The efficacy of an educational movie to improve pain and dysfunctional behavior in school children: A randomized controlled trial

Background Chronic pain in children is a serious issue, therefore calling for effective prevention/intervention measures. This study aimed to evaluate the efficacy of an educational movie on pain knowledge in school children in general and on pain‐related behaviours and pain intensity in those who are affected by chronic pain. Regarding those affected, the association between pain knowledge and intensity, as well as the potential mediating effect of pain‐related behaviours, were investigated. Methods Recruited from four schools, N = 381 students (51.7% female; Mage = 11.4, SD = 0.95) participated, of which n = 108 reported chronic pain. Each school was randomly allocated to the intervention or control group (cluster‐randomization). At two time points spaced 4–5 weeks apart, students provided information on their pain knowledge, pain‐related behaviour (passive pain coping, pain‐related disability, missed school days, medication use) and pain intensity. After the first assessment, students in the intervention group watched an educational movie. Multilevel linear models for all outcomes were calculated as well as a mediation analysis. Results Pain knowledge increased significantly in the intervention group (β = 2.76 [95% CI 2.20, 3.31]). However, no significant time‐by‐group interactions were found for pain‐related behaviour or pain intensity. The mediation model identified that the indirect effect of pain knowledge on pain intensity was mediated by pain‐related behaviour (β = −0.18, p = 0.014 and β = 0.38, p