Chronic Pain, Veterans
Conditions
Keywords
Canadian Veterans, Chronic pain, Acceptance and Commitment Therapy, ACT, Digital health intervention, Digital psychology intervention, Pain self-management, Mobile health, eHealth, Manage My Pain, Co-adaptation, Patient engagement, Veterans' health, Pain psychology, Feasibility Studies, Mindfulness, Internet-based Intervention
Brief summary
The goal of this study is to gather feedback from Canadian Veterans living with chronic pain, and clinicians serving Canadian Veterans, on an existing digital psychology program for self-management of chronic pain delivered through the Manage My Pain app. This feedback will be used to adapt the program for the needs and experiences of Canadian Veterans. The main questions it aims to answer are: * How acceptable, feasible, and engaging is the existing digital psychology program for Canadian Veterans living with chronic pain? * What changes are needed to make the program more relevant and appropriate for Canadian Veterans living with chronic pain? Participants will: * Use the self-guided digital psychology program over a two-week period and complete questionnaires about the program's acceptability and feasibility. Veteran participants will also complete questionnaires about their pain and pain history. * Take part in a 30- to 45-minute virtual interview to provide feedback about the program and recommendations for its adaptation. The study does not include a comparison group.
Detailed description
Chronic pain affects approximately 30% to 50% of Canadian Veterans, many of whom experience barriers to accessing interprofessional pain services, particularly when transitioning from military to civilian healthcare. Digital health interventions may help address gaps in care by providing accessible, evidence-based self-management support while Veterans await services or alongside their existing clinical care. However, these interventions must be adapted to reflect Veterans' needs and experiences, including military culture, values and language, pain- and mental health-related stigma, experiences of trauma, and challenges navigating the civilian healthcare system. Acceptance and Commitment Therapy (ACT) is an evidence-based psychological intervention that can improve pain-related functioning, pain acceptance, and quality of life among people living with chronic pain, including Veterans. The current study will support the co-adaptation of an existing self-guided digital ACT intervention delivered through the Manage My Pain mobile health platform. Canadian Veterans living with chronic pain and clinicians experienced in providing evidence-based pain psychology interventions to Veterans will use the existing program and provide feedback through questionnaires and semi-structured interviews. Their feedback will inform modifications to the program's content, language, format, and delivery to create Advancing Online Pain Psychology Tools for Canadian Veterans (ADOPT-CanVets). The adapted program will subsequently be ready for evaluation in a feasibility trial. Once evaluated, ADOPT-CanVets may provide a scalable approach to increasing Canadian Veterans' access to evidence-based psychological support for chronic pain.
Interventions
OTHERSelf-Guided Digital Acceptance and Commitment Therapy Program
A self-guided digital psychology program based on Acceptance and Commitment Therapy and delivered through the Manage My Pain app. The program includes interactive psychoeducation about chronic pain and Acceptance and Commitment Therapy, recognition of pain-related avoidance, clarification of personal values, identification of meaningful actions, strategies for making room for difficult experiences, and flexible persistence in meaningful activities.
Sponsors
University Health Network, Toronto
Chronic Pain Centre of Excellence for Canadian Veterans
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
(Veterans): * Veterans of the Canadian Armed Forces who report having chronic pain (pain for 3 months or longer). * Have access to a device that can connect to the Internet. Inclusion Criteria (Clinicians): * Healthcare providers actively practicing in Canada. * Healthcare providers delivering evidence-based psychology interventions to Canadian Veterans (e.g., clinical psychologists, psychotherapists, social workers, counselors) * Have access to a device that can connect to the Internet.
Exclusion criteria
(Veterans): * Individuals with a known history of serious mental illness (e.g., psychosis and/or active mania). * Individuals who have limited comprehension of English or comprehension deficits due to dementia. * Individuals with physical or cognitive impairments that prevent effective engagement with an online intervention (e.g., serious uncorrected visual or hearing impairment).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Program Usage and Engagement as assessed by Manage My Pain Platform Usage Analytics | Participants will have their usage analytics tracked from access to the self-guided program to completion of the program, an average of 2 weeks. | Manage My Pain platform usage analytics will be used to assess engagement with the self-guided digital psychology program. Engagement metrics will include module access dates, time spent in each module, and the total number of modules completed by each participant. A greater number of completed modules will indicate greater program engagement. |
| Program Acceptability as assessed by the Treatment Evaluation Inventory-Short Form | Participants will be sent a link to fill out the measure within 1 week of completing the program. | Program acceptability will be assessed using the 9-item Treatment Evaluation Inventory-Short Form (TEI-SF). Items are rated on a 5-point scale and summed to produce a total score ranging from 9 to 45. Higher scores indicate greater acceptability. |
| Program Feasibility as assessed by the Feasibility Survey | Participants will be sent a link to fill out the measure within 1 week of completing the program. | Participants' perceptions of program feasibility, acceptability, usability, and connection to the program will be assessed using a 13-item survey. Items are rated on a 7-point scale and may be examined individually or averaged to produce a mean score ranging from 1 to 7. The survey also includes an open-ended feedback question. |
| Retrospective Semi-structured Interview | Participants will be sent an invitation for an interview within 1 week after completing the survey questions. | A 30- to 45-minute semi-structured interview will explore participants' experiences with the existing program and their recommendations for adapting its content, language, format, and delivery for Canadian Veterans. |
Countries
Canada
Contacts
CONTACTHance A Clarke, MD, PhD
CONTACTPeter M Slepian, PhD
PRINCIPAL_INVESTIGATORHance Clarke, MD, PhD
University Health Network, Toronto
Outcome results
None listed