The study was conducted at Children’s Mercy Kansas City, a freestanding pediatric hospital that serves children from several states in the Midwest region of the United States. The study was approved by the Children’s Mercy Institutional Review Board (IRB #00001335). Participants for this study were recruited from a clinical registry of patients who had been seen in neurology clinics for an evaluation of headaches and who had been diagnosed with a primary headache disorder (e.g., episodic or chronic migraines with or without aura, episodic or chronic tension-type headaches) by a board-certified neurologist or other provider trained in headache medicine (pediatrician or nurse practitioner). In late May 2020 (approximately 3 months after the declaration of a pandemic and prior to the emergence of dominant SARS-CoV-2 variants), an email with information about the study and a link to an online study survey was sent to 2019 families from the registry (“T0”). For families that completed the initial survey, a link to a follow-up survey was sent at 2 months (start of the next school year after pandemic onset, “T1”) and at 4 months (mid-point of the school semester, “T2”) from the date of the initial survey; these timepoints also predated the emergence of dominant SARS-CoV-2 variants. A final longer-term follow-up survey link was sent to respondents at the end of the subsequent school year (24 months from initial survey, “T3”), a time at which the Delta variant (B.1.617.2 lineage) had become the dominant SARS-CoV-2 strain. Parent/caregivers of children younger than 9 years of age were instructed to assist their children in completing the surveys or to record their answers for them if they were unable to do so; patients aged 9 years and older were instructed to complete the questionnaire independently. Participants were not compensated for their participation in the study. Study data were collected and managed online using REDCap (Research Electronic Data Capture) [21 (link),22 (link)].
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