(298) An Intersectional Identity Approach to Chronic Pain Disparities

Abstract

Chronic pain disparities are well documented with individual factors, such as race, sex, socioeconomic status (SES). Given the commonality of individuals with multiple disparities, it is important to examine the intersection of identities. This study applies an intersectional approach using latent class analysis (LCA) to better understand the relationships between multiple disparities and chronic pain. A total of 290 participants with chronic pain were examined from the Learning About My Pain (LAMP) trial, a randomized comparative effectiveness study of group-based psychosocial interventions (PCORI Contract #941, Beverly Thorn, PI; clinicaltrials.gov identifier NCT01967342). LCA examined patterns of responses among categorical variables from pre-treatment to generate latent class disparity profiles and examine cross-sectional relationships with pain severity and pain interference (Brief Pain Inventory). Categorical variables entered into LCA included race, sex, poverty status, employment status, disability status, primary literacy, age, and education. A five-profile solution was supported statistically using model fit indices and substantively using conditional response proportions. The profiles were differentiated by levels of advantage/disadvantage based on multiple indicators. Analysis of variances (ANOVA) examined pain severity and interference on the five LCA disparity profiles with Tukey's post hoc analyses. The univariate analysis was significant for pain severity, F(4, 285) = 4.78, p