DESCRIPTION (provided by applicant): A low-intensity, cognitive-behavioral self-management intervention for chronic musculoskeletal pain in older adults In an influential 2011 report entitled Relieving Pain in America, the Institute of Medicine called attention to the epidemic of chronic pain in the United States, and to the urgent need to improve access to effective pain treatments. Responding to the priorities set in this report, I am seeking to lay the foundation for an independent research program with the goal of increasing the accessibility of evidence-based, cognitive-behavioral interventions for chronic pain management among older adults. This application for a Mentored Career Development Award (K01) proposes training and research activities over a 5-year period that will enable me to launch this research program. To this end, I have formed an interdisciplinary team of mentors and consultants that includes researchers representing Geriatrics, Anesthesiology, Psychology, Physical Medicine and Rehabilitation, Public Health and Psychiatry at the University of Michigan, as well as a prominent pain ethicist from the independent Center for Practical Bioethics. This additional support will build on my strong foundation in conducting behavioral and chronic illness self-management support research among older adults. The training and research aims in this proposal are closely linked. The training goals include acquiring skills and expertise in the areas that are essential for my planned research program: 1) The pathophysiology and management of chronic pain in older adults and cognitive-behavioral approaches to treating chronic pain in this group; 2) Symptom and activity monitoring in older adults, which enables the use of accurate and timely information about patients' progress as part of behavioral interventions, while identifying potential mediators of intervention effects; and 3) Emerging study designs for testing behavioral interventions, with an emphasis on pragmatic, adaptive and patient-centered designs that increase the relevance of research findings. These topics will be mastered through coursework, clinical observations, and self-study under the guidance of the mentorship team. I will also attend relevant seminars, workshops, and scientific conferences throughout the award period. Following the training program, I will develop and pilot-test a low-intensity pain CBT intervention for older adults. The intervention will use a high tech/high touch approach. Using an evidence-based internet CBT intervention for chronic pain management as a starting point, I will develop two additional components that will enhance the appeal and potential efficacy of this program for older adults: a) a series of telephone CBT sessions by non-specialist practitioners to support use of the electronic modules, and b) symptom and activity monitoring using mobile health tools to better tailor the intervention to individual patients' needs. The development an...