Underserved older adults' treatment preferences for a mind-body activity program for chronic pain delivered via shared medical visits in a community clinic

Older adults with chronic pain from underserved communities need evidence-based pain management programs. To meet this need, we interviewed patients and staff from an underserved community clinic to identify their treatment preferences and barriers and facilitators to participating in a mind-body activity program. We conducted nine qualitative interviews (two staff; seven patients) and six focus groups (three staff groups; three patient groups), transcribed them verbatim and then used inductive-deductive thematic analysis guided by two pre-specified superordinate domains: (1) treatment preferences and (2) barriers and facilitators to participation. Participants recommended flexible, group participation options (in person, remote) with a credible leader and with multi-cultural considerations. They generally reacted positively to the proposed content. Barriers included logistical barriers (e.g. transportation, finances), weather, and skepticism about novel treatments; facilitators centered on expanding access and increasing sense of community. Our findings highlight important considerations to facilitate the uptake of mind-body activity programs for underserved older adults with chronic pain.