Randomized Trial of a Low-Literacy Chronic Pain Self-Management Program: Analysis of Secondary Pain and Psychological Outcome Measures

Barbara J. Turner, Yuanyuan Liang, Natalia Rodriguez, Raudel Bobadilla, Maureen J. Simmonds, Zenong Yin

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Based on input of rural, largely Hispanic persons with chronic pain, a low-literacy, 6-month self-management program was developed, drawing on elements of existing pain toolkits. In a randomized trial, low-income, primarily Hispanic patients with chronic pain received the program in 6 sessions of 1-on-1 meetings with a trained health educator in clinic or in 8 group lectures by experts in the community. Intention-to-treat analyses in linear mixed-effects models were conducted for 5 secondary outcomes at 6 months, including Brief Pain Inventory pain severity and interference, Patient Health Questionnaire-9, 12-Item Short-Form Survey Mental Component Summary, and Tampa Scale for Kinesiophobia-11. A total of 111 participants were randomized (15.9% of 700 initially eligible from 3 clinics), and 67 (60.4%) completed 6-month measures. Among completers, the clinic arm improved on 4 measures and community arm on 3 measures (all P <.05). Effect sizes were small to moderate (.41–.52). In intention-to-treat analyses, both arms improved on 4 of 5 measures (all P ≤.001) versus baseline, with clinically significant changes in Brief Pain Inventory pain severity and interference. Improvement in multiple outcomes after this chronic pain self-management program for low-income patients warrants further study. Perspective: In an evaluation of a low-literacy, 6-month chronic pain self-management program, similar improvements were observed among primarily Hispanic participants whether the intervention was delivered by a health educator or in groups with lectures from experts.

Original languageEnglish (US)
Pages (from-to)1471-1479
Number of pages9
JournalJournal of Pain
Issue number12
StatePublished - Dec 2018


  • Chronic pain
  • Hispanic
  • low-income populations
  • patient engagement
  • self-management

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Anesthesiology and Pain Medicine


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