OPTIC Study

Given the health disparities in American Indian/Alaska Native (AI/AN) populations and lack of access to quality care for comorbid chronic pain and opioid misuse/OUD, the OPTIC study seeks to build upon the strong relationships between the research team and the AI/AN populations that we serve. There is a dearth of prior research examining chronic pain, opioid misuse/OUD, and other comorbid conditions (mood disorders, anxiety disorders, other SUD) in AI/AN populations. Using Community-Based Participatory Research methods, we will work with the OPTIC Collaborative Board to develop a culturally centered treatment to improve screening and brief interventions with AI/AN clients with chronic pain and opioid misuse/OUD (Aim 1). Specifically, in collaboration with the community partners and the OPTIC Collaborative Board, we will develop provider training to increase provider skills and self-efficacy to focus conversations on managing chronic pain (rather than trying to eliminate it) and improving client functioning within cultural frameworks of wellbeing. The goal is to develop, implement, and evaluate culturally centered implementation strategies to increase screening and brief intervention for chronic pain and opioid misuse/OUD in primary care clinics serving AI/AN communities. We will conduct an implementation-effectiveness hybrid type III pragmatic trial to test the implementation outcomes (Aim 2) and client experiences and client outcomes (Aim 3). We hypothesize our culturally centered approach will increase rates of screening and brief intervention, and ultimately improve outcomes among AI/AN clients with chronic pain and OUD who receive treatment in primary care.