Development and preliminary testing of a peer narrative video intervention for older adults with chronic pain - Chronic musculoskeletal (MSK) pain, which includes spinal pain, osteoarthritis, and fibromyalgia, is a common
and costly problem for older adults and is associated with decreased quality of life. There is a clear need for
interventions that increase one’s ability to cope with chronic pain and engage in meaningful life activities even
with the presence of chronic pain. Acceptance and Commitment Therapy (ACT) is a psychotherapy that uses
mindfulness and psychological acceptance to support individuals in working toward behavioral goals guided by
their personal values, even in the presence of undesirable experiences such as chronic pain. Clinical practice
guidelines recommend the use of ACT for treating chronic pain based on evidence of effectiveness from
multiple RCTs. However, uptake and reach are limited because there are insufficient numbers of mental health
professionals who currently offer ACT or other recommended therapies (e.g., cognitive-behavioral therapy) for
chronic pain. In addition, many older adults are not willing or able to engage in traditional psychotherapy for
chronic pain even when it is available. Although some bibliotherapy and digital health interventions (e.g., apps)
have been developed for treating pain, many older adults fail to use them due to low levels of comfort with
technology or lack of motivation for intensive self-guided approaches. Narrative communication is an
alternative way to deliver behavior change principles that involves “storytelling” involving real patients talking
about their struggles and recovery progress. Therapeutic narratives delivered via videos may be more
engaging and immersive than traditional self-help formats for older adults. In previous grant-funded research,
our team has developed methods for creating narrative, video-based interventions designed to reduce
depression in primary care patients and prevent suicide in patients following a psychiatric hospital. Thus, in this
project, we propose to create Reclaim Your Day (RYD), which will consist of 6, 30-min weekly video episodes
highlighting patients’ inspiring and illustrative experiences living with chronic pain in order to teach current
patients with chronic MSK pain how to apply ACT’s evidence-based strategies. In Phase 1 of this project, we
will interview older adults with chronic MSK pain about their coping history, and code interviews for consistency
with ACT principles. We will invite a subset of these individuals to work with a professional storytelling coach to
develop and videorecord their ACT-consistent stories. These documentary-style videos that will form the basis
of RYD. In Phase 2, we will conduct a pilot RCT (n=100) of older adults with chronic MSK pain. All participants
will receive a 30-min introductory pain education video. Participants will be randomized to receive either RYD
or a comparison intervention (health education videos). We will examine RYD feasibility and acceptability as
well as changes over time in outcomes (pain interference, depression, quality of life) and putative mediators.
