Pain Self-Management for Veterans: Development and Pilot Test of a Stage-Based Mobile-Optimized Intervention.

Area of Science:

• Digital health interventions
• Behavioral medicine
• Veteran health

Background:

• Chronic pain affects millions of Americans, with veterans experiencing disproportionately high rates.
• Prevalence of chronic pain among previously deployed soldiers and veterans ranges from 44% to 60%.

Purpose of the Study:

• To develop and pilot-test Health eRide, a mobile self-management program for chronic musculoskeletal pain in veterans.
• The program is based on the transtheoretical model, tailoring interventions to veterans' stage of change and preferred strategies.
• It integrates stress management and healthy sleep, crucial for veterans with co-occurring PTSD and TBI, using gamification, SMS, and social networking.

Main Methods:

• A pilot test involving 69 veterans recruited through various channels.
• Participants completed a mobile-delivered baseline assessment and the Health eRide intervention.
• A 30-day follow-up included access to a Personal Activity Center, optional tailored text messages, and pre-post assessments of pain, pain impact, self-management strategies, PTSD, and behavioral stages.

Main Results:

• Statistically significant reductions in pain (P<.001) and pain impact (P<.001) were observed in 44 completers.
• A significant increase in participants adopting pain self-management (P=.01) and stress management (P<.001) stages was noted.
• While user acceptability was high, usability ratings were slightly below average for digital programs.

Conclusions:

• The Health eRide program shows preliminary potential for impacting chronic musculoskeletal pain in veterans.
• Simultaneously addressing pain with other behaviors like stress management is a promising strategy for managing comorbid conditions.
• Further research, including a randomized trial, is needed to refine usability and confirm long-term effects.