Improving Pain Outcomes for Children and Adolescents at School via a Socio-Ecological Public Health Lens: A Strengths-Focused Interview Study With Teachers.

Chronic pain in children and adolescents is widespread and negatively affects school attendance and developmental trajectories. Teachers are central to how pain (both acute and chronic) is experienced by their students because of their position as educators and social role models. Therefore, we aimed to explore how teachers make meaning from and respond to their students' pain, and identify individual and system-level strengths to guide recommendations for clinical and public health interventions for pain management in schools. We conducted a qualitative study using semi-structured individual interviews with schoolteachers using an Appreciative Inquiry approach. We analyzed our results using reflexive thematic analysis, with inductive and deductive approaches. Our analysis was based on a socio-ecological framework. We interviewed 11 teachers working in primary (n = 8), secondary schools (n = 2) and leadership (n = 1). We generated three themes to capture participant experiences: (1) The teacher-student relationship: teachers are dedicated to building a connection and have key teaching and learning skills that can support pain; (2) the school community: inclusion policy and culture can positively influence pain outcomes; and (3) societal influences: misconceptions about pain can influence how teachers perceive the reality of pain. This research enhances our comprehension of the ways in which student pain (whether acute or chronic) is experienced and responded to within the school environment. The insights gained can enrich clinical perspectives and foster collaborative efforts with educators to mitigate the adverse impacts of chronic pain on young individuals, such as increased school absenteeism and pain-related stigma.