title: A randomized trial of a web-based intervention to improve migraine self-management and coping.
abstract: OBJECTIVE
  To test the clinical efficacy of a web-based intervention designed to increase patient self-efficacy to perform headache self-management activities and symptom management strategies, and reduce migraine-related psychological distress.
  
  
  BACKGROUND
  In spite of their demonstrated efficacy, behavioral interventions are used infrequently as an adjunct in medical treatment of migraine. Little clinical attention is paid to the behavioral factors that can help manage migraine more effectively and improve the quality of care and quality of life. Access to evidenced-based, tailored, behavioral treatment is limited for many people with migraine.
  
  
  METHODS
  The study is a parallel group design with 2 conditions: (1) an experimental group exposed to the web intervention; and (2) a no-treatment control group that was not exposed to the intervention. Assessments for both groups were conducted at baseline (T1), 1-month (T2), 3-months (T3), and 6-months (T4).
  
  
  RESULTS
  Compared with controls, participants in the experimental group reported significantly: increased headache self-efficacy, increased use of relaxation, increased use of social support, decreased pain catastrophizing, decreased depression, and decreased stress. The hypothesis that the intervention would reduce pain could not be tested.
  
  
  CONCLUSIONS
  Demonstrated increases in self-efficacy to perform headache self-management, increased use of positive symptom management strategies, and reported decreased migraine-related depression and stress suggest that the intervention may be a useful behavioral adjunct to a comprehensive medical approach to managing migraine.
authors.affiliation: Inflexxion, Inc., Newton, MA 02464, USA. jbromberg@inflexxion.com
authors.forename: Jonas
authors.initials: J
authors.lastname: Bromberg
authors.forename: Mollie E
authors.initials: ME
authors.lastname: Wood
authors.forename: Ryan A
authors.initials: RA
authors.lastname: Black
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Surette
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Zacharoff
authors.forename: Emil J
authors.initials: EJ
authors.lastname: Chiauzzi
mesh_terms: D000223:Adaptation, Psychological / Q000502:physiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D001521:Behavior Therapy / Q000379:methods*; D058443:Catastrophization / Q000534:rehabilitation; D006233:Persons with Disabilities / Q000523:psychology; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000150:complications / Q000523:psychology* / Q000534:rehabilitation*; D010147:Pain Measurement; D012189:Retrospective Studies; D012648:Self Care / Q000379:methods*; D013315:Stress, Psychological / Q000209:etiology / Q000534:rehabilitation; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult