with pain of an extended duration. However, measure length may limit feasibility in clinical settings. Objectives: The primary goal of this study was to develop a short-form (PCQ-SF) that could be used for scre...

Objective Fear of cancer recurrence (FCR) is a common and distressing psychosocial concern for adult cancer survivors. Data on this construct in child survivors is limited and there are no validated measures for this population. This study aimed to adapt the Fear of Cancer Recurrence Inventory-Short Form (FCRI-SF) for survivors of childhood cancer...

Cancer and its treatment can have lasting consequences on somatosensation, including pain, which is often underrecognized and undertreated. Research characterizing the impact of cancer on pain and sensory processing in survivors of childhood cancer is scarce. This study aimed to quantify generalized differences in pain and sensory processing in sur...

Introduction: PICU hospitalization can have a profound impact on child survivors and their families. There is limited research on children's long-term recovery within the context of the family following critical illness. This study aimed to explore children's and parents' perceptions of long-term psychological and behavioral responses within the co...

Objective The COVID-19 pandemic has the potential to disrupt the lives of families and may have implications for children with existing sleep problems. As such, we aimed to: (1) characterize sleep changes during the COVID-19 pandemic in children who had previously been identified as having sleep problems, (2) identify factors contributing to sleep...

Background The social context is critical to children’s pain, and parents frequently form a major aspect of this context. We addressed several gaps in our understanding of parent-child interactions during painful procedures and identified intrapersonal contributions to parental affective responses and behaviors. We used the Pain Empathy Model frame...

Pediatric pain research will only benefit children if the results of this research are used in practice. Knowledge translation (KT) involves the sharing of research evidence to different knowledge users in a manner that is accessible and understandable. This chapter provides an overview of KT and its applications to pediatric pain, with a focus on...

The family has long been acknowledged as an important social context where children learn and receive support for experienced pain. When a child is in pain, the family is responsible for identifying pain and seeking appropriate evaluation and care. Families’ responses may inadvertently encourage or discourage the expression of pain and play a criti...

Background Vaccination is a common painful procedure for children. Parents’ concern regarding vaccination pain is a significant driver of vaccine hesitancy. Despite the wealth of evidence-based practices available for managing vaccination pain, parents lack knowledge of, and access to, these strategies. Knowledge translation (KT) tools can communic...

Introduction: Although several evidence-based strategies for managing children's vaccination pain exist, many parents report being unaware of them. Knowledge translation (KT) tools present evidence-based information in plain language. Objectives: This two-phase study assessed parents/caregivers' uptake of evidence-based pain management strategie...

Objective This study aimed to examine barriers and facilitators to the dissemination of efficacious self-directed digital health tools for adults affected by cancer, and quantify funding used to develop and evaluate these digital health tools. Methods We conducted: 1) a systematic literature review to identify efficacious self-directed digital hea...

Introduction Chronic pain, defined as persistent or recurring pain or pain lasting longer than 3 months, is a common childhood problem and can profoundly impact children’s physical, psychological and social functioning. The last comprehensive systematic review estimating the prevalence of chronic pain in children and adolescents was published in 20...

Objectives/Background: Correlational studies show that short sleep is associated with negative daytime outcomes in school-aged children, but there are few experimental sleep manipulation studies to assess whether this is a causal relation. The aim of this study was to determine the impact of mild, cumulative sleep restriction on daytime functioning...

Despite the many sexual concerns experienced by new parents, and their reported desire for more information on this topic, both parents and healthcare providers remain reticent to broach the subject. The goal of this project was to disseminate evidence-based knowledge from our prior research in a way that was accessible, engaging, and would spark f...

Objective: There is a growing body of research on the impact of stimulant medication on sleep in children with attention-deficit/hyperactivity disorder (ADHD). Negative sleep side effects are a common reason for nonadherence or for discontinuing a course of treatment. However, there is no published evidence as to whether pretreatment sleep can pre...

Children commonly undergo painful needle procedures. Unmanaged procedural pain can have short‐ and long‐term consequences, including longer procedure times, greater distress at future procedures, and vaccine hesitancy. While parent behaviors are one of the strongest predictors of children's response to acute pain, pediatric procedural pain manageme...

Introduction The purpose of this study was to describe the experience of postoperative pain management from the perspectives of parents and identify areas for improvement. Method Forty parents or legal guardians of children aged 5–18 years who underwent outpatient surgery at BC Children's Hospital were recruited. Qualitative semistructured intervi...

The measurement of pain in animals is surprisingly complex, and remains a critical issue in veterinary care and biomedical research. Based on the known utility of pain measurement via facial expression in verbal and especially non-verbal human populations, “grimace scales” were first developed a decade ago for use in rodents and now exist for 10 di...

BACKGROUND Background: ‘Herd immunity’ or ‘community immunity’ refers to the reduced risk of infection among susceptible individuals in a population through the presence and proximity of immune individuals. Recent studies suggest that improving understanding of community immunity may increase intentions to get vaccinated. OBJECTIVE Objective: We a...

Background Herd immunity or community immunity refers to the reduced risk of infection among susceptible individuals in a population through the presence and proximity of immune individuals. Recent studies suggest that improving the understanding of community immunity may increase intentions to get vaccinated. Objective This study aims to design a...

Background: ‘Herd immunity’ or ‘community immunity’ refers to the reduced risk of infection among susceptible individuals in a population through the presence and proximity of immune individuals. Recent studies suggest that improving understanding of community immunity may increase intentions to get vaccinated.Objective: We aimed to design a web ap...

Objective Robust evidence suggests children’s catastrophizing about their own pain is a risk factor for poor child pain‐related outcomes. In children of parents with chronic pain, child catastrophizing about their parents’ pain might be a unique predictor of child pain‐related outcomes given their increased exposure to parental chronic pain and dis...

Background: Hospitalized infants undergo multiple painful procedures daily. Despite the significant evidence, procedural pain assessment and management continues to be suboptimal. Repetitive and untreated pain at this vital developmental juncture is associated with negative behavioral and neurodevelopmental consequences. To address this knowledge...

Background Health researchers are increasingly using social media in a professional capacity, and the applications of social media for health researchers are vast. However, there is currently no published evidence synthesis of the ways in which health researchers use social media professionally, and uncertainty remains as to how best to harness its...

Objective: Given the high levels of pain and low rates of treatment adherence in children with juvenile idiopathic arthritis (JIA) and their families, this study sought to examine the relationship between parent pain cognitions (i.e., pain catastrophizing, fear of pain) and treatment adherence, and how barriers to treatment (e.g., forgetting treat...

Objective: Today over 80% of children diagnosed with cancer are expected to survive. Despite the high prevalence of pain associated with the diagnosis and treatment of childhood cancer, there is a limited understanding of how having cancer shapes children's experience and meaning of pain after treatment has ended. This study addresses this gap by...

Children of parents with chronic pain have higher rates of pain and internalizing (e.g., anxiety, depressive) symptoms than children of parents without chronic pain. Parental modeling of pain behaviour and reinforcement of child pain have been hypothesized to underlie these relationships. These mechanisms were tested in a sample of 72 parents with...

Introduction/Aim: Juvenile Idiopathic Arthritis (JIA) affects approximately 24,000 children throughout Canada, many of whom report pain as the predominant symptom. Caregivers play an important role in managing JIA-related pain; not only are they the primary support, many are also tasked with administering potentially painful treatments at home. Thi...

BACKGROUND Health researchers are increasingly using social media in a professional capacity, and the applications of social media for health researchers are vast. However, there is currently no published evidence synthesis of the ways in which health researchers use social media professionally, and uncertainty remains as to how best to harness its...

Introduction Daily pain experiences are a common feature of pediatric inflammatory bowel disease (IBD), which can negatively influence their health-related quality of life (HRQOL). A holistic, family systems approach is needed to further our understanding of daily pain experiences in youth with IBD and their influence on youth's HRQOL. Objectives...

BACKGROUND Despite the availability of high-quality evidence and clinical practice guidelines for the effective management of pediatric pain, this evidence is rarely used in practice for managing children’s pain from needle procedures such as vaccinations. Parents are generally unaware of pain management strategies they can use with their children....

Background: The 2018 Global Year for Excellence in Pain Education, an initiative of the International Association for the Study of Pain, brought worldwide attention to the need for education that crosses narrow disciplinary boundaries, addresses up-to-date research methods and findings, and encourages teamwork among trainees and mentors at differen...

Background Pain Squad is an evidence-based, freely available iOS app designed to assess pain in children with cancer. Once research-based technologies such as Pain Squad are validated, it is important to evaluate their performance in natural settings to optimize their real-world clinical use. Objective The objective of this study was to evaluate t...

Background: Social media is often used for health communication and can facilitate fast information exchange. Despite its increasing use, little is known about child health information sharing and engagement over social media. Objective: The primary objectives of this study are to systematically describe the content of social media posts about c...

Objectives/background: This paper outlines the current state of Canadian training, clinical services, research, and advocacy initiatives related to non-respiratory sleep disorders, with a specific focus on insomnia, the most common sleep problem in children. Methods: Information for this narrative review was collected from peer-reviewed publicat...

Background: Low levels of agreement between caregiver and child reports of acute pain are well documented. Aims: This study builds on prior research through exploring factors that may contribute to low caregiver-child concordance. Specifically, the study examined the influence of adult and child sex on adult judgments of children's pain and fear...

Background: This is the second update of a Cochrane Review (Issue 4, 2006). Pain and distress from needle-related procedures are common during childhood and can be reduced through use of psychological interventions (cognitive or behavioral strategies, or both). Our first review update (Issue 10, 2013) showed efficacy of distraction and hypnosis fo...

Introduction: Numerous eHealth tools for pain assessment and management have been developed and evaluated with promising results regarding psychometric properties, efficacy, and effectiveness. Although considerable resources are spent on developing and evaluating these tools with the aim of increasing access to care, current evidence suggests they...

Background: Chronic pain affects more than 6 million Canadians. Patients need to be involved in setting research priorities to ensure a focus on areas important to those who will be most impacted by the results. Aims: The aim of this study was to leverage patient experiences to identify chronic pain research priorities in Canada. Method: The proces...

BACKGROUND Social media is often used for health communication and can facilitate fast information exchange. Despite its increasing use, little is known about child health information sharing and engagement over social media. OBJECTIVE The primary objectives of this study are to systematically describe the content of social media posts about child...

The purpose of this narrative review was to synthesize the existing literature on the impact of sleep on daytime functioning in both typically developing (TD) children and children with attention-deficit/hyperactivity disorder (ADHD). Correlational studies in children suggest that insufficient sleep and impaired daytime functioning are significantl...

The current study examined youths’ and their parents’ perceptions concerning participation in an investigation of spontaneous and induced pain during recovery from laparoscopic appendectomy. Youth (age range 5–17 years) and their parents independently completed surveys about their study participation. On a 0 (very negative) -to-10 (very positive) s...

Social media use is on the rise. With a 10-fold increase in use over the last decade, it is estimated that over 69% of adults now use social media on a regular basis. Social media has been identified as a key resource for health professionals, including psychologists, to learn new knowledge, interact with others, keep up-to-date on the latest resea...

Research on family factors in paediatric pain has primarily focused on parents; the role of siblings has been largely ignored. This study examined whether sibling relationship quality was related to siblings' behaviours during experimental pain, and whether the behaviours of an observing sibling were related to children's pain outcomes. Ninety-two...

Background: Up to 25% of 1- to 10-year-old children experience insomnia (ie, resisting bedtime, trouble falling asleep, night awakenings, and waking too early in the morning). Insomnia can be associated with excessive daytime sleepiness and negative effects on daytime functioning across multiple domains (eg, behavior, mood, attention, and learning...

BACKGROUND Pain Squad is an evidence-based, freely available iOS app designed to assess pain in children with cancer. Once research-based technologies such as Pain Squad are validated, it is important to evaluate their performance in natural settings to optimize their real-world clinical use. OBJECTIVE The objective of this study was to evaluate t...

Background: Everyday pain experiences (minor bumps/scrapes) are common in early childhood and create frequent opportunities for socialization of pain behaviors. Nevertheless, everyday pain during the formative toddler period has been largely overlooked. Aims: The aim of the current study was to describe the frequency and nature of toddlers’ everyda...

A multisite cross sectional study was conducted to examine dyadic friendship features between adolescents with chronic pain and their friends compared to non-pain adolescent friendship dyads and the association of these friendship features with loneliness and depressive symptoms. Participants completed a battery of standardized measures to capture...

Background: Sibling relationships are longstanding across an individual’s life, and are influential in children’s development. The study of siblings in pediatric pain is, although in early stages, a growing field. Aims: This scoping review sought to summarize and map the type of research available examining siblings and pediatric pain, to identify...

Objectives: Pain is a common and distressing symptom of pediatric cancer, as reported by both children and their parents. Increasingly, children with cancer are cared for as outpatients, yet little is known about how parents manage their cancer-related pain. The aim of the current study was to examine pain prevalence and characteristics, and the p...

Despite strong evidence that skin-to-skin contact and breast-feeding are effective pain-relieving interventions for infants undergoing painful procedures, they remain underutilized in clinical practice. Given the important contribution of parents, there is a need to find innovative ways to assist parents to become actively involved in their infant'...

Pain catastrophizing has emerged as one of the most robust predictors of child pain outcomes. Although assessments of state (ie, situation-specific) pain catastrophizing in children and parents are often used, their psychometric properties are unknown. This study aimed to assess factor structure, reliability, and predictive validity of state versio...

Social modeling is a process by which pain behaviors are learned, and research has found parents act as models for their children's behavior. Despite social learning theory predicting that same-sex models have greater effect, no experimental investigation to date has examined the role of sex of the model or observer in social learning of pediatric...