# Health Coaching for Chronic Multi-symptom Illness

> **NIH VA I01** · VA NEW JERSEY HEALTH CARE SYSTEM · 2022 · —

## Abstract

Chronic pain is one of the most extensive health care issues facing our society with “severe impacts on all
aspects of the lives of its sufferers.” Pain predominant chronic multisymptom illness (Pain-CMI, e.g.,
fibromyalgia) is a particularly debilitating and treatment resistant chronic pain condition and a presumptive
service connected condition for Veterans who deployed to the Gulf region from 1990-2021. The VA/DoD
Guidelines recommend non-pharmaceutical treatments (e.g., cognitive behavioral therapy) for Pain-CMI and
find evidence they improve disability (typically) by targeting the mechanisms underlying Pain-CMI (e.g., low
perceived pain control, catastrophizing and limiting activity). While no single treatment is (or is likely to be)
acceptable, available and efficacious for all Veterans, having a wide array of treatment options facilitates
Veterans’ uptake of non-pharmaceutical approaches. Health coaching is an appealing potential approach to
improve the disability of Pain-CMI because it has high acceptability and it will be widely available as the VA is
rolling out health coaching for other conditions (high availability). The goal of this proposal is to understand if
health coaching is also efficacious for complex pain condition, Pain-CMI. Health coaching has high
acceptability because it addresses what experts, clinicians and patients agree is a driver of low satisfaction and
adherence - disagreement between the patient and providers about the cause of and best approaches for
Pain-CMI. In health coaching, the health coach elicits the Veteran’s beliefs and uses these to develop a shared
understanding of Pain-CMI. The health coach then identifies discrepancies between where in life the Veteran is
and where the Veteran wants to be. Motivational interviewing, goal setting and problem-solving are used to
help the Veteran reduce these discrepancies. The goal of the current proposal is to conduct a randomized
clinical trial to determine the efficacy of remote-delivered health coaching to reduce the disability and pain
impairment for Veterans with Pain-CMI as compared to supportive psychotherapy (n=250), and to explore
mechanisms of change. The VA has already rolled out whole health coaching approaches for other conditions.
Thus, if found to be efficacious, our health coaching intervention can be taught to VA whole health coaches
and providers nationally. This would increase access to care for Veterans with Pain-CMI. The VA WRIISC,28
which is mandated by Congress to provide leadership and expertise in CMI, is closely following our efforts to
guide their decisions and potential national implementation of health coaching for Pain-CMI. There is a
desperate need for empirical data to guide these decisions.

## Key facts

- **NIH application ID:** 10411901
- **Project number:** 5I01RX003254-03
- **Recipient organization:** VA NEW JERSEY HEALTH CARE SYSTEM
- **Principal Investigator:** Lisa Marie McAndrew
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2020-04-01 → 2025-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10411901

## Citation

> US National Institutes of Health, RePORTER application 10411901, Health Coaching for Chronic Multi-symptom Illness (5I01RX003254-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10411901. Licensed CC0.

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