Key Points Question Is positive psychology effective as a treatment for chronic arthritis pain and does it reduce race disparities in pain management? Findings In this randomized clinical trial involving 360 Veterans Affairs patients with chronic pain from osteoarthritis, a 6-week telephone-administered positive psychological intervention did not improve pain or functional difficulty vs a control program. No difference by race was found in the effect of the intervention. Meaning A telephone-administered positive psychological intervention was not associated with improvement in chronic pain or functional difficulty from osteoarthritis for either white or African American patients.

Background Healthcare experiences associated with perceived racial/ethnic discrimination among patients are poorly understood. Objective Identify domains of patient dissatisfaction associated with perceived racial/ethnic discrimination among patients with pain. Design Semi-structured telephone surveys completed in 2013-2015. Participants White, African American, and Latino participants who reported receiving pain management from 25 Veterans Affairs (VA) Medical Centers. Main measures Surveys included open-ended questions about healthcare satisfaction/dissatisfaction and a measure of perceived racial/ethnic-based discrimination while seeking VA healthcare. Binary indicators for ten qualitative domains of dissatisfaction were derived from openended questions. We used multilevel models to identify dissatisfaction domains associated with perceived discrimination, adjusting for patient characteristics and site. Within domains associated with discrimination, we identified the most frequent codes and examined whether patients primarily referenced clinical or non-clinical staff in their experiences.

Purpose The purpose of the study was to explore an understanding of the psychosocial-behavioral impact of diabetes self-management among veterans with diabetes. Methods Twenty-six veterans participated in 1 of 9 focus groups that were conducted following a group diabetes self-management education class and prior to a mindfulness intervention as part of a feasibility pilot study. Discussions were guided by open-ended questions that addressed the overarching research question, “How do attitudes and experiences with diabetes inform psychosocial-educational approaches to diabetes self-management education and care for veterans?” Focus groups were audio-recorded and transcribed. The data was then independently coded and thematically analyzed by 2 coders. Results Five main themes that reflect veterans’ perceptions of their experiences with diabetes and diabetes self-management were identified: (1) distress and negative emotions, (2) social isolation, (3) perceived lack of control, (4) attitudes toward diabetes support, and (5) desire for information about stress, diabetes, health, and behavior. Conclusions Veterans experience emotional distress and have unmet psychosocial needs related to diabetes self-management. Insight gained from these veteran perspectives suggests a framework for integrating psycho-educational interventions like mindfulness into diabetes care that emphasize stress reduction, person-centered communication, and opportunities for peer support.