A historical review of pain disparities research: Advancing toward health equity and empowerment.

BACKGROUND AND PURPOSE: This theory-guided review draws on 30 years of published data to examine and interrogate the current and future state of pain disparities research. METHODS: Using the Hierarchy of Health Disparity Research framework, we synthesize and present an overview of "three generations" of pain disparities scholarship, while proposing directions for adopting a "fourth generation" that redefines, explains, and theorizes future pain disparities research in a diverse society. DISCUSSION: Prior research has focused on describing the scope of disparities, and throughout the historical context of human existence, racialized groups have been subjected to inadequate pain care. It is imperative that research not only illuminates existing problems but also provides solutions that can be implemented and sustained across varying social milieus. CONCLUSION: We must invest in new theoretical models that expand on current perspectives and ideals that position all individuals at the forefront of justice and equity in their health.

Leveraging community health workers in extending pediatric telebehavioral health care in rural communities: Evaluation design and methods.

OBJECTIVE: The pandemic exacerbated and intensified pediatric behavioral health and access needs in rural and underserved areas due to long-standing workforce shortages, lack of resources, and multigenerational poverty and trauma. Kansas is a predominantly rural and frontier state with 94% of counties designated as mental health professional shortage areas. INNOVATION: The Telehealth ROCKS (THR) program is among the first of its kind to increase the behavioral health workforce capacity by integrating trained school-based community health workers (CHWs) directly into rural communities. CHWs facilitate the coordination of behavioral health appointments and access to social determinants of health needs. METHODS AND RESULTS: We plan to assess the implementation, clinical outcomes, quality of care, and access to care through a mixed-methods design to evaluate the process and impact of expanding the rural behavioral health workforce via CHWs. Preliminary program data suggest CHWs have supported over 90 students/families around social determinants of health in the first 6 months. CONCLUSION: The THR program aims to bring childserving systems of care together, cultivate relationships with rural communities, empower and increase workforce capacity in health care and education, and build trust to enhance acceptance and thus program sustainability. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The Intersection of Pain Outcomes and Social Isolation Among African Americans.

There is increasing evidence suggesting the influence social isolation has on health outcomes and mental well-being. Chronic medical conditions, such as pain, have been shown to impact social relationships and isolation among majority populations, but there is little evidence documenting this relationship among African Americans. To address this lack of scholarly work, the current study aimed to examine subjective and objective social isolation, pain interference with daily life, and problems with pain in a sample of African American adults 18 + years of age. Taken from the National Survey of American Life: Coping with Stress in the 21st Century (NSAL), results showed that participants who were objectively isolated from family only were more likely to have a chronic health problem that was associated with increased pain. Data further showed that those reporting subjective isolation from both family and friends experienced greater interference from pain than those who were not isolated from family and friends. Findings from this study acknowledge a larger issue that addresses the impact social isolation has on health, quality of life, and general well-being. Recognizing the influence of such may allow systems to acknowledge the determinants that perpetuate social isolation, while still recognizing the needs of marginalized groups.