Determinants and effectiveness of non-pharmacologic pain interventions versus prescription opioids - PROJECT SUMMARY
I am a licensed occupational therapist and current PhD student in the Division of Rehabilitation Sciences at the
University of Texas Medical Branch in Galveston, Texas. The purpose of this F31 proposal is to develop my
knowledge, methodological proficiency, analytical skill, and research experience necessary to become a
successful clinician-scientist. This proposal is important to achieve my long-term goals of obtaining a postdoc
position, drafting a K99, and working in a Medical Rehabilitation Research Resource Network with the goal of
using large data to improve equitable access to non-pharmacologic pain interventions. My F31 application
focuses on comparing non-pharmacologic pain interventions, such as occupational and physical therapy, to
prescription opioids for those experiencing surgical or chronic pain. My training as an occupational therapist
has given me a strong understanding of multimodal pain interventions, care pathways, and disparities in
healthcare access. My experiences as a researcher have provided foundational knowledge in using large data,
studying behavioral interventions, and recognizing the importance of social determinants of health and public
policy. During the F31 period, I will train in 2 areas that build upon my prior clinical and research experience:
(1) Academic and Research training including: new data management and analytic methods, supplementary
education on comparative effectiveness research, observational study design, social determinants of health
and principles of clinical pharmacology; and (2) Professional Development training including: networking
experiences at local and national conferences, improving scientific writing and verbal communication, and
offering mentorship to occupational therapy students or PhD students. Training in these areas will make me a
better researcher and will provide opportunities to use rigorous methods, effectively communicate findings, and
translate research into practice via mentoring future health care providers. My training activities are integrated
into a research project in which I use large data from the nationally representative Medical Expenditure Panel
Survey (2011-2018) and Medicare claims (2015-2018) to complete the following aims: (A) Examine temporal
changes—stratified by surgical and chronic pain--in the prevalence of prescription opioids compared to non-
drug interventions, with emphasis on social determinants of health associated with better access to these
services; and (B) Compare the effectiveness between prescription opioids versus occupational and physical
therapy on measures of pain, mobility, and self-care in patients receiving home health. The expected findings
of this research can identify disparities in access to pain interventions, which is important for our growing
population of adults with chronic and disabling pain. The findings can also contribute to developing clinical
practice guidelines for low-risk pain interventions. Completing the F31 training and research will provide me an
opportunity to develop into a clinician-scientist using large data to facilitate equitable and effective care.
