Principal Investigator: Kim Tippens, ND, MSAOM, MPH
Abstract: Chronic pain affects over 100 million Americans and significantly impacts morbidity, mortality and disability in the United States. Low-income populations, racial and ethnic minorities and those with limited access to healthcare suffer disproportionately from inadequate prevention, assessment and treatment of pain. A growing body of evidence supports the use of acupuncture in treating pain conditions, but availability and access to acupuncture are limited. Community acupuncture (CA) is an increasingly popular model of acupuncture delivery that provides low-cost treatments in group-based settings. By increasing access to affordable group acupuncture, the CA model is a promising approach to pain management for the underserved. Through low-cost treatments, the CA model facilitates frequent acupuncture use, which may enhance treatment effects of acupuncture. However, the quality and effectiveness of CA treatments have been questioned because group-based delivery shortens the length of consultations and limits the acupuncture points and techniques used to treat patients. Our long-term objectives are to evaluate effectiveness, accessibility, engagement and retention within the CA model, and to determine its role in pain management for the underserved. We hypothesize that the CA model facilitates patient engagement and retention, and improves clinical symptoms. Using a mixed-methods design and community-based partnership, we will investigate clinical and patient-centered outcomes of CA for chronic pain among underserved patients in a pragmatic randomized controlled trial (RCT). To ensure success of this work, we propose a pilot RCT to test feasibility and select appropriate outcomes. Sixty chronic back and neck pain sufferers will be randomized to eight weeks of CA in addition to usual care or to waitlist control (usual care alone). We will assess recruitment potential from local safety net clinics, adequacy of incentives for participation, attrition, methods for data collection in CA clinic sites, and patient follow-up. Preliminary data on the effect of CA treatments on pain outcomes will be analyzed to inform sample size estimates for a larger randomized trial. We will also explore patient perspectives on effectiveness, accessibility, engagement, and retention in community acupuncture through individual in-depth qualitative interviews. The proposed research aims to develop evidence, based in real-world practices, about the potential of community-based group acupuncture to improve pain management and health promotion.