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Communication by Healthcare Professionals Assessing and Managing Pain.



Chronic pain is one of the main features and presentations of conditions seen in paediatric rheumatology.

It is challenging for children/young people, parents and healthcare professionals to understand and manage chronic pain because of its unpredictability and persistence.

CHAMP aims to develop a theoretically informed behaviour change intervention for healthcare professionals to improve the assessment and communication of pain in paediatric and adolescent rheumatology in the UK.

This research will collect data to provide evidence for this intervention. Further information will be added to this website in due course.

CHAMP is a collaboration across The University of Manchester and three NHS paediatric rheumatology centres in the UK. This work is funded by a Foundation Fellowship award from Versus Arthritis (Grant 12794).


Our research

Assessing and communicating about pain is particularly difficult for children and young people, and interpreting this pain is complex for healthcare professionals.

Gathering pain histories involves time-consuming discussions, and it is tricky to know what to do with such in-depth and rich pain information. It can be demanding to know who, what, when and how to ask about pain.

We are working with several paediatric rheumatology centres across the UK to conduct our research. The project comprises three studies at the moment.

Study 1: Patient and family interviews

This will be a semi-structured interview study exploring the perspectives and experiences of children, young people and parents in terms of current pain assessment and communication approaches in clinical consultations.

Study 2: Observing clinical consultations

This will be a naturalistic observation study of audio-recorded triadic (between children/young people, parents and healthcare professionals) and dyadic (between professionals and adolescents) clinical consultations.

We will identify the extent to which pain is discussed in clinic and the nature of these conversations.

Study 3: Observing multidisciplinary team meetings

This will follow an ethnographic design, observing multidisciplinary team meetings in paediatric rheumatology departments.

This study will explore what pain topics are brought to these meetings for discussion and how professionals have conversations about pain outside of direct consultations with children, young people and families.



Read publications about our findings from the CHAMP study.

A list of publications can be found in The University of Manchester’s Research Explorer.

Plain English summaries of our publications can be found on our blog.

We have presented our research findings at conferences and other events. Find out more on our blog.


Who we are

The CHAMP team includes researchers based in the UK and overseas.

Principal investigator

Dr Rebecca Lee

Dr Rebecca Lee is a Foundation Fellow at the Centre for Epidemiology Versus Arthritis at The University of Manchester.

She has a background in health psychology and works extensively in the field of pain assessment and communication for children and young people with musculoskeletal conditions. 

During her PhD, she worked on the development of a multi-dimensional mobile health application for children and young people to report pain daily called My Pain Tracker.

More recently, she has turned her attention to the ways in which new assessment and communication tools can be adopted and implemented in clinical practice to support pain conversations between professionals, children, young people and their parents.

National co-investigators

Dr Lis Cordingley

Dr Lis Cordingley is a Consultant Health Psychologist and academic in the Division of Musculoskeletal and Dermatological Sciences at The University of Manchester.

Her research focuses on psychological aspects of inflammatory musculoskeletal and dermatological conditions such as juvenile idiopathic arthritis, adult arthritis and psoriasis. 

She has a strong interest in how children, young people and adults can be supported to manage symptoms such as pain.

She has many years of experience of working with and training healthcare professionals to deliver brief psychological interventions for those with physical health conditions.


Dr Janet McDonagh

Dr Janet McDonagh is Senior Lecturer in Paediatric and Adolescent Rheumatology at the Centre for Musculoskeletal Research at The University of Manchester, and Clinical Consultant Adolescent Rheumatologist at Manchester University Hospitals Foundation Trust.

Her research interests focus on developmentally appropriate healthcare for young people including health transitions, vocational readiness and peer support, in addition to research on chronic musculoskeletal pain during adolescence and young adulthood.

She is also passionate at involving young people in all stages of the research process and is project lead for the national youth advisory panel to the Barbara Ansell National Network for Adolescent and Young adult Rheumatology – Your Rheum.

Dr Sarah Peters

Dr Sarah Peters is a Chartered Health Psychologist and senior academic in the Division of Psychology and Mental Health at The University of Manchester.

Her research focuses on healthcare communication, particularly within challenging contexts such as pain, medically unexplained symptoms and unhealthy behaviours. 

Her goal is to improve patient care, particularly equipping health professionals to communicate more effectively with patients, relatives and colleagues.

She is the qualitative and behaviour science methods lead for the Northwest Research Design Service, and Training and Education lead at the Manchester Centre for Health Psychology.


Dr Mark Connelly

Dr Mark Connelly is Professor of Pediatrics at the University of Missouri-Kansas City School of Medicine, and Director of Research for the Division of Developmental and Behavioral Health at Children’s Mercy Hospital in Kansas City, Missouri, USA.

He is a clinical health psychologist by training, with a focus on working with youth with chronic pain and their families.

His research partly centres on the development and evaluation of e-health applications to improve the understanding and treatment of pain in children and adolescents.  

Dr Tonya Palermo

Dr Tonya Palermo is a Pediatric Psychologist and Professor of Anesthesiology and Pain Medicine at the University of Washington, USA, with adjunct appointments in Pediatrics and Psychiatry.

She holds the Hughes M and Katherine Blake Endowed Professorship in Health Psychology. She serves as Associate Director of the Center for Child Health, Behavior and Development at Seattle Children’s Research Institute. 

She directs the Pediatric Pain & Sleep Innovations Lab that aims to improve the lives of children with pain and their families.

Her funded research investigates behavioural, psychosocial and family factors that affect pain experiences, and the development and evaluation of technology-delivered psychological treatments that can be delivered at low cost.

Danielle Mountain

Danielle Mountain.Danielle is a Health Psychology PhD student based within the Centre for Epidemiology Versus Arthritis at The University of Manchester, UK, and is supervised by Dr Rebecca Lee, Dr Daniela Ghio, Dr Janet McDonagh, Dr Lis Cordingley and Prof Sarah Peters.

Danielle’s PhD aims to explore and characterise children’s/young people’s lived experiences of chronic musculoskeletal pain, particularly the differences between musculoskeletal conditions that are perceived to be inflammatory or non-inflammatory. These conditions can receive different pain assessment and management approaches based upon assumptions of the diagnoses’ cause but there is limited evidence to support this.

Danielle’s passion is in developing understanding of these pain experiences to improve assessment and management of pain within the healthcare system. To do this, she applies psychological theories to understand beliefs that are associated with pain.

Her work also broadly characterises children’s/young people’s pain experiences through exploring how pain presents across time within and between individuals. Danielle’s PhD work is supported by a UK-based charity called the Pain Relief Foundation.

Professor Tim Rapley

Professor Tim Rapley.Tim is a Professor of Applied Health Care Research in the Department of Social Work, Education and Community Wellbeing at Northumbria University.

He is a medical sociologist with an interest in social studies of medical work, research and practice, as well as, more recently, social care. He undertakes detailed empirical studies that seek to understand the everyday, taken-for-granted, aspects of health and social care work. 

He is Deputy Theme Lead, Enabling Methodologies, for the North East & North Cumbria Applied Research Collaboration.

Dr Albert Farre

Albert Farre.Albert has a background in social psychology and applied qualitative and mixed-methods health research, with a particular interest in young people’s health, implementation science and complex interventions, health/illness and healthcare experiences, and evidence synthesis.

Albert’s research is informed by two broad interrelated concerns:

  • how change, innovations, and complex interventions are implemented and routinely embedded in health professionals’ everyday work practices;
  • the role of psychosocial understandings of health/illness and healthcare behaviours.

The latter focuses on patients’ and health professionals’ experiences to inform the provision/delivery of health services and public health programmes.

Dr Karine Toupin-April

Dr Karine Toupin-April.Dr Karine Toupin-April is trained in occupational therapy, and is an associate professor at the University of Ottawa and affiliate scientist at the Children’s Hospital of Eastern Ontario Research Institute and the Institut du savoir Montfort.

She has research expertise in chronic disease management and shared decision making. Her work has included research in paediatric and adult rheumatology, with experience in developing clinical practice guidelines, patient decision support interventions and self-management tools.

Her main research project aims to develop, evaluate and implement a web-based decision support intervention called the JIA Option Map to help youth with juvenile arthritis choose among pain management options with their families and health care providers.

She is an Editor of the Cochrane Musculoskeletal Group, the chair of the OMERACT (Outcome Measures in Rheumatology) shared decision making working group and the chair of the Arthritis Health Professions Association (AHPA) research committee. 

Dr Emily Wakefield

Dr Emily Wakefield.Emily Wakefield, PsyD, is an Assistant Professor in Pediatrics at the University of Connecticut School of Medicine and a Pediatric Psychologist in the Division of Pain and Palliative Medicine at Connecticut Children’s.

Dr Wakefield provides behavioral health interventions for children and adolescents with chronic pain and their families. Her research interests broadly are identifying psychosocial factors impacting the quality of life and healthcare for youth with pain conditions.

More specifically, she has published on the physical and emotional associations with racial bias and health-related stigma in youth with sickle cell disease. Dr. Wakefield also has received a K23 award from the National Institutes of Arthritis and Musculoskeletal and Skin Disease to understand pain-related stigma in adolescents with chronic musculoskeletal pain.

She has developed a conceptual model of pain-related stigma in youth with chronic pain. She is working on validating a pain-related stigma scale for adolescents with chronic musculoskeletal pain.



If you would like to get involved in our research, or if you have any questions about the CHAMP project, please get in touch.

Dr Rebecca Lee (Principal Investigator)

Phone: +44 (0) 161 275 7757

Follow us on Twitter: @The_CHAMP_study