# Addressing Disparities In Pain Management

> **NIH VA IK2** · VETERANS ADMIN PALO ALTO HEALTH CARE SYS · 2023 · —

## Abstract

Background: Disparities in pain treatment suggest that Veterans of color and women Veterans (i.e., “diverse
Veterans” in this CDA) are subject to unequal treatment when seeking pain care at VA. Mounting evidence
points to the importance of guideline-concordant, evidence-based non-pharmacological pain treatments
(NPTs) in the management of chronic pain, yet these treatments are not reaching diverse Veterans.
Implementation mapping can be used to rigorously plan implementation of evidence-based practices (e.g.,
NPTs). Using this approach, one can identify key barriers and facilitators to implementation of evidence-based
practices and map them to relevant implementation strategies and target users. The purpose of this CDA is to
develop and test a tailored implementation blueprint for increasing NPT use among diverse Veterans.
Significance/Impact: Over 2 million Veterans suffer from chronic pain. Over the next four decades, Veterans
of color are projected to grow exponentially and there is far more racial/ethnic heterogeneity among women
than men in the VA. There is a critical need to identify effective implementation strategies that can be used to
disseminate NPTs in order to meet the needs of future diverse Veterans with chronic pain.
Innovation: This proposal offers three innovations: 1) An integrated conceptual framework mapping key health
equity domains to implementation science solutions; 2) An implementation blueprint developed using a
comprehensive and rigorous pre-implementation planning approach (i.e., implementation mapping) that is
informed by mixed methods research with target users; and 3) a strong focus on health equity and inclusion of
diverse Veteran engagement via operational partnerships during each stage of research.
Specific Aims: 1) Aim 1: Understand and identify factors driving NPT use among diverse Veterans using
mixed methods; Sub-Aim 1.1: Identify sites at which diverse Veterans are not using NPTs despite NPTs being
available; Sub-Aim 1.2: Evaluate multi-level stakeholder perspectives necessary for designing an
implementation blueprint tailored for diverse Veterans; Sub-Aim 1.3: Assess disparities in NPT use in VA
administrative data; 2) Aim 2: Use implementation mapping to identify core and non-core components of NPT
uptake and design an implementation blueprint tailored for diverse Veterans; Sub-Aim 2.1: Generate a matrix
of change outcomes resulting from use of a tailored implementation blueprint; Sub-Aim 2.2: Develop protocols
and materials comprising the tailored implementation blueprint; and 3) Aim 3: Measure pre-implementation
outcomes of the tailored blueprint developed in Aim 2, including feasibility, acceptability, appropriateness,
dose, complexity, and self-efficacy among target users.
Methodology: In Aim 1.1, a quantitative sampling strategy using VA administrative will inform the selection of
four implementation sites. In Aim 1.2, qualitative interviews will identify factors driving NPT use among diverse
Veteran...

## Key facts

- **NIH application ID:** 10642345
- **Project number:** 1IK2HX003474-01A2
- **Recipient organization:** VETERANS ADMIN PALO ALTO HEALTH CARE SYS
- **Principal Investigator:** Sarah Jane Javier
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2023
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2023-08-01 → 2028-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10642345

## Citation

> US National Institutes of Health, RePORTER application 10642345, Addressing Disparities In Pain Management (1IK2HX003474-01A2). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10642345. Licensed CC0.

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