Empowering Pain Psychology Access and Collaboration (EPPAC) to Improve Treatment Engagement Among Medicaid-insured Adults With Chronic Low Back Pain

Part of paid clinical trials in Baltimore, Maryland.

Sponsor
Johns Hopkins University
Study ID
NCT07843706
Status
Not Yet Recruiting

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Conditions

  • Chronic Low Back Pain (CLBP)

Eligibility Criteria

Sex
ALL
Age
18 Years - 64 Years
Healthy Volunteers
Not accepted

Interventions

  • Empowering Pain Psychology Access and Collaboration (EPPAC) — BEHAVIORAL
    EPPAC is a brief, psychologist-led engagement strategy embedded within a standard pain psychology evaluation. It combines motivational interviewing and shared decision-making, structured pain education, a patient decision aid, two decision points, balanced discussion of CBT and EAET (presented to participants as PERT), and next-step planning to support informed engagement in pain psychology care.
  • Usual Care Pain Psychology Evaluation — BEHAVIORAL
    Usual care consists of the clinic's standard pain psychology evaluation and usual discussion of clinical recommendations and treatment options. It does not include the EPPAC-specific decision aid, standardized EPPAC pain education, exact Decision Point 1 question, or EPPAC next-steps probe. CBT and EAET, presented to participants as PERT, are downstream clinical treatment options available in both study arms.

Study Details

Chronic low back pain (cLBP) is a leading cause of disability, with socioeconomically disadvantaged populations experiencing worse outcomes and lower rates of treatment initiation for evidence-based pain psychology services. Participant engagement strategies such as shared decision-making (SDM) and motivational interviewing (MI) have shown promise in improving treatment uptake, but no study has examined whether integrating these approaches into a pain psychology evaluation can improve engagement among socioeconomically disadvantaged participants or offered participants a structured choice between cognitive behavioral therapy (CBT) and emotional awareness and expression therapy (EAET), presented to participants as Pain and Emotion Reprocessing Therapy (PERT). The Empowering Pain Psychology Access and Collaboration (EPPAC) intervention, a brief, psychologist-led engagement strategy combining SDM and MI within a standard pain psychology evaluation, was developed to address this gap.

Key Dates

First listed
Sep 28, 2026
Start date
Nov 2, 2026
Status verified
Oct 2026
Primary completion
Aug 31, 2028
Completion
Feb 28, 2029

Study Design

Enrollment
70 participants (estimated)
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH

Arms

  • Experimental: Empowering Pain Psychology Access and Collaboration (EPPAC)
    Participants receive the standard pain psychology evaluation followed by the structured EPPAC engagement and shared decision-making process during the same scheduled telehealth appointment. EPPAC helps participants decide whether pain psychology fits their treatment plan and, if treatment is selected, choose between cognitive behavioral therapy (CBT) and emotional awareness and expression therapy (EAET), presented to participants as Pain and Emotion Reprocessing Therapy (PERT). Subsequent CBT or EAET/PERT treatment is routine clinical care and is available in both study arms.
  • Active Comparator: Usual Care
    Participants receive the standard pain psychology evaluation and the clinic's usual discussion of treatment recommendations and available options, without the EPPAC-specific structured elements. CBT and EAET, presented to participants as PERT, remain available as clinically appropriate. Subsequent treatment is routine clinical care.

Primary Outcome Measure

Percentage of participant and provider Acceptability of Intervention Measure (AIM) responses with a mean score of 4 or greater [ Time Frame: Immediately following the initial evaluation appointment ]

Central Contacts

Locations (1)

FacilityCityStateZIPSite coordinators
Johns Hopkins Rehabilitation Psychology ClinicBaltimoreMaryland21205
Fenan S Rass, Ph.D.
[email protected]
667-306-7983
Rachel V Aaron, Ph.D.
[email protected]
667-306-7797
Fenan S Rassu, Ph.D. (PRINCIPAL_INVESTIGATOR)
Rachel V Aaron, Ph.D. (SUB_INVESTIGATOR)

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By research site
Johns Hopkins Rehabilitation Psychology Clinic· Baltimore, MD

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