A Community Health Worker-Led Positive Psychology Intervention for African American Older Adults With Chronic Pain. Janevic M, et al, Gerontologist 2022.
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Résumé et points clés
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.
Références de l'article
A Community Health Worker-Led Positive Psychology Intervention for African American Older Adults With Chronic Pain.
A Community Health Worker-Led Positive Psychology Intervention for African American Older Adults With Chronic Pain.
Janevic M, Robinson-Lane SG, Courser R, Brines E, Hassett AL
The Gerontologist
2022
Gerontologist. 2022 Oct 19;62(9):1369-1380. doi: 10.1093/geront/gnac010.
Humans, Female, Aged, Male, *Black or African American/psychology, *Chronic Pain/therapy, Community Health Workers, Psychology, Positive, Pain Management
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