Addressing Chronic Musculoskeletal Pain among Health Disparity Populations: A Randomized Controlled Trial

Aim To help address chronic musculoskeletal pain among health disparity populations (HDPs), we evaluated an Auricular Point Acupressure (APA) intervention leveraging technology. Specifically, we piloted our 1-month intervention and assessed our ability to recruit, randomize participants into 3 arms, and retain them throughout the study with a three-month follow-up. We also assessed participant adherence, acceptability, and satisfaction to our intervention. Background There are persistent challenges in pain management especially among HDPs (racial/ethnic/LGBT groups, socioeconomically disadvantaged, and underserved). Technology is advancing healthcare but digital interventions need to be evaluated prior to large-scale trials. Our APA intervention included telehealth training sessions, APA app, and telecommunications to self-administer APA for pain self-management. Method We conducted a 3-arm, longitudinal study using a randomized controlled trial. We received Institutional Review Board approval and posted recruitment flyers in settings serving HDPs. We randomized participants into three groups: in-person + app, virtual + app, and waitlist, education-enhanced control. We used ecological momentary assessment for real time evaluation of APA adherence, APA surveys tested and used in prior studies for acceptability and satisfaction measures, and employed descriptive data analysis. Results Despite the pandemic, we recruited 23 participants within a 2-month timeframe and randomized these participants. With one attrition (in-person), data from 22 participants were analyzed (95.7%). All participants adhered to the study protocol and implemented APA over the minimum recommended frequency and duration for pain relief; the virtual + app group used APA more than others. All participants found the APA intervention acceptable and 90% reported satisfaction, with reduced pain outcomes and no adverse events reported. Conclusions Our APA intervention was found to be feasible and ready for larger trials. Among HDPs, self-administered APA is innovative and transformational in pain management to help address pain care access and disparities toward equitable and effective pain management.