Culturally Adapted Pain Management for Indigenous Peoples in the Pacific Northwest (CAP-I)

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PROJECT SUMMARY/ABSTRACT The prevalence of chronic pain is higher among American Indian/Alaskan Native (AI/AN) people than any other group in the United States. Although a number of psychosocial interventions for chronic pain are well-established as effective, there are no culturally adapted interventions for AI/AN individuals. This proposed study aims to begin the process of developing a culturally-adapted psychosocial pain intervention for AI/AN individuals at the Portland Area Indian Health Service – Yakama Service Unit. The K99 phase will focus on the development of the intervention and the R00 will entail a feasibility randomized pilot trial. During the K99 phase, focus groups will aid the in the development of a treatment manual, workbooks, and procedures for a culturally appropriate psychosocial pain intervention (Specific Aim 1). After developing a prototype intervention, focus groups will then provide feedback to improve the intervention (Specific Aim 2). Specific Aim 3 is to assess the feasibility of conducting a future randomized controlled trial with the developed intervention from the K99 phase. This research will provide pilot data for an NIH R01 proposal which will be prepared and submitted towards the end of the R00 phase. The long-term objective of the proposed Pathway to Independence Award is to support the applicant in transitioning into an independent research scientist who studies chronic pain disparities and conducts intervention research in AI/AN communities. The candidate's prior research in chronic pain disparities in low-income communities in Alabama, community-based participatory research, and chronic pain trials are a strong match for this current proposed project. With the current project, she will expand her knowledge and expertise into an important new area of research that has largely been neglected by the research community. With this project, the candidate will have the mentoring and training necessary for enhancing cultural competency in working with AI/AN individuals (Training Goal 1), gaining skills in conducting community-based participatory research with AI/AN communities (Training Goal 2), and fostering skills in the development, adaptation, implementation, and dissemination in clinical trials (Training Goal 3). Drs. Jensen, Walters, Rhudy, and Fuentes will serve as mentors and offer expertise in the areas of chronic pain intervention research, cultural adaptations for psychosocial interventions for AI/AN individuals, tribal based research, and community-based research methods with AI/AN communities. The University of Washington training environment provides significant resources and support that would facilitate the development of skills and expertise needed for the applicant to transition into an independent research scientist. The Yakama Service Unit is strongly committed to this proposed study and will provide critical support in recruitment, retention, and space for focus groups and treatment. Because each tribal community has their own values, traditions, and culture, the proposed study will offer a step-by-step process for culturally adapting chronic pain interventions that may extend to tribal communities across the country.