A patient-informed qualitative evaluation of an online chronic pain treatment for military, police and Veterans

LAY SUMMARY In this study, members and Veterans of the Canadian Armed Forces were asked about their experiences with an online chronic pain treatment that had been specifically tailored to this population, as well as to members of the Royal Canadian Mounted Police. The purpose was to learn what participants in the treatment program liked and disliked about the program itself and the changes they would suggest to improve the program. The authors learned that despite the effort to tailor the treatment to this population, the voices of actual members of the population needed to be heard to truly tailor the program to their needs. The study provides insight into ways to refine the program to better match the unique characteristics of this population, their special connection to each other, and their individual differences. A revised version of the chronic pain program is being developed based on this feedback. Introduction: Chronic pain is a significant problem among military, police, and Veteran populations. An online acceptance-based behavioural treatment for chronic pain was developed and tailored to this specific population. A randomized controlled trial demonstrated the efficacy of the intervention; however, dropout rates were a concern. To address this issue, the authors sought the perspectives of previous participants of the intervention. The goal of the present study was to identify areas to refine online chronic pain treatment to enhance its acceptability and thereby improve completion rates. Methods: Participatory action research methodology was used to conduct a series of focus groups with participants who previously completed the treatment. Through group discussions, participants offered feedback and suggestions for improvements to the program. Data were analyzed using interpretive thematic analysis. Results: Three main themes emerged in this qualitative evaluation of the strengths and weaknesses of the online chronic pain program that highlighted the elements of the target population that participants felt needed to be considered: 1) their unique characteristics, 2) their interconnection, and 3) their individual differences. Discussion: Although participants generally found the program acceptable, they identified areas for improvement. This patient feedback will guide a future revision of the program, intended to better meet the particular cultural sensitivities of military, police, and Veterans, thereby enhancing their treatment experience and reducing dropout rates. The results of this study may be a useful guide for clinicians adapting interventions for military and police populations.