Mixed Methods Study Protocol_Chronic Pain and Marginalized Populations

Chronic Pain Clinical Trial

Official title:

Chronic Musculoskeletal Pain Experiences in Marginalized Populations: A Mixed Methods Study Protocol for Understanding the Impact of Geopolitical, Historical, and Societal Influences

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT03945877
• Other study ID #: HighPointU
• Status: Recruiting
• Start date: February 1, 2017
• Est. completion date: December 31, 2020

Study information

• Verified date: July 2020
• Source: High Point University
• Contact: Alicia Emerson, PT, DPT, MS
• Phone: 336-841-9726
• Email: aemerson1[@]highpoint.edu
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

A mixed-methods sequential explanatory design study. The first quantitative phase will be a multi-language survey that includes questions related to pain status, patient beliefs, pain interference/social support, and perspective on healthcare utilization. Latent class analysis (LCA) will be used to generate experience-based subgroups in CMP. The second qualitative phase will use focus group will elucidate, confirm, and more richly describe the findings from the first phase.

Description:

Background: The global epidemic of chronic musculoskeletal pain (CMP) is an intractable issue adversely impacting gross domestic products and costing billions in lost productivity. The expansion of CMP occurs concurrently with historical global mass population movements. Geopolitical negative and racist rhetoric have arisen in response to increased immigration rates. CMP is an invisible disease decoupled from normal tissue healing and results from the complex interplay of biological and psychological processing. Different theoretical models of CMP development now include potential demographic and socio-cultural factors. CMP occurs disproportionately in populations at risk for marginalization, including women, non-Caucasians, immigrants, and people experiencing increased socioeconomic deprivation. The same marginalized populations also are at greater risk for limited access to healthcare and demonstrate worse functional limitations, outcomes, and quality of life. Aims: The primary aims are 1) to characterize self-reported features in people who have CMP and experience marginalization and 2) to interpret the pain experience for marginalised populations of people who have CMP. Methods: A mixed-methods sequential explanatory design study will be used. The first quantitative phase will be a multi-language survey that includes questions related to pain status, patient beliefs, pain interference/social support, and perspective on healthcare utilization. Latent class analysis (LCA) will be used to generate experience-based subgroups in CMP. Focus group will elucidate, confirm, and more richly describe the findings from the first phase. Discussion: Results from this study will be used to inform clinical conversations with patients who have CMP and experience marginalization. By increasing awareness of the potential influences on the clinical conversation, we hope to build opportunities to address inequities in CMP management.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 400
• Est. completion date: December 31, 2020
• Est. primary completion date: December 31, 2020
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• English, Spanish, and Arabic-speaking adults living in the Piedmont Triad, NC

Exclusion Criteria:

• declined to participate

Related Conditions & MeSH terms

• Chronic Pain
• Marginalization, Social

Intervention

Other:
• No interventions
No interventions

Locations

Country	Name	City	State
United States	High Point University	High Point	North Carolina

Sponsors (2)

Lead Sponsor	Collaborator
High Point University	University of Otago

Country where clinical trial is conducted

United States, 

References & Publications (13)

Burgess DJ, van Ryn M, Crowley-Matoka M, Malat J. Understanding the provider contribution to race/ethnicity disparities in pain treatment: insights from dual process models of stereotyping. Pain Med. 2006 Mar-Apr;7(2):119-34. Review. — View Citation

Craig KD. Social communication model of pain. Pain. 2015 Jul;156(7):1198-9. doi: 10.1097/j.pain.0000000000000185. Review. — View Citation

Edwards RR, Moric M, Husfeldt B, Buvanendran A, Ivankovich O. Ethnic similarities and differences in the chronic pain experience: a comparison of african american, Hispanic, and white patients. Pain Med. 2005 Jan-Feb;6(1):88-98. — View Citation

Fillingim RB, King CD, Ribeiro-Dasilva MC, Rahim-Williams B, Riley JL 3rd. Sex, gender, and pain: a review of recent clinical and experimental findings. J Pain. 2009 May;10(5):447-85. doi: 10.1016/j.jpain.2008.12.001. Review. — View Citation

Franklin ZC, Smith NC, Fowler NE. A qualitative investigation of factors that matter to individuals in the pain management process. Disabil Rehabil. 2016 Sep;38(19):1934-42. doi: 10.3109/09638288.2015.1107782. Epub 2016 Jan 4. — View Citation

Green CR, Anderson KO, Baker TA, Campbell LC, Decker S, Fillingim RB, Kalauokalani DA, Lasch KE, Myers C, Tait RC, Todd KH, Vallerand AH. The unequal burden of pain: confronting racial and ethnic disparities in pain. Pain Med. 2003 Sep;4(3):277-94. Review. Erratum in: Pain Med. 2005 Jan-Feb;6(1):99. Kaloukalani, Donna A [corrected to Kalauokalani, Donna A]. — View Citation

Harding G, Parsons S, Rahman A, Underwood M. "It struck me that they didn't understand pain": the specialist pain clinic experience of patients with chronic musculoskeletal pain. Arthritis Rheum. 2005 Oct 15;53(5):691-6. — View Citation

Kim HJ, Yang GS, Greenspan JD, Downton KD, Griffith KA, Renn CL, Johantgen M, Dorsey SG. Racial and ethnic differences in experimental pain sensitivity: systematic review and meta-analysis. Pain. 2017 Feb;158(2):194-211. doi: 10.1097/j.pain.0000000000000731. Review. Erratum in: Pain. 2017 Oct;158(10):2055. — View Citation

Klonoff EA. Disparities in the provision of medical care: an outcome in search of an explanation. J Behav Med. 2009 Feb;32(1):48-63. doi: 10.1007/s10865-008-9192-1. Epub 2009 Jan 6. Review. — View Citation

Macfarlane GJ, Barnish MS, Jones GT. Persons with chronic widespread pain experience excess mortality: longitudinal results from UK Biobank and meta-analysis. Ann Rheum Dis. 2017 Nov;76(11):1815-1822. doi: 10.1136/annrheumdis-2017-211476. Epub 2017 Jul 21. — View Citation

Mansfield KE, Sim J, Jordan JL, Jordan KP. A systematic review and meta-analysis of the prevalence of chronic widespread pain in the general population. Pain. 2016 Jan;157(1):55-64. doi: 10.1097/j.pain.0000000000000314. Review. — View Citation

Pedraza FI, Nichols VC, LeBrón AMW. Cautious Citizenship: The Deterring Effect of Immigration Issue Salience on Health Care Use and Bureaucratic Interactions among Latino US Citizens. J Health Polit Policy Law. 2017 Oct;42(5):925-960. doi: 10.1215/03616878-3940486. Epub 2017 Jun 29. — View Citation

Trost Z, Van Ryckeghem D, Scott W, Guck A, Vervoort T. The Effect of Perceived Injustice on Appraisals of Physical Activity: An Examination of the Mediating Role of Attention Bias to Pain in a Chronic Low Back Pain Sample. J Pain. 2016 Nov;17(11):1207-1216. doi: 10.1016/j.jpain.2016.08.001. Epub 2016 Aug 20. — View Citation

* Note: There are 13 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Quantitative: Community surveys	Demographic data; Survey data	February 2017-September 2017
Primary	Qualitative: Focus groups	Semi-structured interview data obtained from focus groups	November 2018-December 2019