A Community Health Worker-Led Positive Psychology Intervention for African American Older Adults With Chronic Pain.

Abstract

BACKGROUND AND OBJECTIVES:

Experiencing structural racism over the life course contributes to disproportionate pain-related disability among African American older adults. Positive STEPS, delivered by community health workers, is a culturally congruent chronic pain self-management intervention that incorporates positive psychology principles and gives attention to social determinants of pain and pain management.

RESEARCH DESIGN AND METHODS:

We conducted a randomized pilot trial among older adults with chronic musculoskeletal pain in an underserved, primarily African American community (Detroit, Michigan). The 7-week intervention included weekly telephone sessions with a community health worker; web-based videos teaching pain self-management skills; positive activities (e.g., Life Review, Gratitude Jar); and use of wearable activity trackers. Outcomes were measured at baseline and 8-week follow-up. We assessed participant retention, engagement, and satisfaction.

RESULTS:

Study completers (n = 46; 90% retention) were 93% African American, 89% female, mean 72 years, and completed 5.7 of 7 sessions. Intervention participants versus controls showed greater improvement in PROMIS Pain Interference (4.3-point T-score decrease vs. 0.4-point increase; p = .01) and the Pain Self-Efficacy Questionnaire (p = .007). Furthermore, compared with controls, significantly more intervention participants reported "better" or "much better" global functioning (86% vs. 25%; p = .000) and pain (67% vs. 21%; p = .003) since baseline. Improvements in physical functioning, social participation, and resilience were noted, but differences were not significant. Participant feedback on the intervention was overwhelmingly positive.

DISCUSSION AND IMPLICATIONS:

A community health worker-led chronic pain self-management intervention combining positive activities with self-management skills training demonstrated the potential to enhance pain-related functioning among a vulnerable group of older adults.

CLINICAL TRIAL NUMBER:

NCT04321239.

• Authors: Mary Janevic, Sheria G Robinson-Lane, Rebecca Courser, Elizabeth Brines, Afton L Hassett
• Journal: The Gerontologist (Gerontologist) Vol. 62 Issue 9 Pg. 1369-1380 (10 19 2022) ISSN: 1758-5341 [Electronic] United States
• PMID: 35394525 (Publication Type: Randomized Controlled Trial, Journal Article, Research Support, N.I.H., Extramural)
• Copyright: © The Author(s) 2022. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: [email protected].

Topics

• Humans
• Female
• Aged
• Male
• Black or African American (psychology)
• Chronic Pain (therapy)
• Community Health Workers
• Psychology, Positive
• Pain Management