Changes in headache outcomes after guided website-based headache education: a pilot study with Spanish schoolchildren

Objective: Chronic headaches are one of the most prevalent health complaints in children and are associated with substantial impairments in daily life. Given the scarcity of specialized pediatric chronic pain treatment, educational websites delivering evidence-based information in a comprehensible, child-friendly way offer a promising alternative. In this pilot study, a single-arm intervention was conducted to investigate changes in headache outcomes following a guided, website-based pain education (Los Cabezudos) for Spanish schoolchildren and to explore associations with age. Methods: From eight school classes, all children who consented were eligible to participate. N = 210 schoolchildren (10–14 years; M = 11.8, SD = 1.2) participated in two guided website-based headache education sessions at school. Headache knowledge, pain self-efficacy, pain intensity, and pain interference were measured before the intervention and at 1- and 2-month follow-up. Linear mixed multilevel models were used to detect the effects of time. Results: Significant improvements were observed across all outcomes. Headache knowledge (b = 0.20, p < .001), pain self-efficacy (b = 0.22, p < .001), pain intensity (maximum: b = −0.27, p = .002; average: b = −0.27, p = .001), and pain interference (b = −0.30, p = .002) all improved significantly over time in children with recurrent headaches (n = 26). No significant interactions with age were found. Conclusions: The results support the potential of a website-based educational intervention to improve key headache-related outcomes: knowledge, self-efficacy, intensity, and interference. Future randomized controlled trials are warranted to investigate the long-term effectiveness of pediatric website-based pain education. © The Author(s) 2026. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.