PROJECT SUMMARY
The COVID-19 pandemic has affected everyone in different ways. For people from the rural America with
chronic diseases, particularly those who experience pain, the pandemic can not only worsen pain, but also it can
trigger anxiety, depression, trouble sleeping, and substance use. This psychological distress is exacerbated by
physical and social isolation, fear of seeking in-person visits, and diminished ability to access clinical care during
the pandemic. One way doctors and health systems are reaching out is by video visits, where patients and their
providers communicate online via the Internet. However, video visits still have limits. Therefore, we can help
support them with other techniques. Beyond video visits, there are home-based programs that patients can
administer themselves to help manage their pain. These proven programs can overcome staffing shortfalls, be
used across long distance to reach anyone in the world and can be used at the time and place of the patients'
choosing.
In this study, we will compare two available, evidence-based, digital treatment programs that patients can use
at home. The goal is to see if one approach is better than the other, and whether certain patients respond to one
more than the other. The first program is an app that can run on any smartphone or computer. The program
offers an 8-week, at-home curriculum to learn and practice new skills that can help manage pain. The program
runs on a standard screen on your phone or computer. The second program is also a proven, 8-week program,
but it uses a technology called virtual reality, or VR. VR involves wearing specialized goggles that create a
sensation of being in a 3D world. Evidence shows that virtual worlds can help people learn and retain new skills
that help reduce pain.
The study will recruit 300 people from rural communities in California, Louisiana, and Alabama and randomize
them into either the 2D or 3D programs. We will then follow patients for 8 weeks days and measure their pain
levels. We will also measure signs of distress, including Coronavirus-related anxiety, along with measuring
medications used for pain, such as opioids, and the impact of pain on overall quality of life. To conduct the study,
we will ask patients to periodically complete short surveys online and allow permission for the research team to
collect information from the electronic health record. We developed this study working with patient partners from
the American Chronic Pain Association (ACPA), and they will be part of the research team throughout the
conduct, analysis, and reporting of the study. The results will help patients, doctors, and health system decide
how best to administer home-based, patient-administered, digital treatment programs for pain, and will offer
recommendation on how to select the right treatment for the right patient.