# Engaging Veterans Seeking Service-Connection Payments in Pain Treatment

> **NIH NIH UH3** · YALE UNIVERSITY · 2022 · $1,311,795

## Abstract

Abstract
In 2015 alone, 97,223 new Veterans under age 35 began receiving compensation for injuries related to their
military service. In total, there are 559,999 post-9/11 Veterans being compensated for back or neck conditions,
and a partially overlapping 596,250 for limitation of flexion in joints. Veterans seeking compensation for
musculoskeletal conditions often develop chronic pain and are at high risk for substance misuse. Early
intervention is needed to arrest worsening pain and risky substance use, particularly among post-9/11
Veterans for whom engagement in non-pharmacological pain treatment has the potential to improve their
overall quality of life and spare them the complications of opioid treatments. The service-connection application
is an ideal point-of-contact for initiating early intervention treatments for these at-risk Veterans. We propose to
test the effectiveness and cost-effectiveness of Screening, Brief Intervention and Referral to Treatment for Pain
Management (SBIRT-PM), designed to reduce pain and risky substance use. In brief, the counselor explains
that treating both physical and psychological aspects of pain leads to the best outcomes, outlines what VA
(and non-VA if preferred) services are available to Veterans, explains that substances are sometimes used for
pain relief, and segues into traditional SBIRT. SBIRT-PM's efficacy is supported by a completed clinical trial of
101 Veterans applying for service-connection for MSD, and by studies showing the efficacy of SBIRT for
people with risky substance use and of Motivational Interviewing for engagement in non-pharmacological pain
care. The study will involve a two-year period to arrange for clinicians at a single “hub” site to counsel
Veterans throughout New England by phone with SBIRT-PM, and a four-year period to conduct the clinical trial
and disseminate its findings. During the two-years of preparation for the clinical trial, the team will prepare
SBIRT-PM for implementation by establishing communication (Relational Coordination is the theoretical
framework) between the “hub” where the SBIRT-PM clinician is sited and the “spoke” sites, establishing study-
related procedures, and piloting the intervention at each of the eight VA medical centers in New England. For
the full clinical trial, we will randomize 1200 Veterans applying for compensation related to MSD to either
SBIRT-PM or Usual Care (UC) across eight VA medical centers in New England. Outcome assessment by
phone will occur at 12 and 36-week follow-ups, and will be corroborated with other sources of information ---the
electronic health record and toxicology testing of nail clippings. We hypothesize that, compared to Usual Care,
SBIRT-PM will be more effective and cost-effective in improving Veterans' pain and substance use. We further
hypothesize that a mediator of these improvements will be use of non-pharmacological services, as extracted
from VA records from structured data fields and from narrative text i...

## Key facts

- **NIH application ID:** 10241265
- **Project number:** 5UH3AT009758-05
- **Recipient organization:** YALE UNIVERSITY
- **Principal Investigator:** Marc I Rosen
- **Activity code:** UH3 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $1,311,795
- **Award type:** 5
- **Project period:** 2017-09-20 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10241265

## Citation

> US National Institutes of Health, RePORTER application 10241265, Engaging Veterans Seeking Service-Connection Payments in Pain Treatment (5UH3AT009758-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10241265. Licensed CC0.

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