# Improving Pain and Sleep Outcomes for Veterans with Chronic Pain

> **NIH VA IK2** · MINNEAPOLIS VA  MEDICAL CENTER · 2020 · —

## Abstract

Background: This application is for a five-year Career Development Award (CDA) to support my transition to
becoming an independent VA health services researcher.
Career plan: To successfully achieve my career goal of improving Veterans' health and quality of life by
enhancing the reach and effectiveness of behavioral sleep interventions, I need further mentored training and
content expertise in chronic pain and health services research, including qualitative methodologies, pragmatic
randomized trials, and implementation science, including social marketing theory. I will achieve these
objectives through formal coursework, seminars, clinical training, and mentorship from Melissa Polusny, PhD
(primary mentor; Minneapolis VA Health Care System, MVAHCS), Erin Krebs, MD, MPH (MVAHCS), Michael
Vitiello, PhD (University of Washington), and Hildi Hagedorn, PhD (MVAHCS).
Research plan: Specific aims include 1) understanding the experience of sleep treatment in comorbid chronic
pain and insomnia, 2) optimizing cognitive behavioral therapy for insomnia (CBT-I) delivery for patients with
chronic pain and insomnia, and 3) increasing demand for CBT-I among patients with chronic pain and their
primary care providers. Projects include a qualitative interview study with patient and CBT-I provider dyads
following completion or drop-out from CBT-I to inform hypotheses about strategies to eliminate barriers to
adherence. I will use these findings to draft a package of adherence-promoting adaptations for patients with
chronic pain. A pilot feasibility study will be used to finalize the adherence package and test feasibility of trial
procedures to prepare for a future pragmatic randomized clinical trial. The final project is a local
implementation study to test a social marketing campaign to increase demand for CBT-I among patients with
chronic pain by increasing patient and primary care provider awareness and positive attitudes toward CBT-I.
The social marketing campaign developed in this study will be an important component of a multifaceted
implementation intervention that will be tested in a future multisite trial.
The first two projects will result in a package of adherence-promoting adaptations to be added to CBT-I for
patients with chronic pain. It is likely that components of the adherence package will inform broader efforts to
enhance CBT-I adherence in all patients with insomnia, both those with and without chronic pain, as well as
adherence to other cognitive behavioral therapies. The final CDA project will result in a social marketing
campaign designed to increase demand for CBT-I among patients with chronic pain. We expect that
components of the social marketing campaign can also be used as part of broader campaigns to disseminate
CBT-I widely among patients with insomnia, leading to higher-rates of guideline-concordant care.
Significance and innovation: CBT-I is a highly effective and safe treatment for improving sleep and pain
outcomes and represents a p...

## Key facts

- **NIH application ID:** 10216341
- **Project number:** 5IK2HX001919-03
- **Recipient organization:** MINNEAPOLIS VA  MEDICAL CENTER
- **Principal Investigator:** Erin Koffel
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2017-10-01 → 2022-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10216341

## Citation

> US National Institutes of Health, RePORTER application 10216341, Improving Pain and Sleep Outcomes for Veterans with Chronic Pain (5IK2HX001919-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10216341. Licensed CC0.

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