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A Self-Administered Behavioral Intervention Using Tailored Messages for Migraine


  • Robert Nicholson PhD,

  • Justin Nash PhD,

  • Frank Andrasik PhD

  • From the St. Louis University School of Medicine, Community and Family Medicine, St. Louis, MO (Dr. Nicholson); Brown Medical School/The Miriam Hospital, Centers for Behavioral and Preventive Medicine, Providence, RI (Dr. Nash); and University of West Florida, Institute for Human and Machine Cognition, Pensacola, FL (Dr. Andrasik).

Address all correspondence to Dr. Robert Nicholson, St. Louis University School of Medicine, Community and Family Medicine, St. Louis, MO 63104.


Objective.—The objective of this study was to evaluate the effectiveness of a Self-Administered Behavioral Intervention using Tailored messages (SEABIT) for migraine. The primary measures were headache days, headache-related disability, behavioral/emotional factors, and headache-related beliefs.

Background.—Behavioral and cognitive-behavioral interventions for migraine treatment are well established and possess “Grade-A” evidence based on the U.S. Headache Consortium evidence-based guidelines. To increase the accessibility of behavioral interventions in primary and other settings, treatment can be delivered in self-administered formats. Incorporating tailored health communication strategies (via tailored messages) into a self-administered format can help maintain a level of personalization without requiring regular visits to a behavioral specialist. Tailored messages are created using individual-level assessment data to educate and motivate the patient to develop behavioral skills and strategies for migraine prevention and management.

Methods.—Twenty-five individuals (95% female, 90% Caucasian, mean headache years = 21.0) began and 84% (21/25) completed all phases of the 8-week SEABIT developed for migraine prevention (preceded by a 1-month baseline phase and followed by a 1-month postintervention phase).

Results.—Overall, 62% (13/21) reported at least a 50% reduction in headache frequency, and mean headache frequency for the group was also significantly reduced from baseline to postintervention (16.9 vs. 10.7, P < .001; η2= .61). Headache-related disability, behavioral/emotional factors, and headache-management self-efficacy also showed significant improvement.

Conclusion.—The findings suggest that the SEABIT for migraine prevention is an effective behavioral intervention that potentially could be accessed and distributed in a variety of settings including primary care.