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Randomized Controlled Trial
. 2018 Jan:64:243-253.
doi: 10.1016/j.cct.2017.09.001. Epub 2017 Sep 8.

Rationale and design of the Staying Positive with Arthritis (SPA) Study: A randomized controlled trial testing the impact of a positive psychology intervention on racial disparities in pain

Leslie R M Hausmann  1 , Said A Ibrahim  2 , C Kent Kwoh  3 , Ada Youk  4 , D Scott Obrosky  5 , Debra K Weiner  6 , Ernest Vina  3 , Rollin M Gallagher  2 , Genna T Mauro  5 , Acacia Parks  7
Affiliations
Randomized Controlled Trial

Rationale and design of the Staying Positive with Arthritis (SPA) Study: A randomized controlled trial testing the impact of a positive psychology intervention on racial disparities in pain

Leslie R M Hausmann et al. Contemp Clin Trials. 2018 Jan.

Abstract

Knee osteoarthritis is a painful, disabling condition that disproportionately affects African Americans. Existing arthritis treatments yield small to moderate improvements in pain and have not been effective at reducing racial disparities in the management of pain. The biopsychosocial model of pain and evidence from the positive psychology literature suggest that increasing positive psychological skills (e.g., gratitude, kindness) could improve pain and functioning and reduce disparities in osteoarthritis pain management. Activities to cultivate positive psychological skills have been developed and validated; however, they have not been tested in patients with osteoarthritis, their effects on racial differences in health outcomes have not been examined, and evidence of their effects on health outcomes in patients with other chronic illnesses is of limited quality. In this article we describe the rationale and design of Staying Positive with Arthritis (SPA) study, a randomized controlled trial in which 180 African American and 180 White primary care patients with chronic pain from knee osteoarthritis will be randomized to a 6-week program of either positive skill-building activities or neutral control activities. The primary outcomes will be self-reported pain and functioning as measured by the WOMAC Osteoarthritis Index. We will assess these primary outcomes and potential, exploratory psychosocial mediating variables at an in-person baseline visit and by telephone at 1, 3, and 6months following completion of the assigned program. If effective, the SPA program would be a novel, theoretically-informed psychosocial intervention to improve quality and equity of care in the management of chronic pain from osteoarthritis.

Keywords: Chronic pain; Mind-body therapies; Osteoarthritis; Psychology; Race disparities; Veterans.

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Conflict of interest statement

Potential Conflicts of Interest:

LH: No conflict.

SI: No conflict.

CK: Research funding: Abbvie, EMD Serono; Data Safety Monitoring Board: Novartis, Astellas; Advisory Board: Thusane.

AY: No conflict.

DO: No conflict.

DW: No conflict.

EV: No conflict.

RG: No conflict.

GM: No conflict

AP: Chief Scientist of, receives research funding from, and owns shares of Happify.

Figures

Figure
Figure. Key Events and Compensation
Flow of patients from screening to 6-month follow up in the Staying Positive with Arthritis Study.
See this image and copyright information in PMC

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