Predictors of engagement in an internet-based cognitive behavioral therapy program for veterans with chronic low back pain.

Journal Article (Journal Article)

Internet-based interventions for chronic pain have demonstrated efficacy and may address access barriers to care. Participant characteristics have been shown to affect engagement with these programs; however, limited information is available about the relationship between participant characteristics and engagement with internet-based programs for self-management of chronic pain. The current study examined relationships between demographic and clinical characteristics and engagement with the Pain EASE program, a self-directed, internet-based cognitive behavioral therapy intervention for veterans with chronic low back pain (cLBP). Veterans with cLBP were enrolled in a 10 week trial of the Pain EASE program. Engagement measures included the number of logins, access to coping skill modules, and completed study staff-initiated weekly check-in calls. Regression analyses were conducted to identify significant predictors of engagement from hypothesized predictors (e.g., race/ethnicity, age, depressive symptom severity, and pain interference). Participants (N = 58) were 93% male, 60.3% identified as White, and had a mean age of 54.5 years. Participants logged into the program a median of 3.5 times, accessed a median of 2 skill modules, and attended a median of 6 check-in calls. Quantile regression revealed that, at the 50th percentile, non-White-identified participants accessed fewer modules than White-identified participants (p = .019). Increased age was associated with increased module use (p = .001). No clinical characteristics were significantly associated with engagement measures. White-identified race/ethnicity and increased age were associated with greater engagement with the Pain EASE program. Results highlight the importance of defining and increasing engagement in internet-delivered pain care.

Full Text

Duke Authors

Cited Authors

  • Solar, C; Halat, AM; MacLean, RR; Rajeevan, H; Williams, DA; Krein, SL; Heapy, AA; Bair, MJ; Kerns, RD; Higgins, DM

Published Date

  • June 17, 2021

Published In

Volume / Issue

  • 11 / 6

Start / End Page

  • 1274 - 1282

PubMed ID

  • 33098304

Electronic International Standard Serial Number (EISSN)

  • 1613-9860

Digital Object Identifier (DOI)

  • 10.1093/tbm/ibaa098


  • eng

Conference Location

  • England