# Salud de tu Espalda Primary Care to Physical Therapy (STEPPT): Mitigating ethnic disparities in access and engagement in spine pain rehabilitation

> **NIH NIH R01** · SAN DIEGO STATE UNIVERSITY · 2023 · $607,189

## Abstract

Project Summary
Spine pain is among the most common and disabling health conditions for both non-Hispanic whites (NHWs)
and racial/ethnic minorities. Although Hispanics often report more severe musculoskeletal pain than NHWs,
they are less likely to consult a healthcare professional for pain management, and health care providers are
less likely to assess and treat pain in Hispanic patients. The overall objective of this proposal is to adapt and
test evidence-based, culturally informed practices at multiple levels of influence along the healthcare
continuum to improve access to and engagement in physical rehabilitation as a non-pharmacological treatment
option for Hispanics with spine pain. Aim 1 proposes a mixed-methods approach to adapt and manualize a
multilevel intervention to address modifiable factors contributing to ethnic disparities in rates of physician
referral and patient adherence to physical therapy referral for spine pain in a Federally Qualified Health Center
(FQHC) serving diverse, low-income communities near the US-Mexico border. Aim 2 will then assess
effectiveness of the manualized intervention, referred to as STEPPT (Salud de tu Espalda: Primary Care to
Physical Therapy), using a cluster-randomized stepped-wedge clinical trial in the FQHC setting. Compared to
standard care, we hypothesize that STEPPT will significantly reduce ethnic disparities in rates of physician
referral and patient adherence to physical therapy referral for spine pain. Successful completion of the
proposed aims will provide underserved Hispanic communities with scalable, sustainable, and effective options
for engaging in culturally appropriate pain care. This approach can serve as a model for FQHCs and other
healthcare systems to mitigate disparities in specialty services for a variety of health conditions that
disproportionately impact ethnic and racial minorities.

## Key facts

- **NIH application ID:** 10753365
- **Project number:** 1R01MD018937-01
- **Recipient organization:** SAN DIEGO STATE UNIVERSITY
- **Principal Investigator:** Sara P Gombatto
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $607,189
- **Award type:** 1
- **Project period:** 2023-07-13 → 2028-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10753365

## Citation

> US National Institutes of Health, RePORTER application 10753365, Salud de tu Espalda Primary Care to Physical Therapy (STEPPT): Mitigating ethnic disparities in access and engagement in spine pain rehabilitation (1R01MD018937-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10753365. Licensed CC0.

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