The University of Oklahoma has secured $3.4 million in funding from the US National Institutes of Health (NIH) to develop and test a mobile health application designed to improve access to chronic pain treatment among Native American communities.
The five-year research project will combine digital health technology, psychological treatment methods and Indigenous knowledge to develop a culturally tailored intervention for people experiencing chronic pain.
Led by the university’s TSET Health Promotion Research Center in Tulsa, the initiative will involve community consultation, application development, prototype testing and a randomised controlled trial to evaluate the intervention’s effectiveness.
The project responds to research indicating that nearly one in three Native Americans experience chronic pain, a higher proportion than any other population group in the United States.
Financial constraints, geographic isolation and limited access to specialist healthcare services can make conventional in-person treatment difficult to obtain.
Five-year programme combines technology and community engagement
The project, titled Tailored Mobile Health Technology to Address Native American Chronic Pain, will be led by Jamie L. Rhudy, a professor in the University of Oklahoma’s Department of Health Promotion Sciences and site director of the TSET Health Promotion Research Center.
The research team will develop the application using the Insight mHealth Platform, an existing technology framework designed to support the development, testing and deployment of smartphone- and tablet-based health interventions.
The platform was created by Michael Businelle, co-director of the TSET Health Promotion Research Center.
Rather than developing a standardised treatment programme, the research team intends to work directly with Native American communities to determine the application’s design, content and delivery approach.
Rhudy said the university’s location in Oklahoma provides an important foundation for the research.
“Oklahoma was the end of the Trail of Tears and other forced relocations,” he said. “Our location puts us in a unique position to address this work.”
Community consultation to inform application development
A central component of the project will involve engagement with Native Americans living with chronic pain.
Working with Joanna O. Shadlow, a member of the Osage Nation and teaching professor of psychology at Oklahoma State University-Tulsa, the research team will conduct focus groups and interviews to understand participants’ experiences and treatment needs.
The findings will inform the application’s design and the selection of interventions.
Mark Lumley, a distinguished professor of psychology at Wayne State University, will contribute expertise in evidence-based chronic pain treatments.
The intervention is expected to address factors including stress, anxiety, sleep, physical health and culturally relevant lifestyle practices.
Rhudy said previous research had identified several factors associated with chronic pain among Native American populations, including interpersonal discrimination, stress, high blood pressure and sleep disturbances.
“Sleep, stress and discrimination are not variables easily targeted by medications, but they do respond well to targeted psychological and behavioral interventions,” he said.
The project will seek to translate these findings into digital exercises and recommendations that can be accessed remotely.
Prototype development followed by clinical evaluation
The research programme will progress through several stages, beginning with community engagement and requirements development.
The team will then create and test a prototype before undertaking a randomised controlled trial of the completed mobile health intervention.
The trial will assess the effectiveness of the application in supporting chronic pain management.
By using an existing digital health development platform, the project aims to create an intervention that can eventually be deployed more widely without relying exclusively on in-person treatment facilities.
Rhudy said the combination of community expertise, psychological research and digital technology would support the development of a scalable intervention.
“With the team we have in place we’ll be able to bring all the necessary components together to develop, test and deploy a novel, culturally tailored chronic pain intervention that will be scalable,” he said.
Project addresses barriers to healthcare access
Chronic pain, generally defined as pain lasting longer than three months, can affect physical health, mental wellbeing and everyday activities.
The University of Oklahoma initiative aims to address treatment access challenges experienced by Native American communities, particularly those living significant distances from specialist healthcare facilities.
The research builds on previous work, including the Oklahoma Study of Native American Pain Risk, conducted between 2013 and 2018.
That study examined factors contributing to chronic pain disparities and provides part of the evidence base for the new intervention.
The latest programme is funded through the NIH’s National Institute on Minority Health and Health Disparities, under award R01MD021599.
The five-year project will bring together researchers from multiple institutions and Native American community participants to develop, implement and evaluate the intervention.
Its outcomes will help determine whether culturally tailored mobile health technology can provide an effective and scalable approach to managing chronic pain in underserved communities.
