Clinical trial NCT05492903: COMmunity of Practice And Safety Support for Navigating Pain (COMPASS-NP)
Official title: Translating an Intervention to Address Chronic Pain Among Home Care Workers
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Pain Management
Ergonomics
Wounds and Injuries
Keywords: injury prevention
pain management
ergonomics
home care workers
total worker health
cognitive behavioral therapy
Lead sponsor: Oregon Health and Science University
Sponsor class: OTHER
First posted: 2022-08-09
Enrollment: 140
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: CROSSOVER
Intervention model description: cluster-randomized waitlist control design
Primary purpose: PREVENTION

Brief summary: Home care workers (HCWs) are at-risk for chronic pain and associated problems, including emotional distress, opioid use and misuse, and work-related disability. To address these issues, the proposed study will adapt an established peer-led and supportive group program to address the needs of HCWs with chronic pain. The new program, named COMPASS for Navigating Pain (COMPASS-NP), will integrate work-based injury protections with pain education and cognitive-behavioral therapy strategies for pain self-management in order to reduce pain interference with HCWs' work and life, and advance their safety, health, and well-being.

Detailed description: Organizational intervention research can be all breakthrough with no follow-through. Few effective interventions developed by scientists are widely adopted in practice. To address this research-to-practice gap and address a socially important problem, the investigators will translate their established and disseminated COMPASS (COMmunity of Practice And Safety Support) intervention to address the needs of home care workers (HCWs) with chronic pain. The burden of injuries and pain is great among HCWs, which places them at-risk for emotional distress, opioid use/misuse, and work-related disability. Moreover, HCWs are predominantly low income, middle aged women. Between 1999 and 2015 middle-aged women experienced a 471% increase in prescription opioid-related overdoses. COMPASS is a peer-led and scripted group curriculum that produced many significant impacts on meaningful outcomes for HCWs in a randomized controlled trial (Cohen's d range = .45 to .84), including increased safety communication with clients and hazard correction in homes. COMPASS was subsequently adopted by the Oregon Home Care Commission, and is currently offered statewide as a paid training course to publicly funded HCWs. While these are exceptional research-to-practice impacts, the original curriculum did not directly address chronic pain, and resulted in only small non-significant reductions in pain severity. The investigators also found that HCWs with pain-related limitations at baseline made significant safety changes, but experienced less benefit from the intervention than workers without limitations. An added barrier is that protective low-tech ergonomic tools (e.g., slide boards, transfer belts) are typically not funded by insurance. The investigators' qualitative research revealed that low-wage HCWs are often forced to improvise or do without such tools. In the translation plan, existing COMPASS lessons will be adapted for HCWs with chronic pain, and new lessons from the Pain Survival Guide (co-authored by Dr. Turk, Co-I) will integrate pain education and proven cognitive-behavioral therapy pain self-management strategies. The investigators will also strengthen injury protections by including an online ergonomic assessment and voucher for HCWs to purchase tools. The translated COMPASS for Navigating Pain (COMPASS-NP) intervention will be evaluated with a cluster randomized waitlist control design. The primary hypothesis is that COMPASS-NP will reduce pain interference with work and life. Secondary outcomes include pain/injury prevention behaviors (e.g., ergonomic tool use), injuries, pain severity, risk for opioid misuse, and worker well-being. Regional implementation and evaluation with partners in Oregon (government), Washington (labor), and Idaho (private sector) will maximize dissemination knowledge and impact. The 5-year project will accomplish 4 aims: 1) Adapt and pilot COMPASS-NP in Oregon; 2) Determine effects of COMPASS-NP across Oregon, Washington, and Idaho; 3) Describe the translation and implementation of COMPASS-NP across partners and systems; and 4) Disseminate COMPASS-NP knowledge, tools, and toolkits.

Eligibility criteria: Inclusion Criteria:

* 18 years (adults)
* Employed as a home care worker
* Has chronic pain (pain lasting 3+ months and \> 4 average intensity)
* The presence of pain interference with work (response of 'agree' or 'strongly agree' on single-item)
* Currently working 4 hours or more per week
* Access to the internet with a video capable device (e.g., smart phone, tablet, or computer)

Exclusion Criteria:

* Prior exposure to the original COMPASS program
* Experiencing a surgery in the prior 6 months
* Current pregnancy or intention to become pregnant during the study period.

Primary outcomes:
measure: Between Groups Difference in Changes in Ratings of Pain Interference with Work
timeFrame: Changes between 0 weeks and 10 weeks
measure: Between Groups Difference in Changes in Ratings of Pain Interference with Life
timeFrame: Changes between 0 weeks and 10 weeks
Secondary outcomes:
measure: Between Groups Difference in Changes in Reported Number of Pain/Injury Prevention Actions
timeFrame: Changes between 0 weeks and 10 weeks
measure: Between Groups Difference in Changes in Reported Number of Minor Injuries
timeFrame: Changes between 0 weeks and 10 weeks
measure: Between Groups Difference in Changes in Reported Number of Lost Work Time Injuries
timeFrame: Changes between 0 weeks and 10 weeks
measure: Between Groups Difference in Changes in the Rating of Average Pain Severity
timeFrame: Changes between 0 weeks and 10 weeks
measure: Between Groups Difference in Changes in Ratings of Well-being
timeFrame: Changes between 0 weeks and 10 weeks
measure: Between Groups Difference in Changes in Daily Minutes of Physical Activity
timeFrame: Changes between 0 weeks and 10 weeks
measure: Between Groups Difference in Changes in Average Nightly Sleep Duration
timeFrame: Changes between 0 weeks and 10 weeks
measure: Between Groups Difference in Changes in Average Nightly Sleep Efficiency
timeFrame: Changes between 0 weeks and 10 weeks
measure: Between Groups Difference in Changes in Pain Medication Use
timeFrame: Changes between 0 weeks and 10 weeks
measure: Between Groups Difference in Changes in Risk of Future Opioid Misuse
timeFrame: Changes between 0 weeks and 10 weeks
measure: Between Groups Difference in Changes in Current Opioid Misuse
timeFrame: Changes between 0 weeks and 10 weeks
Other outcomes:
Locations:
city: Portland
country: United States
facility: Oregon Health & Science University
state: Oregon
Study officials:
References: