Susan Haddow

Background/Objective: Adolescents experience stress, anxiety, depression, and chronic pain at rates comparable to adults. Opportunity youth are a unique subset of adolescents/young adults with a higher risk of chronic pain and mental health comorbidities. Group Medical Visits (GMVs) for adults are a well-established model supporting whole-person care for chronic pain and co-incident mental health challenges. Research on GMVs among adolescents is limited. This program evaluation explores the feasibility, acceptability, and sustainability of a chronic pain GMV curriculum adapted for opportunity youth at a residential employment-readiness center. Preliminary signals of program impact were explored as a secondary objective of the study. Methods: After completing a chronic pain GMV training program, two pediatricians adapted and piloted the curriculum for opportunity youth through an 8-week Group Visit Series (GVS) offering integrative and lifestyle-based approaches to mental health, stress, and chronic pain. This was a single-site, uncontrolled, mixed-methods pilot program evaluation. Attendance was recorded as a measure of feasibility. A weekly progress sheet captured pre-/post-visit participant feedback, and semi-structured interviews (n = 6), conducted one month post-GVS, were examined using rapid analysis to explore acceptability. Sustainability was observed by program continuation beyond the pilot. Exploratory participant-reported outcomes were collected through PROMIS-29 (n = 6), PROMIS Positive Affect (n = 5), and Patient Global Impression of Change (n = 6). Results: Fourteen participants enrolled, with nine completing ≥3 visits. Weekly progress sheets demonstrated intra-visit changes from pain, fatigue, and concern to calm. Interview analysis yielded concepts of appreciation for skills learned and the group experience. Sustainability was observed. Six of seven PROMIS-29 domains showed positive signals of improvement, with 6/6 (100%) of respondents meeting a minimal clinical important difference (MCID) threshold for depression and 5/6 (83%) for anxiety. PROMIS-Positive Affect and Patient Global Impression of Change showed positive trends at visit 8. Conclusions: This chronic pain and mental health GVS for opportunity youth was found to be feasible, acceptable, and sustainable. Positive trends in participant-reported depression and anxiety scores were also observed. Larger studies beyond program evaluation are needed to confirm these results.