Barriers and Facilitators to Implementing Bundled Acupuncture and Yoga Therapy to Treat Chronic Pain in Community Healthcare Settings: A Feasibility Pilot

Anderson, Belinda; Meißner, Paul; Mah, Donna M; Nielsen, Arya; Moonaz, Steffany; McKee, M. Diane; Kligler, Benjamin; Milanes, Mirta; Guerra, Hernidia; Teets, Raymond

doi:10.1089/acm.2020.0394

Cited by 8 publications

(3 citation statements)

References 56 publications

(73 reference statements)

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“…Factors associated with implementing bundled therapies at health centers that care for underserved populations are discussed in a separate paper. 79 Study challenges included difficulty reaching lower socioeconomic participants by telephone during recruitment, and site coordination to integrate group acupuncture with yoga therapy. In addition, the COVID pandemic caused the study to be stopped early before full recruitment could be achieved.…”

Section: Discussionmentioning

confidence: 99%

Group Acupuncture Therapy With Yoga Therapy for Chronic Neck, Low Back, and Osteoarthritis Pain in Safety Net Settings for an Underserved Population: A Feasibility Pilot Study

Teets,

Nielsen,

Moonaz

et al. 2023

Global Advances in Integrative Medicine and Health

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Background Acupuncture and yoga have both been shown to be effective in chronic pain. Underrepresented populations have poorer pain outcomes with less access to effective pain care. Objective To assess the feasibility of bundling group acupuncture with yoga therapy for chronic neck, back or osteoarthritis pain in safety net settings. Methods This was a feasibility pilot in Bronx and Harlem primary care community health centers. Participants with chronic neck, back or osteoarthritis pain received acupuncture and yoga therapy over a 10-week period. Participants received 10 weekly acupuncture treatments in group setting; with Yoga therapy sessions beginning immediately following the 3rd session. Primary outcome was pain interference and pain intensity on the Brief Pain Inventory (BPI); Outcomes were measured at baseline, 10-week close of intervention, and 24-week follow-up. Results 93 patients were determined to be eligible and completed the baseline interview. The majority of participants were non-White and Medicaid recipients. 78 (84%) completed the intervention and 10-week survey, and 58 (62%) completed the 24-week post intervention survey. Participants received an average number of 6.5 acupuncture sessions (out of a possible 10), and 4 yoga sessions (out of a possible 8) over the 10-week intervention. Patients showed statistically significant improvements in pain at the close of the intervention and at a somewhat lesser rate, at 24-weeks post intervention. Challenges included telephone outreach and site coordination integrating acupuncture with yoga therapy. The trial also had to be stopped early due to the COVID-19 pandemic. Conclusions Bundling acupuncture therapy and yoga therapy is feasible for an underrepresented population with chronic pain in urban community health centers with preliminary indications of acceptability and benefit to participants.

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Section: Discussionmentioning

confidence: 99%

Group Acupuncture Therapy With Yoga Therapy for Chronic Neck, Low Back, and Osteoarthritis Pain in Safety Net Settings for an Underserved Population: A Feasibility Pilot Study

Teets,

Nielsen,

Moonaz

et al. 2023

Global Advances in Integrative Medicine and Health

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“…19 Adequate access to trained professionals, limited Medicare coverage, and fear of needles are common barriers to acupuncture that nurses can help address. [20][21][22] Self-management strategies. Sleep hygiene, maintaining a healthy weight and diet, and using dietary supplements may alleviate musculoskeletal pain with little risk.…”

Section: • Topical Capsaicin (Such As Capzasin or Salonpasmentioning

confidence: 99%

“…Acupuncture can safely and effectively treat pain and discomfort while improving ability to function and well-being 19. Adequate access to trained professionals, limited Medicare coverage, and fear of needles are common barriers to acupuncture that nurses can help address 20-22…”

Section: Lower-risk Approaches To Managing Painmentioning

confidence: 99%

Managing Older Adults' Chronic Pain

Arnstein

Shade

Herr

et al. 2023

Home Healthcare Now

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This article is part of a series, Supporting Family Caregivers: No Longer Home Alone, published in collaboration with the AARP Public Policy Institute. Results of focus groups, conducted as part of the AARP Public Policy Institute's No Longer Home Alone video project, supported evidence that family caregivers aren't given the information they need to manage the complex care regimens of family members. This series of articles and accompanying videos aims to help nurses provide caregivers with the tools they need to manage their family member's health care at home. This new group of articles provides practical information nurses can share with family caregivers of persons living with pain. To use this series, nurses should read the articles first, so they understand how best to help family caregivers. Then they can refer caregivers to the informational tear sheet—Information for Family Caregivers—and instructional videos, encouraging them to ask questions. For additional information, see Resources for Nurses. Cite this article as: Arnstein, P., et al. Managing Older Adults' Chronic Pain: Lower-Risk Interventions. Am J Nurs 2023; 123 (2): 46-52.

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Primary care barriers and facilitators to nonpharmacologic treatments for low back pain: A qualitative pilot study

Roseen,

Joyce,

Winbush

et al. 2024

PM&R

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BackgroundClinical practice guidelines encourage primary care providers (PCPs) to recommend nonpharmacologic treatment as first‐line therapy for low back pain (LBP). However, the determinants of nonpharmacologic treatment use for LBP in primary care remain unclear, particularly in low‐income settings.ObjectiveTo pilot a framework‐informed interview guide and codebook to explore determinants of nonpharmacologic treatment use in primary care.MethodsIn this qualitative interview study, we enrolled PCPs and community health workers (CHWs) from four primary care clinics at a safety net hospital. A semistructured interview guide informed by the Consolidated Framework for Implementation Research (CFIR) guided inquiry on barriers/facilitators to nonpharmacologic treatments for LBP (eg, acupuncture, chiropractic care, physical therapy). We included questions on whether current CHW roles may address barriers to nonpharmacologic treatment use. Interviews were audio‐recorded, transcribed verbatim, and independently coded by four investigators. An a priori codebook composed of CFIR determinants and known CHW roles guided deductive content analysis to identify major themes.ResultsEight individuals (six PCPs, two CHWs; age range: 32–51 years, five female) participated in hour‐long interviews. Half had worked at the hospital for ≥15 years and all reported seeing patients with LBP (range: 2–20 patients per week). All participants identified the following CFIR factors as barriers/facilitators: nonpharmacologic treatment characteristics (perceived cost, relative advantage compared to other treatments); outer setting (patient needs/resources, limited connections with community‐based nonpharmacologic treatment) and PCP characteristics (attitudes/beliefs about nonpharmacologic treatments). Although participants indicated several CHW roles could be adapted to address barriers (eg, care coordination, resource linking, case management), other roles seemed less feasible (eg, targeted health education) in our health care system.ConclusionsPreliminary insight on key determinants of nonpharmacologic treatments for LBP should be further examined in large multisite studies. Future studies may also determine whether a CHW‐led strategy can improve nonpharmacologic treatment access and clinical outcomes in primary care.

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Barriers and Facilitators to Implementing Bundled Acupuncture and Yoga Therapy to Treat Chronic Pain in Community Healthcare Settings: A Feasibility Pilot

Cited by 8 publications

References 56 publications

Group Acupuncture Therapy With Yoga Therapy for Chronic Neck, Low Back, and Osteoarthritis Pain in Safety Net Settings for an Underserved Population: A Feasibility Pilot Study

Group Acupuncture Therapy With Yoga Therapy for Chronic Neck, Low Back, and Osteoarthritis Pain in Safety Net Settings for an Underserved Population: A Feasibility Pilot Study

Managing Older Adults' Chronic Pain

Primary care barriers and facilitators to nonpharmacologic treatments for low back pain: A qualitative pilot study

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