Headache Action Plan Project for Youth: System Change through School-Facilitated Intervention

Migraine is one of the top five health problems experienced by youth and can become increasingly disabling if not treated early with evidence-based approaches. School nurses and primary care physicians are optimally positioned to facilitate treatment before the risk of worsening disability is created but typically have limited training in migraine management. Our project goal is to establish a generalizable framework for system change in which community schools become a vehicle for the early identification of migraine and facilitation of optimal primary care management. To achieve this goal, an innovative education plan centered on use of an evidence-based migraine management template (“Headache Action Plan”) will be implemented in a target community. School nurses will be trained to screen students for migraine in need of improved management and to facilitate a process for Headache Action Plans to be implemented during primary care visits for headache. Primary care providers in the targeted community will be educated through a series of live sessions on migraine management and use of the Headache Action Plans to help prevent worsening migraine-related disability. A dedicated web portal will supplement live education through assisting in implementation of Headache Action Plans and furnishing useful resources to school nurses, PCPs, and students and their parents. Feasibility and system level outcomes (i.e., changes in prescription patterns, changes in patient disability, and changes in healthcare utilization) will be evaluated over time and between the target and control regions of a community served by the applicant pediatric hospital to determine project impact.