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- Title
Race-Based Differences in the Response to a Mindfulness Based Integrative Medical Group Visit Intervention for Chronic Pain.
- Authors
Incollingo Rodriguez, Angela C.; Nephew, Benjamin C.; Polcari, Justin J.; Melican, Veronica; King, Jean A.; Gardiner, Paula
- Abstract
Background: Chronic pain is one of the most common drivers of healthcare utilization and a marked domain for health disparities, as African American/Black populations experience high rates of chronic pain. Integrative Medical Group Visits (IMGV) combine mindfulness techniques, evidence-based integrative medicine, and medical group visits. In a parent randomized controlled trial, this approach was tested as an adjunct treatment in a diverse, medically underserved population with chronic pain and depression. Objective: To determine race-based heterogeneity in the effects of a mindfulness based treatment for chronic pain. Methods: This secondary analysis of the parent trial assessed heterogeneity of treatment effects along racialized identity in terms of primary patient-reported pain outcomes in a racially diverse sample suffering from chronic pain and depression. The analytic approach examined comorbidities and sociodemographics between racialized groups. RMANOVAs examined trajectories in pain outcomes (average pain, pain severity, and pain interference) over three timepoints (baseline, 9, and 21 weeks) between participants identifying as African American/Black (n = 90) vs White (n = 29) across both intervention and control conditions. Results: At baseline, African American/Black participants had higher pain severity and had significantly different age, work status, and comorbidity profiles. RMANOVA models also identified significant race-based differences in the response to the parent IMGV intervention. There was reduced pain severity in African American/Black subjects in the IMGV condition from baseline to 9 weeks. This change was not observed in White participants over this time period. However, there was a reduction in pain severity in White participants over the subsequent interval from 9 to 21 week where IMGV had no significant effect in African American/Black subjects during this latter time period. Conclusion: Interactions between pain and racialization require further investigation to understand how race-based heterogeneity in the response to integrative medicine treatments for chronic pain contribute to the broader landscape of health inequity.
- Subjects
UNITED States; CHRONIC pain treatment; INTEGRATIVE medicine; MEDICALLY underserved areas; PAIN measurement; POST-traumatic stress disorder; SUBSTANCE abuse; SELF-evaluation; SECONDARY analysis; AFRICAN Americans; RESEARCH funding; INCOME; MINDFULNESS; HYPERTENSION; INSOMNIA; QUESTIONNAIRES; TREATMENT effectiveness; ANXIETY; BRIEF Pain Inventory; DESCRIPTIVE statistics; RACE; BEHAVIORAL sciences; MEDICAL appointments; PAIN management; QUALITY of life; ONE-way analysis of variance; HEALTH equity; TREATMENT effect heterogeneity; HEALTH outcome assessment; PSYCHOLOGY of parents; COMPARATIVE studies; DATA analysis software; GROUP process; PATIENTS' attitudes; MENTAL depression; COMORBIDITY; DISEASE complications
- Publication
Global Advances in Integrative Medicine & Health, 2024, p1
- ISSN
2753-6130
- Publication type
Article
- DOI
10.1177/27536130241254793