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Empowering Pain Psychology Access and Collaboration (EPPAC) to Improve Treatment Engagement Among Medicaid-insured Adults With Chronic Low Back Pain
Sponsor: Johns Hopkins University
Summary
Chronic low back pain (cLBP) is a leading cause of disability, with socioeconomically disadvantaged populations experiencing worse outcomes and lower rates of treatment initiation for evidence-based pain psychology services. Participant engagement strategies such as shared decision-making (SDM) and motivational interviewing (MI) have shown promise in improving treatment uptake, but no study has examined whether integrating these approaches into a pain psychology evaluation can improve engagement among socioeconomically disadvantaged participants or offered participants a structured choice between cognitive behavioral therapy (CBT) and emotional awareness and expression therapy (EAET), presented to participants as Pain and Emotion Reprocessing Therapy (PERT). The Empowering Pain Psychology Access and Collaboration (EPPAC) intervention, a brief, psychologist-led engagement strategy combining SDM and MI within a standard pain psychology evaluation, was developed to address this gap.
Official title: Empowering Pain Psychology Access and Collaboration (EPPAC) to Improve Treatment Engagement Among Medicaid-insured Adults With Chronic Low Back Pain: a Pilot Randomized Controlled Trial
Key Details
Gender
All
Age Range
18 Years - 64 Years
Study Type
INTERVENTIONAL
Enrollment
70
Start Date
2026-11-02
Completion Date
2029-02-28
Last Updated
2026-10-09
Healthy Volunteers
No
Conditions
Interventions
Empowering Pain Psychology Access and Collaboration (EPPAC)
EPPAC is a brief, psychologist-led engagement strategy embedded within a standard pain psychology evaluation. It combines motivational interviewing and shared decision-making, structured pain education, a patient decision aid, two decision points, balanced discussion of CBT and EAET (presented to participants as PERT), and next-step planning to support informed engagement in pain psychology care.
Usual Care Pain Psychology Evaluation
Usual care consists of the clinic's standard pain psychology evaluation and usual discussion of clinical recommendations and treatment options. It does not include the EPPAC-specific decision aid, standardized EPPAC pain education, exact Decision Point 1 question, or EPPAC next-steps probe. CBT and EAET, presented to participants as PERT, are downstream clinical treatment options available in both study arms.
Locations (1)
Johns Hopkins Rehabilitation Psychology Clinic
Baltimore, Maryland, United States