Translating an Intervention to Address Chronic Pain Among Home Care Workers

COMPASS for Navigating Pain (COMPASS-NP) is a translational study that evaluates the effectiveness of an intervention for home care workers with chronic pain. Building on an established and successfully disseminated Oregon Healthy Workforce Center intervention named COMPASS (COMmunity of Practice And Safety Support), COMPASS-NP is designed to promote worker well-being and halt the progression of pain and its related problems, including work-related disability and opioid use/misuse.

COMPASS-NP aims to achieve these outcomes through a supportive group program completed online over 10 weeks. The original program will be adapted to include strengthened ergonomic protections and Cognitive Behavioral Therapy strategies for pain self-management.

In our preliminary research, more than 50% of home care workers met study-specific criteria for having elevated pain. Workers who experience chronic pain are at risk for progressing to work-related disability and pain-related problems, including the misuse of prescription drugs such as opioids. Typical work-based programs for workers with chronic pain are limited, and typically activated only after an injury causes lost work time (e.g., return to work programs). Such programs also typically focus on physical functioning, and neglect pain education and proven Cognitive Behavioral Therapy strategies for pain self-management. The need for interventions is particularly acute for home care workers, who often lack a traditional employer who is responsible for controlling environmental hazards. For these reasons, home care workers with chronic pain need proactive secondary prevention programs that address both injury prevention and proven pain self-management strategies.

COMPASS for Navigating Pain builds on the success of the Oregon Healthy Workforce Center intervention named COMPASS (COMmunity of Practice And Safety Support). COMPASS (see program materials here) is a peer-led and scripted group program that produced a range of medium-to-large improvements home care workers’ safety and health outcomes in a randomized controlled trial. The program was subsequently adopted by the Oregon Home Care Commission as a training course available to over half of the state’s home care and personal support workers. It is offered in both in person and online formats.

The translated version of COMPASS (COMPASS for Navigating Pain) will build upon the successes of the original supportive group program. Some original lessons will be tailored for workers experiencing chronic pain. New lessons will integrate Cognitive Behavioral Therapy strategies for self-managing pain adapted from The Pain Survival Guide (co-authored by Dr. Dennis Turk, co-investigator). Strategies taught in this book have previously been evaluated and shown to improve physical and emotional functioning, and reduce pain-related disability. Ergonomic protections will be strengthened through an online ergonomic assessment tool followed by purchasing recommended low-tech ergonomic tools for workers. This tool will be adapted from an established handbook titled Caring for Yourself While Caring for Others developed by NIOSH and the Labor Occupational Health Program at the University of California, Berkley.

The COMPASS for Navigating Pain study is funded by the Oregon Healthy Workforce Center, a National Institute for Occupational Safety and Health (NIOSH) Center of Excellence in Total Worker Health® [grant number U19OH010154]. This work is also partly supported by the Oregon Institute of Occupational Health Sciences at Oregon Health & Science University via funds from the Division of Consumer and Business Services of the State of Oregon (ORS 656.630).

Ryan Olson, PhD, Professor an Co-Director OHWC, Pregon Institute of Occupational Health Sciences, OHSU

Ryan Olson, PhD
Principal Investigator (OHSU)

Dennis Turk, PhD – Co-Investigator (University of Washington)

Dennis Turk, PhD
Co-Investigator (University of Washington)

Jennifer Hess, PhD – Co-Investigator (University of Oregon)

Jennifer Hess, PhD
Co-Investigator (University of Oregon)

Miguel Marino, PhD Associate Professor of Family Medicine, School of Medicine Associate Professor, OHSU-PSU School of Public Health

Miguel Marino, PhD
Co-Investigator (OHSU)

Lindsey Alley, MS – Senior Research Associate (OHSU)

Lindsey Alley, MS
Senior Research Associate (OHSU)

Courtney Donovan Research Project Manager

Courtney Donovan, MPH
Research Project Manager (OHSU)

Stacy Stoffregan, Ryan Olson Lab

Stacy Stoffregen, PhD
Research Associate (OHSU)

Ivana Da Anda

Ivanna De Anda
Senior Research Assistant (OHSU)

Phuc Nguyen
Research Assistant II (OHSU)