Communication and Activation in Pain to Enhance Relationships and Treat Pain with Equity (COOPERATE): Rationale, study design, methods, and sample characteristics

Marianne S. Matthias, Jasma Adams, Diana J. Burgess, Joanne Daggy, Johanne Eliacin, Perla Flores, Adam T. Hirsh, Laura J. Myers, Anthony J. Perkins, Tetla Menen, Philip Procento, Kevin L. Rand, Michelle P. Salyers, Mackenzie L. Shanahan, Matthew J. Bair

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Background: Chronic pain is associated with profound negative effects, and racial disparities are well-documented in chronic pain treatment. In addition, Black patients report poorer communication with providers and exhibit lower levels of patient activation (self-management self-efficacy) than White patients. Although the causes of healthcare disparities are complex and require intervention at multiple levels, empowering patients is one critical path to achieving health equity. The current study is a coaching intervention focused on increasing patient activation and building communication skills for Black patients with chronic pain. Methods: In this randomized controlled trial, 250 Black patients with chronic pain were randomized to either the coaching intervention or an attention control arm. Intervention patients attended 6 telephone-delivered individual coaching sessions over 12 weeks. Coaching focused on clarifying and prioritizing goals and on communication skills, such as agenda setting. The primary outcome is patient activation. Secondary outcomes include communication self-efficacy, pain intensity and interference, and psychological functioning. Discussion: Having the knowledge and confidence to participate in one's pain care, coupled with the skills needed to effectively communicate with providers, is essential to optimize chronic pain care. This is particularly important for Black patients who often experience lower quality pain care. Interventions such as COOPERATE hold promise for helping patients to acquire the requisite tools to take greater control of their chronic pain care. Trial Registration:, # NCT03562793.

Original languageEnglish (US)
Article number106790
JournalContemporary Clinical Trials
StatePublished - Jul 2022

Bibliographical note

Funding Information:
This work was supported by a Department of Veterans Affairs Health Services Research and Development Merit Review Award to Dr. Matthias (IIR 17-032). The sponsor had no role in study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the article for publication. The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs.

Publisher Copyright:
© 2022


  • Chronic pain
  • Healthcare disparities
  • Patient-provider communication
  • Randomized controlled trial

PubMed: MeSH publication types

  • Journal Article
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, Non-P.H.S.


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