PROJECT SUMMARY/ABSTRACT This K23 career development award proposal addresses the underutilization of pain psychology, an effective frontline treatment, among socioeconomically disadvantaged individuals suffering from chronic low back pain (cLBP). The primary investigator (PI) seeks to bridge this healthcare disparity through a three-fold research strategy. Aim 1 proposes to investigate the impact of socioeconomic status on pain psychology utilization via a retrospective cohort analysis. The PI will leverage data from a large, PCORI-funded trial across healthcare systems in Baltimore, MD, and Salt Lake City, UT. Aim 2 aims to identify the barriers and facilitators to pain psychology utilization through qualitative interviews with psychologists and patients from a low socioeconomic stratum. This step will guide the development of the Empowering Pain Psychology Access and Collaboration (EPPAC) intervention, a patient-centered approach using shared decision-making and motivational interviewing. Aim 3 pilots the EPPAC intervention among socioeconomically disadvantaged patients with cLBP, evaluating its acceptability, feasibility, and preliminary efficacy compared to a usual care control group. This K23 career development award proposal is spearheaded by Dr. Fenan Rassu, an Assistant Professor in the Department of Physical Medicine and Rehabilitation and a clinical researcher at The Johns Hopkins University School of Medicine who is determined to address underutilization of evidence-based pain psychology treatments among socioeconomically disadvantaged individuals with cLBP. The proposed career development plan includes didactic and research training activities that will substantially build his skills and expertise. These will include training in health services research, stakeholder engaged research and qualitative research methods, and implementation science . This training will occur in the rich training environment of the Johns Hopkins Medical Institutions, including the Bloomberg School of Public Health. He will receive guidance from his outstanding team of mentors and advisors with expertise in the methodologies needed for conducting the planned research, and a track record of mentoring and funding. The award and protected time will allow Dr. Rassu to build an independent NIH-funded research career and become a leader in improving access and engagement in evidence-based treatments for vulnerable populations living with pain.