title: Applying the RE-AIM Framework to Evaluate Integrative Medicine Group Visits Among Diverse Women with Chronic Pelvic Pain.
abstract: The purpose of this study was to evaluate group medical visits using an integrative health approach for underserved women with chronic pelvic pain (CPP). We implemented an integrative medicine program to improve quality of life among women with CPP using Centering, a group-based model that combines healthcare assessment, education, and social support. Patients were from university-affiliated and public hospital-affiliated clinics. We evaluated the program with qualitative and quantitative data to address components of the RE-AIM framework: Reach, Effectiveness, Adoption, Implementation, and Maintenance. Participants of the Centering CPP Program participants (n = 26) were demographically similar to a sample of women with CPP who sought care at Bay Area hospitals (n = 701). Participants were on average 40 years of age, a majority of whom were racial/ethnic minorities with low household income (76%). Women who attended four or more sessions (n = 16) had improved health-related quality of life, including decreases in average number of unhealthy days in the past month (from 24 to 18, p < .05), depressive symptoms (from 11.7 to 9.0, p < .05), and symptom severity (from 4.2 to 3.1, p < .01). Sexual health outcomes also improved (30.5 to 50.3, p = .02). No improvements were observed for pain catastrophizing. Our pilot program provides preliminary data that an integrative health approach using a group-based model can be adapted and implemented to reach diverse women with CPP to improve physical and psychological well-being. Given these promising findings, rigorous evaluation of implementation and effectiveness of this approach compared with usual care is warranted.
authors.affiliation: Osher Center for Integrative Medicine, University of California, San Francisco, California; Division of General Internal Medicine, University of California, San Francisco, California. Electronic address: maria.chao@ucsf.edu.
authors.forename: Maria T
authors.initials: MT
authors.lastname: Chao
authors.affiliation: Women's Health & Healing, Healdsburg, California.
authors.forename: Priscilla D
authors.initials: PD
authors.lastname: Abercrombie
authors.affiliation: Osher Center for Integrative Medicine, University of California, San Francisco, California.
authors.forename: Trilce
authors.initials: T
authors.lastname: Santana
authors.affiliation: School of Human Ecology, University of Wisconsin-Madison, Madison, Wisconsin.
authors.forename: Larissa G
authors.initials: LG
authors.lastname: Duncan
mesh_terms: D000328:Adult; D059350:Chronic Pain / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D055048:Integrative Medicine / Q000592:standards*; D008875:Middle Aged; D017699:Pelvic Pain / Q000534:rehabilitation*; D010865:Pilot Projects; D015397:Program Evaluation; D011615:Psychotherapy, Group / Q000592:standards*; D011788:Quality of Life; D012495:San Francisco; D055815:Young Adult