Acceptability and Feasibility of a Pain and Depressive Symptoms Management Intervention in Middle-Aged and Older African American Women

Abstract

Background and Objectives The intersection of race, gender and age puts older African American women at high risk of experiencing comorbid pain and depressive symptoms. The purpose of this study was to assess feasibility and acceptability of a 12-week behavioral activation intervention to target self-selected goals related to pain and depressive symptoms in middle aged and older African American women. Research Design and Methods This randomized waitlist control study included 34 self-identified African American women, 50 years of age or older, with moderate to severe chronic pain and depressive symptoms. The intervention consisted of eight in person or virtual 1-hour visits with a nurse. Follow-up acceptability assessments were conducted with 10 participants. Results The average age of the participants was 64.8 (SD: 10.5). They reported an average pain intensity score of 7.0 (SD:1.9) out of 10 and an average PHQ-9 depressive symptoms score of 11.9 (SD:4.0) at baseline. Of the 34 participants who consented, 28 (82.4%) women started the intervention, and 23 (82.1%) completed the intervention. Participants described the study as useful and beneficial. Participants recommended including a group component in future iterations. Effect sizes at 12 weeks were -0.95 for depressive symptoms indicating a substantial decrease in experienced depressive symptoms, but pain intensity was virtually unchanged (+ 0.09). Discussion and Implications The findings of this study demonstrate that the intervention is acceptable among middle-aged and older African American women and their personal goals were met. Including a group component and identifying effective ways to decrease attrition rates will be key in the next steps of development for this intervention. It is crucial to provide tailored, non-pharmacological approaches to pain, and depression symptom management in older adult populations who experience inequities in pain and mental health outcomes. This study emphasizes the importance of participant-driven goal-setting interventions.

Introduction to Special Issue: Translational Research on Pain and Pain Management in Later Life

“… Taylor et al (2023) employed a pilot RCT design to evaluate the feasibility, acceptability, and preliminary efficacy of a behavioral intervention for use by middle-aged and older African American women experiencing comorbid pain and depressive symptoms. The intervention employed behavioral activation with individual goal setting and consisted of up to eight in-person (or virtual) visits with a nurse interventionist.…”