Abstract

BackgroundThe Pain Coping Skills Training for African Americans with OsteoaRTthritis (STAART) trial is examining the effectiveness of a culturally enhanced pain coping skills training (CST) program for African Americans with osteoarthritis (OA). This disparities-focused trial aimed to reach a population with greater symptom severity and risk factors for poor pain-related outcomes than previous studies. This paper compares characteristics of STAART participants with prior studies of CST or cognitive behavioral therapy (CBT)-informed training in pain coping strategies for OA.MethodsA literature search identified 10 prior trials of pain CST or CBT-informed pain coping training among individuals with OA. We descriptively compared characteristics of STAART participants with other studies, in 3 domains of the National Institutes of Minority Health and Health Disparities’ Research Framework: Sociocultural Environment (e.g., age, education, marital status), Biological Vulnerability and Mechanisms (e.g, pain and function, body mass index), and Health Behaviors and Coping (e.g., pain catastrophizing). Means and standard deviations (SDs) or proportions were calculated for STAART participants and extracted from published manuscripts for comparator studies.ResultsThe mean age of STAART participants, 59 years (SD = 10.3), was lower than 9 of 10 comparator studies; the proportion of individuals with some education beyond high school, 75%, was comparable to comparator studies (61–86%); and the proportion of individuals who are married or living with a partner, 42%, was lower than comparator studies (62–66%). Comparator studies had less than about 1/3 African American participants. Mean scores on the Western Ontario and McMaster Universities Osteoarthritis Index pain and function scales were higher (worse) for STAART participants than for other studies, and mean body mass index of STAART participants, 35.2 kg/m2 (SD = 8.2), was higher than all other studies (30–34 kg/m2). STAART participants’ mean score on the Pain Catastrophizing scale, 19.8 (SD = 12.3), was higher (worse) than other studies reporting this measure (7–17).ConclusionsCompared with prior studies with predominantly white samples, STAART participants have worse pain and function and more risk factors for negative pain-related outcomes across several domains. Given STAART participants’ high mean pain catastrophizing scores, this sample may particularly benefit from the CST intervention approach.Trial registrationNCT02560922

Highlights

  • The Pain Coping Skills Training for African Americans with OsteoaRTthritis (STAART) trial is examining the effectiveness of a culturally enhanced pain coping skills training (CST) program for African Americans with osteoarthritis (OA)

  • Given STAART participants’ high mean pain catastrophizing scores, this sample may benefit from the CST intervention approach

  • Because of these well-documented racial differences, the Institute of Medicine has identified interventions to reduce disparities in OA and other musculoskeletal diseases among its top 25 priority topics for comparative effectiveness research [7]. In alignment with this priority, the Pain Coping Skills Training for African Americans with OsteoaRTthritis (STAART) study is evaluating the effectiveness of a culturally enhanced pain coping skills training (CST) program for African Americans with OA [8]

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Summary

Introduction

The Pain Coping Skills Training for African Americans with OsteoaRTthritis (STAART) trial is examining the effectiveness of a culturally enhanced pain coping skills training (CST) program for African Americans with osteoarthritis (OA) This disparities-focused trial aimed to reach a population with greater symptom severity and risk factors for poor pain-related outcomes than previous studies. Because of these well-documented racial differences, the Institute of Medicine has identified interventions to reduce disparities in OA and other musculoskeletal diseases among its top 25 (highest tier) priority topics for comparative effectiveness research [7] In alignment with this priority, the Pain Coping Skills Training for African Americans with OsteoaRTthritis (STAART) study is evaluating the effectiveness of a culturally enhanced pain coping skills training (CST) program for African Americans with OA [8]. This is important because of evidence that behavioral and psychological interventions are most effective when they are adapted to meet the needs and expectations of minority populations [26]

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