Mixed Methods Study Protocol_Chronic Pain and Marginalized Populations

NCT ID: NCT03945877

Last Updated: 2020-07-30

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

400 participants

Study Classification

OBSERVATIONAL

Study Start Date

2017-02-01

Study Completion Date

2020-12-31

Brief Summary

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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.

Detailed Description

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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.

Conditions

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Chronic Pain Marginalization, Social

Study Design

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Observational Model Type

OTHER

Study Time Perspective

OTHER

Study Groups

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English-speaking Community Members

Survey respondents

No interventions

Intervention Type OTHER

No interventions

Spanish-speaking Community Members

Survey respondents

No interventions

Intervention Type OTHER

No interventions

Arabic-speaking Community Members

Survey respondents

No interventions

Intervention Type OTHER

No interventions

Interventions

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No interventions

No interventions

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

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

Exclusion Criteria

* declined to participate
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Otago

OTHER

Sponsor Role collaborator

High Point University

OTHER

Sponsor Role lead

Responsible Party

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Alicia Emerson

Assistant Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Alicia Emerson, PT, DPT, MS

Role: PRINCIPAL_INVESTIGATOR

High Point University and University of Otago

Locations

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High Point University

High Point, North Carolina, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Alicia Emerson, PT, DPT, MS

Role: CONTACT

336-841-9726

Facility Contacts

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Alicia Emerson

Role: primary

336-841-9726

References

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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. doi: 10.1002/art.21451.

Reference Type BACKGROUND
PMID: 16208656 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 26728636 (View on PubMed)

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. doi: 10.1111/j.1526-4637.2006.00105.x.

Reference Type BACKGROUND
PMID: 16634725 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 19127421 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 26270591 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 28733474 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 19411059 (View on PubMed)

Pedraza FI, Nichols VC, LeBron 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.

Reference Type BACKGROUND
PMID: 28663179 (View on PubMed)

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. doi: 10.1111/j.1526-4637.2005.05007.x.

Reference Type BACKGROUND
PMID: 15669954 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 27682208 (View on PubMed)

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. doi: 10.1046/j.1526-4637.2003.03034.x.

Reference Type BACKGROUND
PMID: 12974827 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 27555428 (View on PubMed)

Craig KD. Social communication model of pain. Pain. 2015 Jul;156(7):1198-1199. doi: 10.1097/j.pain.0000000000000185. No abstract available.

Reference Type BACKGROUND
PMID: 26086113 (View on PubMed)

Other Identifiers

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HighPointU

Identifier Type: -

Identifier Source: org_study_id

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