# Cooperative Pain Education and Self-management: Expanding Treatment for Real-World

> **NIH NIH UH3** · YALE UNIVERSITY · 2020 · $873,664

## Abstract

PROJECT SUMMARY/ABSTRACT
Cognitive behavioral therapy for chronic pain (CBT-CP) is an evidence-based psychological intervention that is
effective for reducing pain and improving function for patients with chronic pain. Numerous barriers exist to
face-to-face delivery of this treatment, including patient travel limitations, the need for frequent in-person
sessions, and the scarcity of trained therapists. Leveraging technology-based interventions, like interactive
voice response (IVR), which allow patients to engage in treatment from their home, may improve access to
CBT-CP. The overall goal of this project is to conduct a pragmatic trial to examine the real world effectiveness
of an IVR-based form of CBT-CP called COoperative Pain Education and Self-management (COPES). In the
spirit of pragmatic trials, our approach will minimize clinic disruption and avoid adding research staff in the field
by using the VHA’s electronic health record (EHR) to facilitate recruitment and to collect data, all while
delivering COPES from a centralized VA location. In preparation for the pragmatic trial, the initial study phase
(UG3) will: a) identify facilities to participate in the trial from among the 60 Women’s Health Practice Based
Network (WH-PBRN) sites, b) examine the adequacy of the EHR for providing outcome data, c) determine the
feasibility of using EHR provider alerts to promote recruitment and d) secure all regulatory approvals along with
support from leadership at selected sites. Phase two (UH3) will then compare outcomes among Veterans
randomized to either: 1) COPES, a 10-week IVR-based CBT and walking program plus any provider
prescribed pharmacological and non-pharmacological pain treatments (COPES+UC), or 2) in-person CBT-CP
provided by clinicians, previously trained through VHA’s evidence based psychotherapy program plus any
provider prescribed pharmacological and non-pharmacological treatments (VHA CBT-CP+UC). Patients will be
compared on a composite measure of pain intensity and functioning, EHR pain intensity, and health care use
including emergency department, urgent care, and specialty pain services along with pharmacological and
non-pharmacological pain interventions. Uptake and variation in outcomes across groups will also be
evaluated where treatment disparities are possible (e.g. by sex, race, mental health comorbidities).
Additionally, the cost of the COPES intervention will be examined, including intervention delivery expenditures
and budget impact analysis. Finally, evaluation of the intervention process will be informed by the Consolidated
Framework for Implementation Research (CFIR). CFIR-guided interviews with study site clinicians and
administrators will assess experiences with the COPES and CBT-CP interventions and implementation
findings will be communicated with participating sites and stakeholders.

## Key facts

- **NIH application ID:** 10015199
- **Project number:** 5UH3AT009767-04
- **Recipient organization:** YALE UNIVERSITY
- **Principal Investigator:** DIANA M HIGGINS
- **Activity code:** UH3 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $873,664
- **Award type:** 5
- **Project period:** 2017-09-20 → 2023-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10015199

## Citation

> US National Institutes of Health, RePORTER application 10015199, Cooperative Pain Education and Self-management: Expanding Treatment for Real-World (5UH3AT009767-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10015199. Licensed CC0.

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