Reaching Rural Veterans: Applying Mind-Body Skills for Pain Using a Whole Health Telehealth Intervention - UH3

The goal of the RAMP mind-body program is to provide Veterans with information and tools that can help them manage their pain. The program explores the important connection between our bodies and minds, and how to use this special connection to manage pain more effectively.

Our long-term objective is to improve pain management and reduce opioid use among rural patients in the VA. To accomplish this, we will conduct a randomized clinical trial (RCT) to test the effectiveness of an innovative multi-component complementary and integrative intervention, Reaching Rural Veterans: Applying Mind-Body Skills for Pain Using a Whole Health Telehealth Intervention (RAMP) delivered via group telehealth, for improving rural Veterans' pain management, function, and wellbeing, within the VA healthcare system. This project addresses the significant challenge of implementing effective, non-opioid interventions for chronic pain management among rural Veterans, who experience a disproportionate share of the national pain burden, with more chronicity, opioid harms, comorbid mental health conditions and substance abuse, and are prescribed more opioids and have less access to evidence-based, chronic pain care that addresses their "whole-person" or biopsychosocial needs. The RAMP program strategically coalesces multiple evidence based CIH self-management strategies to address rural Veterans' biopsychosocial needs and overcome existing barriers to implementation. Comprised of pain education, mindfulness, pain specific exercises, and cognitive behavioral strategies, the program is cohesive and scalable.

Inclusion Criteria: (1) 18 years of age or older (2) rural-dwelling based on U.S. Health Services Research Administration Criteria (3) chronic pain based on two qualifying pain diagnoses in their electronic health record (EHR) within the same diagnostic category, at least 90 days apart, during the previous 2 years; (4) self-reported pain on at least most days in the past 3 months, (5) Brief Pain Inventory Interference subscale score ≥ 4/10; (6) access to a device with internet, (7) willingness to engage in intervention-specific procedures (e.g., meet remotely online for sessions), and (8) an email address listed in the EHR. Exclusion Criteria: Exclusion criteria: (1) severe, poorly controlled psychiatric or substance use disorder (identified by chart review); (2) active members of advisory panels for the study, (3) enrollment in another research study for pain, (4) enrollment in a similar study (5) enrollment in a similar facilitated, multi-week, multi-modal complementary and integrative health program.