Transition from Acute to Chronic Pain After Thoracic Surgery

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Project Summary/Abstract Increasing the racial/ethnic diversity of participants in clinical pain research and including diverse partners in the design and conduct of research are intertwined goals that are essential to increasing the acceptability, feasibility, rigor, and relevance of pain research. This proposed administrative supplement to the parent Multisite Clinical Center (MCC) for the Acute to Chronic Pain Signatures Program (A2CPS) at the University of Michigan will support a robust effort to enhance patient and other community engagement, particularly that of underrepresented minorities, and to implement a sustained outreach effort to under-resourced Black and Hispanic communities in and around Detroit, Michigan. The goal of the A2CPS consortium is to develop biological markers and groupings of patient characteristics that predict the development of chronic pain after surgery, as well as well as resilience to chronic pain development. The biological markers to be studied include patient questionnaires (e.g., pain, mood, function), brain imaging, experimental pain testing, and blood markers (e.g., genetics). The study assesses patients before surgery and through one year after total knee replacement or thoracic surgery. Supplement Aim 1 is to hire a full-time Community Research Facilitator (CRF) who will conduct outreach in the Detroit areas and affiliated groups within the Henry Ford Health System and Wayne State University. The CRF will have experience as a community health worker or similar role; that is, they will possess deep knowledge of local resources and support a sustainable partnership between researchers and diverse communities. The CRF will lead outreach efforts in predominantly Black and Hispanic communities in the Detroit area to boost study recruitment efforts and increase cohort diversity; facilitate bidirectional communication and knowledge transmission between the study team and community partners; and help enrolled participants navigate the challenges of participating in clinical research, thereby enhancing retention. Supplement Aim 2 is to partner with an existing Community Advisory Board, which includes people living with pain who are diverse in terms of race/ethnicity, age, gender, and rural/urban location; as well as other advisors including providers, clinicians, and pain researchers. This group will review study materials and processes and give feedback on changes needed to enhance recruitment and retention of underrepresented populations. Supplement Aim 3 will increase the research staff within the Henry Ford Detroit research and Wayne State University teams to better staff the surgery clinics with more diverse patients and facilitate navigation of and comfort with the in-person study visits. Finally, Supplement Aim 4 will support all research staff with direct patient contact at our MCC to do the Faster Together training from Coursera focused on unconscious bias and training in recruitment of underrepresented minority cohorts. The additional infrastructure afforded by this supplement will facilitate getting input from diverse patients for new studies as they are being planned, recruiting more diverse populations into ongoing studies, and disseminating findings to communities.