Toppenish

Researchers are evaluating culturally tailored screening and brief intervention methods for chronic pain and opioid misuse or opioid use disorder among American Indian and Alaska Native (AI/AN) clients in three clinics serving these communities. This study addresses the health disparities and limited access to quality care for these conditions in AI/AN populations, aiming to improve provider skills and client outcomes using a culturally centered approach. The trial is a type III effectiveness-implementation study conducted over 24 months at each site. The study involves several phases: an initial baseline period, followed by a 6-month workgroup phase where clinic-specific goals are set, then a 6-month implementation phase where evidence-based strategies are practiced, and finally a sustainment phase to measure how well the clinic maintains these goals. The intervention focuses on training providers to better manage chronic pain and opioid misuse within cultural frameworks that emphasize client functioning rather than pain elimination. Participants will be involved through surveys and electronic medical record data collection to assess staff perspectives and client outcomes. The main outcomes measured include the number of clients screened for chronic pain and opioid misuse/OUD during the implementation and sustainment phases. The study also gathers data on treatment needs and evaluates the effectiveness of the provider-level intervention. Overall participation is structured around these phases and ongoing monitoring of implementation success.