Chronic Pain Clinical Trial
Official title:
Reducing Disparities in the Treatment of Chronic Pain Using an Innovative mHealth Tool
This project will work to increase knowledge about the utility of a website for management of chronic pain, Our Whole Lives (OWL). It will do so by examining barriers and facilitators to patient use. In order to gather this information, the investigators will conduct a Science Cafe with 30 individuals (including participants with chronic pain, who have family members with chronic pain or are a stakeholder in the chronic pain community) to gather feedback about how to tailor the OWL website to their needs and preferences and how to improve ease of use for this tool. The investigators will also pilot two cohorts with 40 patients with chronic pain (2 groups of 20 patients) with OWL, the patient-centered, mobile health chronic pain management resource, measuring pain impact (pain severity, pain interference, physical function) and pain associated outcomes (e.g., depression, anxiety, fatigue, sleep disturbance, ability to participate in social roles and activities, pain self-efficacy, health education impact and internalized stigma related to chronic pain).
During the first 4 months, conduct a science café targeting 30 individuals/families who live
with chronic pain and reside in Boston's low-income, ethnically diverse neighborhoods, in
order to: a) gather feedback about how to tailor the OWL curriculum based on their needs and
preferences, and b) identify potential enhancements to the mobile technology to improve ease
of use. For the science cafe, the investigators will use social media (facebook, twitter,
listservs, etc.) to invite the community to meet for a two-hour dialog. . Each participant
will be paid for attending, refreshments will be served, and a small thank you gift will be
provided. Dr. Gardiner will begin the science café by giving an overview of chronic pain in
the US. The moderator will ask the participants questions about how chronic pain impacts
their communities and how technology might help address it.
A trained qualitative research assistant will be transcribe the science cafe and the
transcripts will be analyzed using qualitative methods.
Pilot Cohort Study During the first ten months, the investigators will pilot, using pre-post
measures, with 40 patients (2 groups of 20 patients) with OWL. The main outcome is pain
impact (pain severity, pain interference, physical function) and pain associated outcomes
(e.g., depression, anxiety, depression, fatigue, sleep disturbance, ability to participate in
social roles and activities, and pain self-efficacy).
The target population includes low-income adults >18 years old who self-report: chronic
musculoskeletal (extremity, joint, back, neck) pain for at least 3 months, with an average
pain intensity for the previous week >4 on a 0 to 10 numerical rating scale. The
investigators also require English fluency sufficient to follow instructions. Exclusion
criteria include: active or planned worker's compensation, active substance abuse, psychosis,
disability or personal injury claims, and known pregnancy. Participants who do not currently
have access to the internet are also excluded.
The investigators will recruit patients from 14 Boston area Community Health Centers and the
community of Boston Medical Center by reaching out to primary care providers for referrals.
Based upon previous pilot experiences, the investigators do not anticipate any difficulty in
recruiting for the pilot groups. The investigators will recruit from BMC's primary care
practices and several of its 14 affiliated Community Health Centers located in Boston.
Participants will receive $50 for their involvement. Based upon this initial referral, if an
individual appears to be eligible for participation, he/she will be invited to meet in person
with the research assistant. At this visit, eligibility is verified; the study is discussed
at length with all questions answered to the participant's satisfaction; and if the patient
desires, the patient enrolls by signing the informed consent. For the study, all recruitment
materials will be IRB-approved prior to dissemination.
At the beginning of the study, the investigators will hold a group orientation for all 20
participants in the class on how to navigate OWL. A clinician (assisted by a RA) will
demonstrate how to use the OWL system, log on, navigate through the nine sessions, complete
self-assessment, set goals, and interact on the community page. Participants will have access
to OWL for 9 weeks. Each week they will have access to a new content. The clinician will
monitor and post questions to facilitate conversation on the community page. At the end of
the 9 weeks participants will be invited back to participate in a focus group and complete 9
week follow up surveys.
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