A Mobile Intervention to Reduce Pain and Improve Health (MORPH)

Chronic pain has emerged as an urgent age-related health issue that significantly effects
physical functioning and quality of life, with the unfavorable effects worsened by both
obesity and sedentary behavior. The annual cost of pain in the United States is nearly 30%
higher than the combined costs of cancer and diabetes. In 2016, the NIH called for a National
Pain Strategy to: 1) expand non-pharmacological treatment options in older adults, who are
particularly susceptible to the side effects of opioid and other pain medications; 2) develop
accessible treatments that are tailored to individuals; and 3) increase the development of
self-management programs for chronic pain. The purpose of this R-21 is to develop and test
the feasibility and acceptability of a novel, patient-centered intervention to reduce chronic
pain and improve physical functioning in older adults, leveraging the combination of
telecoaching and individually-adaptive mHealth tools to decrease both body mass and sedentary
behavior. A pilot randomized controlled trial will be conducted to provide initial evidence
for effect sizes (pain and physical function) associated with the proposed intervention, and
to estimate the sample size needed for a full scale randomized controlled trial design that
compares the effects of the intervention versus usual care on pain ratings and physical
function in overweight/obese older adults with chronic pain.

Inclusion Criteria:

- Own smartphone

- Pain in 2 of 5 areas (i.e., back, neck, shoulders, hips, knees) on most days during
the previous 3 months

- No contraindication for participation in exercise with approval for participation by
their physician

- Obese (BMI=30-45 kg/m2)

- Weight-stable (i.e., no weight loss or gain > 5% in the past 6 months)

- Low-active (i.e., engaging in less than 2 days/week of structured physical activity
for at least 20 minutes).

- Approved for participation by LMC Pain Center Director and Dr. Brooks

- Willingness to provide consent; Agree to all study procedures and assessments; Able to
provide own transportation to study visits

- Access to home Wi-Fi and smartphone device

Exclusion Criteria:

- Dependent on cane or walker

- >1 fall (injurious or non-injurious) in past year

- Vision insufficient to read a smartphone screen, unable to read

- Participation in regular resistance training and/or > 20 mins/d of aerobic exercise in
past 6 months

- No contraindication to exercise

- Unable to walk without assistive devices

- Cognitive impairment as indicated by a Montreal Cognitive Assessment score < 22

- Uncontrolled hypertension (>160/90 mmHg);

- Current or recent past (within 1 year) severe symptomatic heart disease, uncontrolled
angina, stroke, chronic respiratory disease requiring oxygen, neurological or
hematological disease; cancer requiring treatment in past yr, except non-melanoma skin
cancers

- Regular use of: growth hormones, oral steroids, or prescription osteoporosis
medications

- Current participation in other research study targeting pain, physical activity, or
weight loss