JMIR Publications

ABSTRACT

Background:

The Veterans Health Administration Pain Coach mobile health application (app) was developed to support Veterans with chronic pain.

Objective:

Our objective was to evaluate early user experiences with the Pain Coach app and preliminary impacts of app use on pain-related outcomes.

Methods:

Following a sequential explanatory mixed-methods design, we mailed surveys to Veterans at two time-points with an outreach program in between and conducted semi-structured interviews with a sub-sample of survey respondents. We analyzed survey data using descriptive statistics among Veterans who completed both surveys and examined differences in key outcomes using paired-samples t-tests. We analyzed semi-structured interview data using thematic analysis.

Results:

Of 1,507 Veterans invited and eligible to complete the baseline survey, we received responses from 393 (26.1%). These Veterans received our outreach program; 236 (60.1%) completed follow-up surveys. We conducted interviews with 10 app users and 10 non users. Among survey respondents, 10.2% (n=24) used Pain Coach and 58.4% reported it was easy to use, though interviews identified various app usability issues. Veterans who used Pain Coach reported greater pain self-efficacy (m=23.1 vs. m=16.6, p=0.01) and lower pain interference (m=34.6 vs. m=31.8, p=0.03) after (vs. before) use. The most frequent reason Veterans reported for not using the app was that their healthcare team had not discussed it with them (45.3%).

Conclusions:

Our findings suggest that future efforts to increase adoption of Pain Coach and other mobile apps among Veterans should include healthcare team endorsement. Our findings regarding the impact of Pain Coach use on outcomes warrants further study.