Research Supporting Our Mission

Scientific Research Support for The DistrActors

Summary

According to the CDC, roughly 40% of school aged children in the U.S. have one or more chronic conditions as of 2021 [8]. These conditions can range from more common conditions such as Asthma and Obesity to more rare and severe conditions such as Epilepsy and Cystic Fibrosis. Over 3 million children are hospitalized every year in the U.S., and nearly 18,000 of those children are admitted to Rady’s Children right here in San Diego. Aside from the physical turmoil of their injury or illness, it’s no surprise that chronic illness and hospitalization negatively impacts a child’s mental wellbeing. According to a study published in a CDC Journal, “children with at least 1 physical condition were 62% more likely to have a mental health disorder than were children without a physical illness.” [9] Additionally, in a study published in 2008, preschoolers who suffered from a chronic illness (even something like chronic ear infections) were significantly more likely to experience depressive symptoms, bullying, and impaired psychosocial functioning. Researchers observed that these effects became more drastic if the child had more than one chronic illness or medical problem, and tragically, this study reports that “preschoolers from lower socioeconomic status had a greater number of medical problems.” [7] So chronic illnesses and medical issues disproportionately affect youths who are already at a socioeconomic disadvantage.

While doctors’ offices and hospitals do a world of good for treating hospitalized children physically, medical facilities are also boring and scary places for kids. When a child is ill, their lives are out of their control, they’re separated from things that bring them security, and they’re often experiencing physical pain. On top of all of that, there’s often limited opportunity for play, leaving them with little to do but dwell on their fears. That’s where The DistrActors come in. We are a nonprofit of professional actors, musicians, and writers that helps chronically ill and hospitalized children conquer their fears through creativity.

The DistrActors is a group of specially-trained professional performers, and through songs, storytelling, and puppetry, we strive to give kids the creative tools they need to thrive in a medical environment. We help them focus on their strengths and interests, place each individual child in a winning narrative, and teach them to use creativity to reframe their circumstances. We believe there is healing in the power of distraction.

Not only do we believe that ourselves, but there are actually multiple research studies that support the importance of play and distraction in pain attenuation, nausea reduction, long term treatment retention, quality of life, and the biological and psychological stress response in hospitalized children!

A 2015 study showed that play within a hospital setting has multiple objectives such as reducing anxiety and distress, release from negative feelings, maintenance of self-esteem and a sense of control (which is significant when a child is feeling like they have little within their purview of control due to their chronic illness), and reducing illness regression [2]. Subsequently, A 2019 research study found that interactive distractions and exposure to medical procedures in a playful light could be hugely beneficial to long term recovery, because these sorts of positive and imaginative emotional experiences and reframings reduce a child’s fear and resistance to ongoing treatment and repeat hospital visits [1]. Using a mixed methods study, researchers from the University of Colorado Denver found that creative arts therapy produced a significant reduction in patient nausea and improved quality of life (reported increase in excitement and happiness and reduction in nervousness) in children receiving chemotherapy [3]. And in a study on 108 children, researchers within the Pain Service and Palliative Care Department at Meyer’s Children’s Hospital in Florence, Italy observed a significant decrease in distress and pain intensity in children during and after their venipuncture procedure if the child could interact with a musician during their procedure. [4]

Additionally, medical research has shown that salivary alpha amylase is a reliable biomarker for autonomic nervous system activation and psychosocial stress. In a study of 73 children with cancer, collaborating researchers at UCI and CHOC Children’s Hospital found that children who had been taught to use distraction as an emotional regulation strategy had lower levels of salivary alpha amylase during and after a painful procedure compared to children who implemented a reassurance strategy. This study highlights the positive impact specifically distraction has on pain attenuation, and is especially relevant to children suffering from chronic illnesses, who have to undergo painful procedures frequently. [5] In like kind, neuroscientists from Dalhousie University, Canada recommend that anesthesiologists play video clips of the child’s choice while anesthetizing the child for surgery, because this form of distraction is a proven effective method for reducing anxiety while a child is being induced for surgery [6].

This is only some of the research that supports the role playfulness and distraction play in empowering children to conquer their scary and painful hospital visits and promote healing and wellness within the community of children suffering from chronic illnesses. As our name suggests, The DistrActors seek to be excellent at distracting children with imagination and creativity…helping them survive their scary hospital stays and heal!

Additional Information/Notes for the Summary

Support for the importance of play and distraction

[1] Long: In a 2019 Research article titled “Attractions to Fuel the Imagination: Reframing Understandings of the Role of Distraction Relative to Well-Being in the Pediatric Hospital” they found that interactive distractions and exposure to medical procedures in playful lights could be hugely beneficial to long term recovery, because these sorts of positive emotional experiences and reframings reduce a child’s fear and resistance to ongoing treatment and repeat hospital visits. They explain the power of imaginative distraction and play, as they write, “Environmental features that can ignite the imagination of children and young people and incite a desire to return to the hospital could offer significant benefits to well-being, particularly in the context of absenteeism from outpatient appointments and in reducing patient resistance to future, or ongoing, treatments.”

[1] Short: A 2019 Research study found that interactive distractions and exposure to medical procedures in a playful light could be hugely beneficial to long term recovery, because these sorts of positive and imaginative emotional experiences and reframings reduce a child’s fear and resistance to ongoing treatment and repeat hospital visits.

[2] Long: A 2015 study showed that play within a hospital setting has multiple objectives such as reducing anxiety and distress, release from negative feelings, maintenance of self-esteem and a sense of control (which is significant when a child is feeling like they have little within their purview of control due to their chronic illness), and reducing illness regression. These researchers highlight that, “a child’s ability to play in the hospital restores the discontinuity resulting in his/her life due to hospital admission and shows somehow that he child may continue his/her normal life even inside the hospital. [...] Through the use of play, they have the chance to gain control in many situations, thus changing hospitalizations into a positive rather than a negative experience.”

[2] Short: A 2015 study showed that play within a hospital setting has multiple objectives such as reducing anxiety and distress, release from negative feelings, maintenance of self-esteem and a sense of control (which is significant when a child is feeling like they have little within their purview of control due to their chronic illness), and reducing illness regression.

[3] Long/Short: Researchers from the University of Colorado Denver performed a mixed methods study on children receiving chemotherapy, and they found that creative arts therapy produced a marked reduction in patient nausea and improved the children’s quality of life (observed through self-reported increase in excitement and happiness and reduction in nervousness). [3]

[4] Long: Hospitalized children often have to undergo frequent and routine blood work. And according to a 2009 study, “the experience of venipuncture is seen by children as one of the most fearful experiences during hospitalization.” A research group within the Pain Service and Palliative Care Department at Meyer’s Children’s Hospital in Florence, Italy sought to understand the impact of interactive music on pain and stress management during and after a procedure. In a study on 108 children, researchers observed a significant decrease in distress and pain intensity in children during and after their blood drawn if the child could interact with a musician during their procedure. [4]

[4] Short: In a study on 108 children, researchers within the Pain Service and Palliative Care Department at Meyer’s Children’s Hospital in Florence, Italy observed a significant decrease in distress and pain intensity in children during and after their venipuncture procedure if the child could interact with a musician during their procedure. [4]

[5] Long: Salivary alpha amylase is a reliable biomarker for autonomic nervous system activation and psychosocial stress. In a study of 73 children with cancer, researchers at UCI and CHOC Children’s Hospital found that children who had been taught to use distraction as an emotional regulation strategy had lower levels of salivary alpha amylase during and after a painful procedure compared to children who implemented a reassurance strategy. This study highlights the positive impact distraction has on pain attenuation, and is specifically relevant to children suffering from chronic illnesses, who have to undergo painful procedures frequently. [5]

[5] Short: In a study of 73 children with cancer, researchers at UCI and CHOC Children’s hospital found that children who had been taught to use distraction as an emotional regulation strategy had lower levels of salivary alpha amylase (a biomarker for autonomic nervous system activation and psychosocial stress) during and after a painful procedure compared to children who implemented a reassurance strategy. This study highlights the positive impact distraction has on pain attenuation.

[6] Long/Short: In like kind, neuroscientists from Dalhousie University, Canada recommend that anesthesiologists play video clips of the child’s choice while anesthetizing the child for surgery, because this form of distraction is a proven effective method for reducing anxiety while a child is being induced for surgery [6].

Impact on hospitalization on children

[7] Long/Short: It’s no surprise that chronic illness and hospitalization negatively impacts a child’s mental wellbeing. According to a 2008 study, preschoolers who suffered from a chronic illness (even something like chronic ear infections) were significantly more likely to experience depressive symptoms, bullying, and impaired psychosocial functioning. Researchers observed that these effects became more drastic if the child had more than one chronic illness or medical problem, and tragically, this study reports that “preschoolers from lower socioeconomic status had a greater number of medical problem.” [7] So chronic illnesses and medical issues disproportionately affect youths who are already at a socioeconomic disadvantage.

[8] Long/Short: According to the CDC, roughly 40% of school aged children in the U.S. have one or more chronic conditions as of 2021 [8].

[9] Long/Short: According to a study published in a CDC Journal, “after controlling for sociodemographic and health care access characteristics, we found that children with at least 1 physical condition were 62% more likely to have a mental health disorder than were children without a physical illness.” [9]

Summary: According to the CDC, roughly 40% of school aged children in the U.S. have one or more chronic conditions as of 2021 [8]. These conditions can range from more common conditions such as Asthma and Obesity to more rare and severe conditions such as Epilepsy and Cystic Fibrosis. And over 3 million children are hospitalized every year in the U.S., with nearly 18,000 of those children being admitted to Rady’s Children right here in San Diego. And aside from the physical turmoil of their injury or illness, it’s no surprise that chronic illness and hospitalization negatively impacts a child’s mental wellbeing. According to a study published in a CDC Journal, “children with at least 1 physical condition were 62% more likely to have a mental health disorder than were children without a physical illness.” [9] Additionally, in a study published in 2008, preschoolers who suffered from a chronic illness (even something like chronic ear infections) were significantly more likely to experience depressive symptoms, bullying, and impaired psychosocial functioning. Researchers observed that these effects became more drastic if the child had more than one chronic illness or medical problem, and tragically, this study reports that “preschoolers from lower socioeconomic status had a greater number of medical problems.” [7] So chronic illnesses and medical issues disproportionately affect youths who are already at a socioeconomic disadvantage.

References:

[1] McLaughlan R, Sadek A, Willis J. Attractions to Fuel the Imagination: Reframing Understandings of the Role of Distraction Relative to Well-Being in the Pediatric Hospital. HERD: Health Environments Research & Design Journal. 2019;12(2):130-146. doi:10.1177/1937586718810878

[2] Koukourikos K, Tzeha L, Pantelidou P, Tsaloglidou A. THE IMPORTANCE OF PLAY DURING HOSPITALIZATION OF CHILDREN. Mater Sociomed. 2015 Dec;27(6):438-41. doi: 10.5455/msm.2015.27.438-441. PMID: 26889107; PMCID: PMC4733554.

[3] Madden JR, Mowry P, Gao D, Cullen PM, Foreman NK. Creative arts therapy improves quality of life for pediatric brain tumor patients receiving outpatient chemotherapy. J Pediatr Oncol Nurs. 2010 May-Jun;27(3):133-45. doi: 10.1177/1043454209355452. PMID: 20386062.

[4] Caprilli S, Anastasi F, Grotto RP, Scollo Abeti M, Messeri A. Interactive music as a treatment for pain and stress in children during venipuncture: a randomized prospective study. J Dev Behav Pediatr. 2007 Oct;28(5):399-403. doi: 10.1097/DBP.0b013e31811ff8a7. Erratum in: J Dev Behav Pediatr. 2009 Jun;30(3):254. Abeti, Mariana Scollo [corrected to Scollo Abeti, Marianna]. PMID: 18049324.

[5] Brooke N. Jenkins, Douglas A. Granger, Ryan J. Roemer, Ariana Martinez, Tara K. Torres, Michelle A. Fortier. Emotion regulation and positive affect in the context of salivary alpha-amylase response to pain in children with cancer. Ped Blood & Cancer. 2018 June;65(6). Doi: https://doi.org/10.1002/pbc.26973

[6] Mifflin KA, Hackmann T, Chorney JM. Streamed video clips to reduce anxiety in children during inhaled induction of anesthesia. Anesth Analg. 2012 Nov;115(5):1162-7. doi: 10.1213/ANE.0b013e31824d5224. Epub 2012 Oct 9. PMID: 23051880.

[7] Curtis CE, Luby JL. Depression and social functioning in preschool children with chronic medical conditions. J Pediatr. 2008 Sep;153(3):408-13. doi: 10.1016/j.jpeds.2008.03.035. Epub 2008 May 23. PMID: 18534206; PMCID: PMC2574499.

[8] “Managing Chronic Health Conditions” CDC, https://www.cdc.gov/healthyschools/chronicconditions.htm

[9] Suryavanshi MS, Yang Y. Clinical and Economic Burden of Mental Disorders Among Children With Chronic Physical Conditions, United States, 2008–2013. Prev Chronic Dis 2016;13:150535. DOI: http://dx.doi.org/10.5888/pcd13.150535

References:

[8] “Managing Chronic Health Conditions” CDC, https://www.cdc.gov/healthyschools/chronicconditions.htm