An Online Acceptance and Mindfulness Intervention for Chronic Pain in Veterans: Development and Protocol for a Pilot Feasibility Randomized Controlled Trial

BackgroundIn the veteran community, chronic pain is particularly prevalent and often debilitating. Until recently, veterans with chronic pain were offered primarily pharmacological intervention options, which rarely suffice and can also have negative health consequences. To b...

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Main Authors: Erin D Reilly, Ummul-Kiram Kathawalla, Hannah E Robins, Alicia A Heapy, Timothy P Hogan, Molly E Waring, Karen S Quigley, Charles E Drebing, Timothy Bickmore, Matias Volonte, Megan M Kelly
格式: 文件
语言:English
出版: JMIR Publications 2023-03-01
丛编:JMIR Research Protocols
在线阅读:https://www.researchprotocols.org/2023/1/e45887
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author Erin D Reilly
Ummul-Kiram Kathawalla
Hannah E Robins
Alicia A Heapy
Timothy P Hogan
Molly E Waring
Karen S Quigley
Charles E Drebing
Timothy Bickmore
Matias Volonte
Megan M Kelly
author_facet Erin D Reilly
Ummul-Kiram Kathawalla
Hannah E Robins
Alicia A Heapy
Timothy P Hogan
Molly E Waring
Karen S Quigley
Charles E Drebing
Timothy Bickmore
Matias Volonte
Megan M Kelly
author_sort Erin D Reilly
collection DOAJ
description BackgroundIn the veteran community, chronic pain is particularly prevalent and often debilitating. Until recently, veterans with chronic pain were offered primarily pharmacological intervention options, which rarely suffice and can also have negative health consequences. To better address chronic pain in veterans, the Veterans Health Administration has invested in novel, nonpharmacological behavior interventions that target both pain management and chronic pain–related functional issues. One approach, acceptance and commitment therapy (ACT) for chronic pain, is supported by decades of efficacy evidence for improving pain outcomes; however, ACT can be difficult to obtain owing to issues such as a lack of trained therapists or veterans having difficulty committing to the time and resources needed for the full clinician-led ACT protocol. Given the strong ACT evidence base combined with access limitations, we set out to develop and evaluate Veteran ACT for Chronic Pain (VACT-CP), an online program guided by an embodied conversational agent to improve pain management and functioning. ObjectiveThe aims of this study are to develop, iteratively refine, and then conduct a pilot feasibility randomized controlled trial (RCT) of a VACT-CP group (n=20) versus a waitlist and treatment-as-usual control group (n=20). MethodsThis research project includes 3 phases. In phase 1, our research team consulted with pain and virtual care experts, developed the preliminary VACT-CP online program, and conducted interviews with providers to obtain their feedback on the intervention. In phase 2, we incorporated feedback from phase 1 into the VACT-CP program and completed initial usability testing with veterans with chronic pain. In phase 3, we are conducting a small pilot feasibility RCT, with the primary outcome being assessment of usability of the VACT-CP system. ResultsThis study is currently in phase 3; recruitment for the RCT began in April 2022 and is expected to continue through April 2023. Data collection is expected to be completed by October 2023, with full data analysis completed by late 2023. ConclusionsThe findings from this research project will provide information on the usability of the VACT-CP intervention, as well as secondary outcomes related to treatment satisfaction, pain outcomes (pain-related daily functioning and pain severity), ACT processes (pain acceptance, behavioral avoidance, and valued living), and mental and physical functioning. Trial RegistrationClinicalTrials.gov NCT03655132; https://clinicaltrials.gov/ct2/show/NCT03655132 International Registered Report Identifier (IRRID)DERR1-10.2196/45887
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spelling doaj.art-512293ec015d4e4f9f853dc45d5e90b52023-08-28T23:43:00ZengJMIR PublicationsJMIR Research Protocols1929-07482023-03-0112e4588710.2196/45887An Online Acceptance and Mindfulness Intervention for Chronic Pain in Veterans: Development and Protocol for a Pilot Feasibility Randomized Controlled TrialErin D Reillyhttps://orcid.org/0000-0003-1796-954XUmmul-Kiram Kathawallahttps://orcid.org/0000-0001-6258-568XHannah E Robinshttps://orcid.org/0000-0003-4924-7816Alicia A Heapyhttps://orcid.org/0000-0003-1284-8263Timothy P Hoganhttps://orcid.org/0000-0002-6888-0927Molly E Waringhttps://orcid.org/0000-0002-9884-9824Karen S Quigleyhttps://orcid.org/0000-0001-8844-990XCharles E Drebinghttps://orcid.org/0000-0001-9649-2684Timothy Bickmorehttps://orcid.org/0000-0002-2676-9788Matias Volontehttps://orcid.org/0000-0002-9423-3408Megan M Kellyhttps://orcid.org/0000-0003-1433-1129 BackgroundIn the veteran community, chronic pain is particularly prevalent and often debilitating. Until recently, veterans with chronic pain were offered primarily pharmacological intervention options, which rarely suffice and can also have negative health consequences. To better address chronic pain in veterans, the Veterans Health Administration has invested in novel, nonpharmacological behavior interventions that target both pain management and chronic pain–related functional issues. One approach, acceptance and commitment therapy (ACT) for chronic pain, is supported by decades of efficacy evidence for improving pain outcomes; however, ACT can be difficult to obtain owing to issues such as a lack of trained therapists or veterans having difficulty committing to the time and resources needed for the full clinician-led ACT protocol. Given the strong ACT evidence base combined with access limitations, we set out to develop and evaluate Veteran ACT for Chronic Pain (VACT-CP), an online program guided by an embodied conversational agent to improve pain management and functioning. ObjectiveThe aims of this study are to develop, iteratively refine, and then conduct a pilot feasibility randomized controlled trial (RCT) of a VACT-CP group (n=20) versus a waitlist and treatment-as-usual control group (n=20). MethodsThis research project includes 3 phases. In phase 1, our research team consulted with pain and virtual care experts, developed the preliminary VACT-CP online program, and conducted interviews with providers to obtain their feedback on the intervention. In phase 2, we incorporated feedback from phase 1 into the VACT-CP program and completed initial usability testing with veterans with chronic pain. In phase 3, we are conducting a small pilot feasibility RCT, with the primary outcome being assessment of usability of the VACT-CP system. ResultsThis study is currently in phase 3; recruitment for the RCT began in April 2022 and is expected to continue through April 2023. Data collection is expected to be completed by October 2023, with full data analysis completed by late 2023. ConclusionsThe findings from this research project will provide information on the usability of the VACT-CP intervention, as well as secondary outcomes related to treatment satisfaction, pain outcomes (pain-related daily functioning and pain severity), ACT processes (pain acceptance, behavioral avoidance, and valued living), and mental and physical functioning. Trial RegistrationClinicalTrials.gov NCT03655132; https://clinicaltrials.gov/ct2/show/NCT03655132 International Registered Report Identifier (IRRID)DERR1-10.2196/45887https://www.researchprotocols.org/2023/1/e45887
spellingShingle Erin D Reilly
Ummul-Kiram Kathawalla
Hannah E Robins
Alicia A Heapy
Timothy P Hogan
Molly E Waring
Karen S Quigley
Charles E Drebing
Timothy Bickmore
Matias Volonte
Megan M Kelly
An Online Acceptance and Mindfulness Intervention for Chronic Pain in Veterans: Development and Protocol for a Pilot Feasibility Randomized Controlled Trial
JMIR Research Protocols
title An Online Acceptance and Mindfulness Intervention for Chronic Pain in Veterans: Development and Protocol for a Pilot Feasibility Randomized Controlled Trial
title_full An Online Acceptance and Mindfulness Intervention for Chronic Pain in Veterans: Development and Protocol for a Pilot Feasibility Randomized Controlled Trial
title_fullStr An Online Acceptance and Mindfulness Intervention for Chronic Pain in Veterans: Development and Protocol for a Pilot Feasibility Randomized Controlled Trial
title_full_unstemmed An Online Acceptance and Mindfulness Intervention for Chronic Pain in Veterans: Development and Protocol for a Pilot Feasibility Randomized Controlled Trial
title_short An Online Acceptance and Mindfulness Intervention for Chronic Pain in Veterans: Development and Protocol for a Pilot Feasibility Randomized Controlled Trial
title_sort online acceptance and mindfulness intervention for chronic pain in veterans development and protocol for a pilot feasibility randomized controlled trial
url https://www.researchprotocols.org/2023/1/e45887
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