title: A brief peer support intervention for veterans with chronic musculoskeletal pain: a pilot study of feasibility and effectiveness.
abstract: OBJECTIVE
  The aim of this study was to pilot test a peer support intervention, involving peer delivery of pain self-management strategies, for veterans with chronic musculoskeletal pain.
  
  
  METHODS
  Pretest/posttest with 4-month intervention period.
  
  
  METHODS
  Ten peer coaches were each assigned 2 patients (N = 20 patients). All had chronic musculoskeletal pain. Guided by a study manual, peer coach-patient pairs were instructed to talk biweekly for 4 months. Pain was the primary outcome and was assessed with the PEG, a three-item version of the Brief Pain Inventory, and the PROMIS Pain Interference Questionnaire. Several secondary outcomes were also assessed. To assess change in outcomes, a linear mixed model with a random effect for peer coaches was applied.
  
  
  RESULTS
  Nine peer coaches and 17 patients completed the study. All were male veterans. Patients' pain improved at 4 months compared with baseline but did not reach statistical significance (PEG: P = 0.33, ICC [intra-class correlation] = 0.28, Cohen's d = -0.25; PROMIS: P = 0.17, d = -0.35). Of secondary outcomes, self-efficacy (P = 0.16, ICC = 0.56, d = 0.60) and pain centrality (P = 0.06, ICC = 0.32, d = -0.62) showed greatest improvement, with moderate effect sizes.
  
  
  CONCLUSIONS
  This study suggests that peers can effectively deliver pain self-management strategies to other veterans with pain. Although this was a pilot study with a relatively short intervention period, patients improved on several outcomes.
authors.affiliation: VA HSR&D Center for Health Information and Communication, Roudebush VA Medical Center, Indianapolis, Indiana, USA; Regenstrief Institute, Inc., Indianapolis, Indiana, USA; Department of Communication Studies, Indiana University-Purdue University, Indianapolis, Indiana, USA.
authors.forename: Marianne S
authors.initials: MS
authors.lastname: Matthias
authors.forename: Alan B
authors.initials: AB
authors.lastname: McGuire
authors.forename: Marina
authors.initials: M
authors.lastname: Kukla
authors.forename: Joanne
authors.initials: J
authors.lastname: Daggy
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Myers
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Bair
mesh_terms: D000368:Aged; D059350:Chronic Pain / Q000534:rehabilitation*; D003376:Counseling / Q000379:methods*; D005240:Feasibility Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000534:rehabilitation*; D059408:Pain Management / Q000379:methods*; D010379:Peer Group; D010865:Pilot Projects; D012648:Self Care / Q000379:methods; D014728:Veterans
keywords: Chronic Pain; Pain Management; Social Support