# An Efficacy Trial of Community Health Worker-Delivered Chronic Pain Self-Management Support for Vulnerable Older Adults

> **NIH NIH R01** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2021 · $617,996

## Abstract

Project Summary
Chronic pain is an enormous public health problem, and African American older adults bear a disproportionate
burden of disabling pain. Evidence-based chronic pain self-management support can improve pain-related
functioning, yet standard models for providing this support are not well-suited to reach older people in
communities of color such as Detroit, Michigan, which face severe racial segregation and socioeconomic
disadvantage. Existing pain self-management interventions are mostly group-based and require in-person
contact, making them less accessible to older adults with transportation or mobility barriers. Moreover, existing
interventions seldom address the social determinants of health (e.g., economic stressors) that are rooted in the
same structural inequities that produce high rates of pain and hinder its management. The long-term goal of
this line of research is to build a robust evidence base for chronic pain self-management interventions that
meet the needs of vulnerable older adults in underserved communities. The objective of this proposed project
is to determine whether community health workers (CHWs)—i.e., lay health workers with close ties to the
communities they serve – can effectively teach cognitive-behavioral pain management strategies to older
adults in a disadvantaged urban setting. CHWs are uniquely suited for this role, given their ability to provide
culturally appropriate care and their deep knowledge of community resources that enables them to address
social determinants of health. The central hypothesis is that a CBT-based pain self-management intervention
(“STEPS”) delivered over 7 weeks through telephone sessions with a CHW and mobile health tools improves
one-year pain-related outcomes. Our highly encouraging preliminary findings indicate that STEPS is feasible,
deliverable by CHWs with high fidelity, and well-received by participants (n=31). Its potential efficacy is
suggested by significant improvement in pain interference (pre-post Standardized Mean Difference = 0.84, p =
000). The proposed trial will take place in partnership with the Detroit-based Henry Ford Health System. There
are three specific aims: 1) Conduct a Stage 3 efficacy trial to assess whether STEPS can reduce one-year pain
interference and intensity among 414 primarily African American older adults, 2) Assess psychobehavioral
mediators and moderators of intervention effects, and 3) Using qualitative data from participants and other
stakeholders, conduct mixed-methods analysis to provide context for quantitative findings and inform a toolkit
for dissemination, if the intervention is effective. This project is innovative in that it enlists CHWs, who have
delivered evidence-based interventions for other conditions but are not yet part of the pain care workforce. It
has strong potential impact given that the model being tested is low-cost, scalable, and suitable for deeply
disadvantaged settings, where the burden of chronic pain is great...

## Key facts

- **NIH application ID:** 10178426
- **Project number:** 1R01AG071511-01
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** Mary Rose Janevic
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $617,996
- **Award type:** 1
- **Project period:** 2021-09-15 → 2026-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10178426

## Citation

> US National Institutes of Health, RePORTER application 10178426, An Efficacy Trial of Community Health Worker-Delivered Chronic Pain Self-Management Support for Vulnerable Older Adults (1R01AG071511-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10178426. Licensed CC0.

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