September 2021

In This Issue: Helping Veterans Cope with and Conquer Pain
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Targeting Barriers to Pain Self-Management in Women Veterans

Feature Article

Takeaway: Project CONNECT (Refinement and Feasibility of a Novel Peer Support Intervention) is expected to reduce costs and improve access to behavioral pain care. This study targets previously unaddressed and potentially modifiable factors (e.g. social support) thought to be relevant for the adjustment and uptake of pain self-management among women Veterans.

Women are the fastest-growing segment of VA healthcare users and addressing their unique needs is a priority for VA. Although men and women Veterans both report high rates of chronic pain, rates are higher in women, therefore VA has placed renewed emphasis on promoting self-management for pain, including cognitive behavioral therapy for chronic pain (CBT-CP). However, several barriers to accessing this care and engaging optimally with its recommendations may be particularly salient for women, such as logistical, healthcare delivery, and psychosocial barriers. Patient-centered efforts to address these may translate to improved treatment access, engagement, adherence, and more optimal outcomes for women Veterans. Accordingly, a home-based intervention integrating an evidence- based CBT-CP program with reciprocal peer support (RPS) has been developed called Project CONNECT (Refinement and Feasibility of a Novel Peer Support Intervention) and is currently being pre-piloted.

This ongoing study (May 2020 – April 2024) will examine the potential feasibility of candidate control conditions for a future randomized trial. More specifically, investigators will:

• Solicit Veterans’ feedback on recruitment strategies, treatment components and materials, duration/content, engagement strategies, peer-matching, and data collection methods.
• Evaluate the feasibility and acceptability of a refined 8-week RPS pain self-management intervention (CONNECT) in a sample of 30 women Veterans with chronic musculoskeletal pain.
• Assess the percentage of women Veterans that evidence clinically meaningful improvements in pain intensity/interference and depressive symptoms.

Further, in preparation for a randomized-controlled trial (RCT), they will conduct a feasibility analysis to determine Veterans’ preferences for treatment, as well as qualitative interviews to ascertain motivations for, concerns about, and factors influencing participation in a future RCT.

Methodology

This is a single-arm pilot design and an analogue study to examine the feasibility of randomization to candidate control conditions. If CONNECT is feasible, a Hybrid Type 1 trial will be warranted to determine whether providers may confidently recommend CONNECT to women Veterans and to examine implementation factors.

Findings

None to report at this time.

Anticipated Impact

Project CONNECT is expected to reduce costs and improve access to behavioral pain care. This study targets previously unaddressed and potentially modifiable factors (e.g. social support) thought to be relevant for adjustment and uptake of pain self-management among women Veterans.  

Principal Investigator

Mary Driscoll, PhD, is an investigator with HSR&D’s Pain Research, Informatics, Multi-morbidities, and Education (PRIME) Center in West Haven, CT.

View study abstract