Recent Presentations
The relationship between patient pain severity and provider communication skills
There is growing evidence that when providers talk with patients with pain about their pain beliefs and treatment beliefs, patients are more satisfied. This poster sought to examine the relationship between patient pain severity and providers use of specific communication skills. We used linear regression to predict whether patient pain severity was related to provider communication skills related to pain cause and pain management. We found that 75.5% of providers used at least one of the twelve communication skills. 87% of providers discussed their patient’s cause of chronic pain; whereas, only 63% of providers discussed with their patients that the initial cause of their chronic pain might have changed since the start of their symptoms. Our findings suggest that providers are naturally using communication skills related to cause and self-management with their patients. However, patient’s experiences of pain do not predict whether or not providers use certain communication skills.
| Kimber, J.M., Crosky, S., Brunkow, A., Cannon, M., Winograd, D., McAndrew, L. (2021, April). The relationship between patient pain severity and provider communication skills. Poster presented at the at Society of Behavioral Medicine. |
A randomized controlled trial of health coaching for Veterans with chronic pain: Study protocol
Chronic pain is a particularly debilitating source of disability found to disrupt and decrease overall quality of life. Pain predominant chronic multisymptom illness (Pain-CMI; e.g., chronic widespread pain) is a treatment resistant chronic pain condition which is common among combat Veterans. This poster sought to describe the study protocol of a clinical trial seeking to determine the efficacy of health coaching to reduce the disability and pain impairment of Pain-CMI for Veterans. The health coaching intervention will consist of 12 weekly tele-health health coaching sessions which aim to assist the Veterans in developing and maintaining health behaviors that meet their personal life goals.Baseline assessment following screening, 6-week mid-treatment assessment, 12-week post-treatment assessment, and 24-week follow-up assessment. This study will test the efficacy of health coaching in reducing the disability and pain impairment from Pain-CMI.
| Crosky, S., McFarlin, M., Sullivan, N., Litke, D., Masheb, R., Lu, S., Costanzo, M., Anastasides, N., Gonzalez, C., Graff, F., Khatib, L., Thien, S., McAndrew, L. M. (2021, April 12-16). A randomized controlled trial of health coaching for Veterans with chronic pain: Study protocol. To be presented at the Society of Behavioral Medicine 42nd Annual Meeting. |
Impacts of COVID-19 Risk Messaging on Mask Wearing Intention
Since January 2020, there have been 8 million cases and 200,000 deaths from COVID-19 in the US. The Centers for Disease Control recommends universal mask wearing along with social distancing and other precautions to stop the spread of COVID-19. This poster sought to evaluate how COVID-19 risk messaging can impact perceived risk from COVID-19 and intentions to wear a mask. Across all messages, participants’ perceptions of the severity of risk from COVID-19 increased after reading any message. There were differences between the messages such that the message that provided information on social distancing & mask wearing increased perceptions of the severity of risk from COVID-19.We found that during the height of the pandemic, risk communication messages can increase perceptions of severity of risk from COVID-19, with a message about behaviors to reduce risk having the greatest impact. There were no differences between messages in intentions to wear a mask.
| Crosky, S., Winograd, D. M., Long, P., Kimber, J., Egli, M., Brunkow, A., Cannon, M., McFarlin, M., Breland, J. Y., Phillips, A., Santos, S., McAndrew, L. M. (2021, April 12-16). Impacts of COVID-19 Risk Messaging on Mask Wearing Intentions. To be presented at Society of Behavioral Medicine 42nd Annual Meeting. |
Veterans with Gulf War Illness perceptions of self-management strategies
Gulf War Illness (GWI) is a particularly severe persistent medically unexplained symptom/syndrome. With no symptom etiology to guide treatment, treatment for unexplained syndromes often relies on unnecessary assessments, surgeries, and consultations. Integrating guidelines recommendations like self-management is difficult because patient self-management preferences are unknown. Therefore, this study sought to evaluate which GWI self-management strategies. Results show that Veterans currently utilize a variety of self-management strategies, many of which are consistent with clinical practice guidelines for unexplained symptoms, including lifestyle change (e.g., exercise) and non-pharmacological strategies (e.g., counseling). This suggests opportunities for providers to encourage and integrate effective self-management approaches that Veterans want to use.
| Winograd D., Sullivan N, Thien S, Pigeon W., Litke D., Helmer D., Rath J., Lu S., Kimber J., Brunkow A., Cannon M., Long P., McFarlin M., Crosky S., McAndrew M. (2020). Veterans with Gulf War Illness perceptions of self-management strategies. Poster to be presented at the 42nd annual meeting of the society for behavioral medicine. |
Student Veterans' Mental Health Causal Attributions & Perceived Barriers to Care
Student veterans (SV) report more perceived barriers to seeking healthcare (e.g., mental health) compared to non-student veterans. Despite a high incidence of mental health concerns among student veterans, previous
research has not studied the relationship between student veterans' causal attributions and
perceived barriers to mental healthcare. The current study surveyed 165 student veterans across the United States. Participants were asked to report causal attributions (i.e., psychosocial, sociocultural, biological, stress) of current psychological symptoms. Our findings suggest that sociocultural and stress-related causal attributions seem to be most relevant to predict perceived barriers to care. These findings indicate that mental health settings that serve student veterans should incorporate de-stigmatizing conversation on mental health which incorporates discussions on sociocultural factors.
research has not studied the relationship between student veterans' causal attributions and
perceived barriers to mental healthcare. The current study surveyed 165 student veterans across the United States. Participants were asked to report causal attributions (i.e., psychosocial, sociocultural, biological, stress) of current psychological symptoms. Our findings suggest that sociocultural and stress-related causal attributions seem to be most relevant to predict perceived barriers to care. These findings indicate that mental health settings that serve student veterans should incorporate de-stigmatizing conversation on mental health which incorporates discussions on sociocultural factors.
| Kimber, J., Long, P., McAndrew, L. (2020, August). Student Veterans' Mental Health Causal Attributions & Perceived Barriers to Care. Poster to be presented at the 128th Annual Convention of the American Psychological Association, Washington, D.C. |
Beliefs about mental illness are related to self-management and outcomes: A meta-analysis.
Improving how clients self-manage (SM) their mental health is a primary goal of therapy. However, relatively little is known about how individuals SM their mental health. The Common-Sense Model of Self-Regulation (CSM) theorizes that people develop an understanding of their mental health, termed illness perceptions (IP), and use their IP to guide their SM, ultimately influencing health outcomes.The goal of this meta-analysis was to quantify the associations between IP, mental health outcomes and self-management (SM). Outcomes of symptoms severity and quality of life (QOL) were evaluated. Results show consequence, identity, timeline, and emotional representation beliefs are related to worse SM and health outcomes including greater symptoms and lower QOL. Greater coherence and personal control beliefs were related to better SM and health outcomes including lower symptoms and better QOL. The relationship between SM and health outcomes was smaller than the relationship of IP to either SM or health outcomes, suggesting that the pathways between IP and outcomes are not fully elucidated. The findings suggest that clients’ perspectives of their mental illness may be a key to improving outcomes and therapists should consider being responsive to clients’ perceptions about their mental illness.
| Cannon, M., Crede, M., Kimber, J., Brunkow, A., Nelson, R., Karpel, E., & McAndrew, L. (2020, August). Beliefs about mental illness are related to self-management and outcomes: A meta-analysis. Poster to be presented at the 128th Annual Convention of the American Psychological Association, Washington, D.C. |
Examining the relationship between opioid misuse and suicidality level
Little is known about the mechanisms through which suicidal ideation turns into action among this population people with chronic pain. Opioid misuse may lower inhibition and increase impulsive behavior increasing the likelihood that patients act on their suicidal ideation. The purpose of this study was to elucidate the relationship between opioid misuse and suicidality among people with chronic pain. We asked a national sample of 1090 people with chronic pain who reported feeling hopeless about their pain about their suicidal thoughts (i.e., ideation) and behaviors (i.e., attempts) in the past year. We found that among people with chronic pain, opioid misusers are more likely to have attempted suicide within the past year than opioid users or those who do not currently take opioids. Further still, findingsshow people in all groups had comparable rates of ideation, but those who misuse opioids are most likely to act on this ideation. Clinical implications include asking people with chronic pain about their history of suicidal thoughts and behaviors and current opioid use behavior.
| Long, P., McAndrew, L., Kimber, J., Brunkow, A., Cannon, M., & Winograd, D., (2020, August). Examining the relationship between opioid misuse and suicidality level. Poster to be presented at the 128th Annual Convention of the American Psychological Association, Washington, D.C. |
Treatment of patients with chronic pain at risk for suicide: Room for innovative approaches
People with chronic pain (PWCP) are at least twice as likely to die by suicide than the general population. PWCP who die by suicide are more likely to see a primary care provider than mental health provider. We conducted a national survey of 1090 PWCPs who were feeling hopeless. We asked where and from whom they would be interested in receiving treatments for their hopelessness. Overall, PWCPs at risk for suicide are most interested in receiving treatments in primary care and are open to either mental health or medical providers. A small proportion at highest risk for suicide are open to receiving treatment in mental health. These findings suggest opportunities to integrate suicide treatment into medical settings to reduce suicide risk for this high-risk population.
| Brunkow, A., Cannon, M., Kimber, J., Long, P., Winograd, D., & McAndrew, L. (2020, April). Treatment of patients with chronic pain at risk for suicide: Room for innovative approaches. Poster to be presented at the 41st Annual Convention of the Society of Behavioral Medicine, San Francisco, CA |
Patients interest in integrating treatment for suicide prevention into treatment for chronic pain
Patients with chronic pain are at elevated risk for suicidal ideations and suicide attempts, however, few receive treatment for their suicide risk. The goal of this study was to understand the types of intervention patients with chronic pain and suicide risk are interested in receiving. This study used a national, online, and anonymous survey of 1,090 chronic pain patients. The survey evaluated individual’s interest in seeking behavioral treatment for pain, for hopelessness, along with doctor recommendations. Results indicate that individuals with chronic pain and hopelessness are not regularly interested in behavioral or medication treatment for hopelessness. They are interested in receiving behavioral and medication treatment for their pain. Importantly, they were also interested in receiving behavioral treatment that integrates treatment for hopelessness within treatment for their chronic pain. Future research should examine the efficacy of integrating suicide prevention treatment into care for chronic pain.
| Winograd, D., Brunkow, A., Cannon, M., Long, P., Kimber, J., & McAndrew, L. (2020, August). Patients interest in integrating treatment for suicide prevention into treatment for chronic pain. Poster to be presented at the 128th Annual Convention of the American Psychological Association, Washington, D.C. |
| Poster |
Feasibility and Acceptability of Health Coaching for Chronic Pain
We are conducting a feasibility acceptability pilot for patients comparing health coaching to a
treatment as usual control. We recruited 40 patients and found 100% completed their baseline assessment and thus far, 80% completed their post-treatment assessment (n=20 completed baseline). Patients find health coaching to be acceptable with over 90% completing their sessions and over 90% being satisfied. Health coaching impacted the cognitive behavioral mechanisms underlying pain, as patients achieved their goals (e.g., increased exercise), they decreased activity limiting(Cohen’s d = ~.50) and were less likely to feel pain is unbearable (i.e., decreased catastrophizing; Cohen’s d = ~1.0). This led to reductions in pain impairment (Cohen’s d = ~1.0) and disability (Cohen’s d > 1.0) as compared to the control arm. This pilot study found that health coaching was acceptable and feasible.
We are conducting a feasibility acceptability pilot for patients comparing health coaching to a
treatment as usual control. We recruited 40 patients and found 100% completed their baseline assessment and thus far, 80% completed their post-treatment assessment (n=20 completed baseline). Patients find health coaching to be acceptable with over 90% completing their sessions and over 90% being satisfied. Health coaching impacted the cognitive behavioral mechanisms underlying pain, as patients achieved their goals (e.g., increased exercise), they decreased activity limiting(Cohen’s d = ~.50) and were less likely to feel pain is unbearable (i.e., decreased catastrophizing; Cohen’s d = ~1.0). This led to reductions in pain impairment (Cohen’s d = ~1.0) and disability (Cohen’s d > 1.0) as compared to the control arm. This pilot study found that health coaching was acceptable and feasible.
