A New Model to Reach Vulnerable Older Adults With Pain Self-management Support

Not Applicable

Completed

Interventions: Behavioral: STEPS (Seniors using Technology to Engage in Pain Self-management)

Brief Summary: Learning chronic pain self-management skills can help patients improve daily functioning and quality of life, while avoiding risks associated with opioids and other pharmacological treatments. Community health workers (CHWs) may help make chronic pain self-management interventions more accessible to older adults living in underserved communities. The goal of this study is to conduct a feasibility test of a chronic pain self-management intervention delivered by CHWs, in conjunction with mobile health tools, in a sample of 25 older adults recruited from community sites in Detroit, Michigan. This study will involve the use of mixed quantitative and qualitative methods to assess participant engagement and satisfaction, and change in pain-related outcomes.

Recruitment & Eligibility

Inclusion Criteria

English-proficient
Age >= 60 years
Ambulatory with or without assistive device
Community-living
Have a cell or landline phone
Have Internet access (home or elsewhere)
Self-reported chronic musculoskeletal pain (pain in muscles or joints for > 3 months); >4 (0-10 scale) average pain level over last week; >1 day/previous 30 when pain made it difficult to do usual activities
Ability to attend a one-time study orientation session

Exclusion Criteria

Serious acute illness or hospitalization in last month
Planned surgery in next three months
Significant cognitive impairment as indicated by affirmative response to question: "Do you have significant difficulties with your memory that get in the way of your usual daily activities?"
Other severe physical or psychiatric disorder judged by study team to pose significant barrier to deriving program benefit.

Arm && Interventions

Group	Intervention	Description
Intervention	STEPS (Seniors using Technology to Engage in Pain Self-management)	Participants will engage in a 7-week chronic pain self-management program.

Primary Outcome Measures

Name	Time	Method
Change in pain interference	baseline and 8 weeks	The Pain Interference 6-item subscale of the Patient-Reported Outcomes Measurement Information System (PROMIS)-43 Adult Profile. Items ask how much pain in the last 7 days has interfered with daily activities such as household chores and social activities (1=not at all to 5=very much); raw total scale scores range from 6 (low interference) to 30 (high interference)..
Participant engagement	8 weeks	Number of completed sessions with the community health worker (range 1 to 7).

Secondary Outcome Measures

Name	Time	Method
Participant Global Impression of Change	8 weeks	Two items: 1) How participant thinks their pain has changed from baseline (much worse (-3) to much better(+3)). 2) How participant thinks their functioning has changed from baseline (much worse (-3) to much better(+3)).
Participant satisfaction: Likert-scale questions	8 weeks	Likert-scale questions about participant satisfaction with the program; e.g., whether participation increased understanding of pain management (Strongly Agree=1 to Strongly Disagree=5), and with selected program elements (e.g., community health workers, videos, website).

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