Arti Prasad

Background/Objective: Adolescents experience stress, anxiety, depression, and chronic pain at rates comparable to adults. Opportunity youth are a unique subset of adolescents/young adults with a higher risk of chronic pain and mental health comorbidities. Group Medical Visits (GMVs) for adults are a well-established model supporting whole-person care for chronic pain and co-incident mental health challenges. Research on GMVs among adolescents is limited. This program evaluation explores the feasibility, acceptability, and sustainability of a chronic pain GMV curriculum adapted for opportunity youth at a residential employment-readiness center. Preliminary signals of program impact were explored as a secondary objective of the study. Methods: After completing a chronic pain GMV training program, two pediatricians adapted and piloted the curriculum for opportunity youth through an 8-week Group Visit Series (GVS) offering integrative and lifestyle-based approaches to mental health, stress, and chronic pain. This was a single-site, uncontrolled, mixed-methods pilot program evaluation. Attendance was recorded as a measure of feasibility. A weekly progress sheet captured pre-/post-visit participant feedback, and semi-structured interviews (n = 6), conducted one month post-GVS, were examined using rapid analysis to explore acceptability. Sustainability was observed by program continuation beyond the pilot. Exploratory participant-reported outcomes were collected through PROMIS-29 (n = 6), PROMIS Positive Affect (n = 5), and Patient Global Impression of Change (n = 6). Results: Fourteen participants enrolled, with nine completing ≥3 visits. Weekly progress sheets demonstrated intra-visit changes from pain, fatigue, and concern to calm. Interview analysis yielded concepts of appreciation for skills learned and the group experience. Sustainability was observed. Six of seven PROMIS-29 domains showed positive signals of improvement, with 6/6 (100%) of respondents meeting a minimal clinical important difference (MCID) threshold for depression and 5/6 (83%) for anxiety. PROMIS-Positive Affect and Patient Global Impression of Change showed positive trends at visit 8. Conclusions: This chronic pain and mental health GVS for opportunity youth was found to be feasible, acceptable, and sustainable. Positive trends in participant-reported depression and anxiety scores were also observed. Larger studies beyond program evaluation are needed to confirm these results.

Objective: The Non-Opioid Pain Alleviation Information Network (NOPAINMN) project was designed to identify, consolidate, and map evidence-based non-opioid and non-pharmacological pain management complementary and integrative health (CIH) modalities for chronic pain management across Minnesota into a searchable and informational website ( www.nopainmn.org ). Methods: The Academic Consortium for Integrative Medicine & Health's Pain Task Force White Paper identifying evidence-based research of non-pharmacological pain practice (NPPC) was reviewed and referenced. National and state certifying boards and accrediting organizations for NPPC modalities were accessed to identify Minnesota-based NPPC providers' name, business/health-system affiliation, address, contact information, and credentials. The NOPAINMN website displays these data in a consumer-facing website with searchable fields such as NPPC modality type, and location with varying distances. The website was β-tested by practitioners and stakeholders for optimization. Eight main NPPC modalities and their respective subcategories were identified and mapped: Acupuncture; Integrative Medical Care (Functional medicine consultation and Integrative medicine consultation); Massage Therapy; Mind–Body Therapies (Biofeedback, Clinical Hypnosis, Mindfulness-Based Stress Reduction, and Music Therapy); Movement Therapies (Tai Chi, qigong , and Yoga Therapy); Psychology (Cognitive Behavioral Therapy); Rehabilitative Therapies (Physical and Occupational Therapy); and Spinal Manipulation. Results: All information compiled resulted in 17,155 providers/practitioners. Physical Therapy had the greatest number of reported providers ( n = 5224), followed by Occupational Therapy ( n = 3792), Psychology ( n = 3324), Chiropractic ( n = 3033), Acupuncture ( n = 591), and Massage Therapy ( n = 544). The Resource Map included 56 major health systems, 686 facilities, 2651 solo or private group practices, and 14 academic training schools. With web-based cross-referencing, providers and facilities were affiliated and linked with health systems to produce an interconnected mapping system. β-Testing with patients found that the website was reported as relatively easy to use and informative. Conclusion: The website was created to assist individuals, health care providers, insurance carriers, and health care facilities in finding evidence-based information and resources on NPPC to guide, support, and proactively manage and engage chronic pain patients across Minnesota.