Psychosocial Predictors of Chronic Musculoskeletal Pain Outcomes and their Contextual Determinants Among Black Individuals: A Narrative Review

Bakhshaie, Jafar; Penn, Terence; Doorley, James; Pham, Tony V; Greenberg, Jonathan; Bannon, Sarah M.; Saadi, Altaf; Vranceanu, Ana‐Maria

doi:10.1016/j.jpain.2022.04.013

Cited by 11 publications

(4 citation statements)

References 138 publications

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“…For example, Black African female participants in our study said that pain is viewed as a disability, leading to negative disclosure behavior (ie, people are less likely to report their pain). This aligns with findings from a review by Bakhshaie et al [ 9 ] in 2022 who suggested that stigma internalization (eg, when somebody links their disability to their personality) in Black individuals results from the interplay between interpersonal, community, and societal factors, which in turn is related to discrimination and societal injustice [ 9 ]. Similarly, South Asians indicated that pain among women is considered inevitable because of women’s household responsibilities.…”

Section: Discussionsupporting

confidence: 86%

“…For example, lower socioeconomic status is associated with higher bodily pain levels in the United Kingdom, Australia, and Germany, particularly in older people [ 6 ], and pain is more prevalent among the Black and Asian ethnic minorities [ 7 ]. Asians are less likely to receive pain medication than White patients [ 8 ], and Black individuals may have different pain management preferences and expectations [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

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Exploring the Cross-cultural Acceptability of Digital Tools for Pain Self-reporting: Qualitative Study

Ali¹,

Lee²,

McBeth³

et al. 2023

JMIR Hum Factors

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Background Culture and ethnicity influence how people communicate about their pain. This makes it challenging to develop pain self-report tools that are acceptable across ethnic groups. Objective We aimed to inform the development of cross-culturally acceptable digital pain self-report tools by better understanding the similarities and differences between ethnic groups in pain experiences and self-reporting needs. Methods Three web-based workshops consisting of a focus group and a user requirement exercise with people who self-identified as being of Black African (n=6), South Asian (n=10), or White British (n=7) ethnicity were conducted. Results Across ethnic groups, participants shared similar lived experiences and challenges in communicating their pain to health care professionals. However, there were differences in beliefs about the causes of pain, attitudes toward pain medication, and experiences of how stigma and gender norms influenced pain-reporting behavior. Despite these differences, they agreed on important aspects for pain self-report, but participants from non-White backgrounds had additional language requirements such as culturally appropriate pain terminologies to reduce self-reporting barriers. Conclusions To improve the cross-cultural acceptability and equity of digital pain self-report tools, future developments should address the differences among ethnic groups on pain perceptions and beliefs, factors influencing pain reporting behavior, and language requirements.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Exploring the Cross-cultural Acceptability of Digital Tools for Pain Self-reporting: Qualitative Study

Ali¹,

Lee²,

McBeth³

et al. 2023

JMIR Hum Factors

View full text Add to dashboard Cite

show abstract

“…For example, ethnic minority groups may experience inequalities in pain prevalence and treatment outcomes because of perceived racial injustice, culturally adopted pain coping strategies and their preferences for seeking health services. 46 , 71 Future studies need to actively engage with these groups to better understand their reporting preferences and requirements and how digital manikins can address these. Such studies should be guided by a structured approach to assessing the health equity impact of digital tools that involves all stakeholders, including people with lived experience.…”

Section: Discussionmentioning

confidence: 99%

Feasibility and acceptability to use a smartphone-based manikin for daily longitudinal self-reporting of chronic pain

et al. 2023

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Background As management of chronic pain continues to be suboptimal, there is a need for tools that support frequent, longitudinal pain self-reporting to improve our understanding of pain. This study aimed to assess the feasibility and acceptability of daily pain self-reporting using a smartphone-based pain manikin. Methods For this prospective feasibility study, we recruited adults with lived experience of painful musculoskeletal condition. They were asked to complete daily pain self-reports via an app for 30 days. We assessed feasibility by calculating pain report completion levels, and investigated differences in completion levels between subgroups. We assessed acceptability via an end-of-study questionnaire, which we analysed descriptively. Results Of the 104 participants, the majority were female ( n = 87; 84%), aged 45-64 ( n = 59; 57%), and of white ethnic background ( n = 89; 86%). The mean completion levels was 21 (± 7.7) pain self-reports. People who were not working (odds ratio (OR) = 1.84; 95% confidence interval (CI), 1.52-2.23) were more likely, and people living in less deprived areas (OR = 0.77; 95% CI, 0.62-0.97) and of non-white ethnicity (OR = 0.45; 95% CI, 0.36-0.57) were less likely to complete pain self-reports than their employed, more deprived and white counterparts, respectively. Of the 96 participants completing the end-of-study questionnaire, almost all participants agreed that it was easy to complete a pain drawing ( n = 89; 93%). Conclusion It is feasible and acceptable to self–report pain using a smartphone–based manikin over a month. For its wider adoption for pain self–reporting, the feasibility and acceptability should be further explored among people with diverse socio–economic and ethnic backgrounds.

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“…Future work in this area may benefit from studying approaches to facilitate improved pain care for minoritized patients in the face of ongoing systemic biases. 2,5,30 For example, enhancing access to empirically supported treatments for chronic pain, 30 improving assessment and intervention approaches that address psychosocial risk factors such as high levels of distress, 34,35 and using diverse teams of healthcare providers to support culturally competent care 26 all have the potential to universally improve pain outcomes, with the largest effects on patients from minority and underserved backgrounds, which could aid in reducing the existing painrelated disparities.…”

Section: Discussionmentioning

confidence: 99%

Race differences in pain and pain-related risk factors among former professional American-style football players

Edwards¹,

Tan

Dairi³

et al. 2023

Pain

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The burden of pain is unequal across demographic groups, with broad and persisting race differences in pain-related outcomes in the United States. Members of racial and ethnic minorities frequently report more pervasive and severe pain compared with those in the majority, with at least some disparity attributable to differences in socioeconomic status. Whether race disparities in pain-related health outcomes exist among former professional football players is unknown. We examined the association of race with pain outcomes among 3995 former professional American-style football players who self-identified as either Black or White. Black players reported more intense pain and higher levels of pain interference relative to White players, even after controlling for age, football history, comorbidities, and psychosocial factors. Race moderated associations between several biopsychosocial factors and pain; higher body mass index was associated with more pain among White but not among Black players. Fatigue and psychosocial factors were more strongly related to pain among Black players relative to White players. Collectively, the substantial social and economic advantages of working as a professional athlete did not seem to erase race-related disparities in pain. We highlight an increased burden of pain among elite Black professional football players and identify race-specific patterns of association between pain and biopsychosocial pain risk factors. These findings illuminate potential future targets of interventions that may serve to reduce persistent disparities in the experience and impact of pain.

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Psychosocial Predictors of Chronic Musculoskeletal Pain Outcomes and their Contextual Determinants Among Black Individuals: A Narrative Review

Cited by 11 publications

References 138 publications

Exploring the Cross-cultural Acceptability of Digital Tools for Pain Self-reporting: Qualitative Study

Exploring the Cross-cultural Acceptability of Digital Tools for Pain Self-reporting: Qualitative Study

Feasibility and acceptability to use a smartphone-based manikin for daily longitudinal self-reporting of chronic pain

Race differences in pain and pain-related risk factors among former professional American-style football players

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