A Community-Based Chronic Pain Self-Management Program in West Virginia
A Community-Based Chronic Pain Self-Management Program in West Virginia
Chronic pain (CP) affects 1 in 3 US adults and costs up to $635 billion annually in medical
 costs and lost work productivity. Use of opioid medications for CP has risen in the US, and
 opioid overdose deaths have quadrupled, yet with no overall change in pain. Although
 one-third of US adults have CP, there is a lack of affordable, non-pharmacological,
 evidence-based, community-delivered interventions for people with CP.

 One program, the Chronic Pain Self-Management Program (CPSMP), provides short-term
 improvements in pain but its long-term effects have not been evaluated. This study will
 examine the long-term effects of CPSMP in the medically underserved state of West Virginia
 (WV). The objectives of this community-engaged, randomized, wait-list controlled study are
 to: 1) determine the short- (26 weeks) and long-term (52 weeks) effectiveness of the 6-week
 CPSMP in adults with CP in WV; 2) evaluate the Reach (number of participants, completers),
 Effectiveness (outcomes), Adoption (number of sites, leaders, trainings), Implementation
 (fidelity), and Maintenance (satisfaction, continuation) of CPSMP using the RE-AIM Framework;
 and 3) disseminate the results to key stakeholders including evidence-based organizations,
 public health practitioners/researchers, and healthcare providers.

 The study will enroll 240 participants in 24 workshops at 12 community-based sites in 2
 counties in WV, Greenbrier (rural) and Wood (urban). Participants will attend free, 2.5-hour
 weekly sessions for 6 weeks. Self-reported, performance-based, and physiological data will be
 collected at baseline and 26, and 52 weeks after the start of the intervention. The primary
 outcomes are pain (severity, quality, interference, medication use), mental health (mood,
 anxiety, catastrophizing), function (self-efficacy, coping, health-related quality of life,
 sleep, fatigue, communication, physical activity), healthcare utilization, missed work days,
 and gait speed.
Chronic pain (CP) affects 1 in 3 US adults and costs up to $635 billion annually in medical
 costs and lost work productivity. The impact of CP is worse in people with both CP and
 comorbid chronic diseases such as arthritis, diabetes, and heart disease. Use of opioid
 medications for CP has risen in the US, and opioid overdose deaths have quadrupled, yet with
 no overall change in pain. Although one-third of US adults have CP, there is a lack of
 affordable, non-pharmacological, evidence-based, community-delivered interventions for people
 with CP. Thus, there is a vital need to rigorously test more interventions that can be
 brought to scale and widely disseminated in the US.

 One program, the Chronic Pain Self-Management Program (CPSMP), provides short-term
 improvements in pain but its long-term effects have not been evaluated. This study will
 examine the long-term effects of CPSMP in the medically underserved state of West Virginia
 (WV). With one of the worst health profiles in the US, WV has the highest rates of arthritis,
 diabetes, heart disease, and drug overdose deaths, and therefore has a compelling need for
 the CPSMP. The objectives of this community-engaged, randomized, wait-list controlled study
 are to: 1) determine the short- (26 weeks) and long-term (52 weeks) effectiveness of the
 6-week CPSMP in adults with CP in WV; 2) evaluate the Reach (number of participants,
 completers), Effectiveness (outcomes), Adoption (number of sites, leaders, trainings),
 Implementation (fidelity), and Maintenance (satisfaction, continuation) of CPSMP using the
 RE-AIM Framework; and 3) disseminate the results to key stakeholders including evidence-based
 organizations, public health practitioners/researchers, and healthcare providers.

 The study will enroll 240 participants in 24 workshops at 12 community-based sites in 2
 counties in WV, Greenbrier (rural) and Wood (urban). Participants will attend free, 2.5-hour
 weekly sessions for 6 weeks. Two trained leaders will facilitate group discussions on
 managing pain, emotions, depression, fatigue, and sleep; proper exercise, nutrition, and
 medication use; weight management; strategies for effective communication with healthcare
 professionals; evaluating treatments; and pacing/planning. Self-reported, performance-based,
 and physiological data will be collected at baseline and 26, and 52 weeks after the start of
 the intervention. The primary outcomes are pain (severity, quality, interference, medication
 use), mental health (mood, anxiety, catastrophizing), function (self-efficacy, coping,
 health-related quality of life, sleep, fatigue, communication, physical activity), healthcare
 utilization, missed work days, and gait speed.
Inclusion Criteria:

 -  Adults over age 18

 -  Have chronic pain (pain on most days or everyday) for the past 3 months or more

 -  Able to attend 1 CPSMP workshop a week over 6 weeks

 -  Able to attend 3-4 testing sessions for data collection (testing sessions are
 scheduled before the workshops begin and then six months, one year and, for those
 assigned to the control group, one and a half years after the start of the study)

 Exclusion Criteria:

 -  Chronic pain caused by current cancer diagnosis or an open wound

 -  Lack reliable transportation

 -  Having surgery for the painful area in the next year

 -  Not community-dwelling (i.e., living in a nursing home, assisted living or personal
 care home, mental hospital, or correctional facility)

 -  Not willing to be randomized to either start CPSMP workshop now or in six months

 -  Participation in another self-management program (e.g., Diabetes Self-Management
 Program) in the past 12 months

 -  Unable to speak English