# Mechanisms of transition from acute to chronic pain in Non-Hispanic Black and White injury patients

> **NIH NIH R01** · VANDERBILT UNIVERSITY MEDICAL CENTER · 2024 · $739,654

## Abstract

Current understanding of how and why race influences the transition from acute to chronic pain following
traumatic injury remains limited. Traumatic injuries result in over 30 million emergency department visits and 2.5
million hospitalizations each year in the U.S. Risk for developing post-injury chronic pain is significantly greater
for non-Hispanic Black (NHB) patients compared to non-Hispanic White (NHW) patients with similar injuries.
Although NHB patients experience higher levels of acute post-injury pain and are more likely to transition to
chronic pain than NHW patients, the biobehavioral and social factors that influence this transition are not well
understood. The overall aim of this proposal is to improve understanding of the factors that influence racial
disparities in the transition to post-injury pain. In order to address our aims, will recruit 150 NHB and 150 NHW
adult traumatic injury patients from a level 1 trauma center and assess pain outcomes during hospitalization
(acute pain intensity) and across monthly follow-ups (pain intensity, pain-related interference, chronic pain
status). First, we will evaluate the extent to which NHBs exhibit worse post-injury pain outcomes as compared
to NHWs. We hypothesize that NHBs will exhibit higher in-hospital pain intensity, higher rates of chronic pain
conditions over 6-month follow-up, and greater pain intensity/interference across monthly assessments. Next,
we will determine the extent to which biobehavioral factors explain racial differences in post-injury pain. We
hypothesize that higher odds of chronic pain and greater pain intensity/interference over time in NHB relative to
NHW patients will be accounted for by the indirect effects of greater pain sensitivity (assessed in hospital via
quantitative sensory testing), higher inflammatory biomarkers (hsCRP, TNFα, IL1β, IL-6), more negative
cognitions (pain catastrophizing, expectations regarding pain/treatment), and higher depressive/posttraumatic
stress symptoms in NHB patients. Finally, we will determine the extent to which racial differences in post-injury
pain depend on social factors. We hypothesize that greater life and neighborhood stress and lower
socioeconomic status and social support will be associated with higher odds of chronic pain and greater pain
intensity/interference over time in NHB relative to NHW patients. Together, these aims will test key elements of
an innovative integration of the diathesis-stress model of chronic pain and minority stress theory. The
investigators assembled for this multidisciplinary team possess complementary skill sets in traumatic injury,
chronic pain, quantitative sensory testing, inflammation, pain-relevant biobehavioral and social factors, and racial
disparities in chronic pain. The comprehensive assessment of mediators and moderators across multiple levels
of the biopsychosocial model will advance our understanding of the pathways that contribute to racial differences
in post-injury pain. ...

## Key facts

- **NIH application ID:** 10986182
- **Project number:** 7R01MD016838-03
- **Recipient organization:** VANDERBILT UNIVERSITY MEDICAL CENTER
- **Principal Investigator:** Matthew C. Morris
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $739,654
- **Award type:** 7
- **Project period:** 2022-09-11 → 2027-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10986182

## Citation

> US National Institutes of Health, RePORTER application 10986182, Mechanisms of transition from acute to chronic pain in Non-Hispanic Black and White injury patients (7R01MD016838-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10986182. Licensed CC0.

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