Acceptability of telephone-based pain coping skills training among African Americans with osteoarthritis enrolled in a randomized controlled trial: a mixed methods analysis

Francis J. Keefe,Crystal W. Cené,Chamara J. Dharmasri,Kelli D. Allen,Eugene Z. Oddone,Lisa C. Campbell,Ida Griesemer,Tamara J. Somers,Liubov Arbeeva

doi:10.1186/s12891-020-03578-7

Abstract

BackgroundOsteoarthritis (OA) disproportionately impacts African Americans compared to Caucasians, including greater pain severity. The Pain Coping Skills Training for African Americans with Osteoarthritis (STAART) study examined a culturally enhanced Pain Coping Skills Training (CST) program among African Americans with OA. This mixed methods study evaluated the acceptability of the Pain CST program among STAART participants.MethodsSTAART was a randomized controlled trial evaluating the effectiveness of an 11-session, telephone-based pain CST program, compared to a usual care control group. Participants were from the University of North Carolina and Durham Veterans Affairs Healthcare Systems. The present analyses included 93 participants in the CST group who completed a questionnaire about experiences with the program. Descriptive statistics of the questionnaire responses were calculated using SAS software. Thematic analysis was applied to open-response data using Dedoose software.ResultsParticipants’ mean rating of overall helpfulness of the pain CST program for managing arthritis symptoms was 8.0 (SD = 2.2) on a scale of 0–10. A majority of participants reported the program made a positive difference in their experience with arthritis (83.1%). Mean ratings of helpfulness of the specific skills ranged from 7.7 to 8.8 (all scales 0–10). Qualitative analysis of the open-response data identified four prominent themes: Improved Pain Coping, Mood and Emotional Benefits, Improved Physical Functioning, and experiences related to Intervention Delivery.ConclusionsThe high ratings of helpfulness demonstrate acceptability of this culturally enhanced pain CST program by African Americans with OA. Increasing access to cognitive-behavioral therapy-based programs may be a promising strategy to address racial disparities in OA-related pain and associated outcomes.Trial registrationNCT02560922, registered September 25, 2015.

Highlights

Osteoarthritis (OA) disproportionately impacts African Americans compared to Caucasians, including greater pain severity
Studies indicate that African Americans report greater levels of pain catastrophizing and that racial differences in pain coping patterns may be key contributors to disparities in pain severity [5, 6, 8, 9]
The Pain Coping Skills Training for African Americans with Osteoarthritis (STAART) study adapted a pain CST program based on input from African Americans with OA regarding cultural factors relevant to coping behaviors [13]

Summary

Introduction

Osteoarthritis (OA) disproportionately impacts African Americans compared to Caucasians, including greater pain severity. The Pain Coping Skills Training for African Americans with Osteoarthritis (STAART) study examined a culturally enhanced Pain Coping Skills Training (CST) program among African Americans with OA. African Americans experience greater prevalence of OA than Caucasians, as well as more severe OA-related pain and functional limitations [3,4,5,6,7]. Studies indicate that African Americans report greater levels of pain catastrophizing and that racial differences in pain coping patterns may be key contributors to disparities in pain severity [5, 6, 8, 9].

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Discussion

Conclusion