Peer Support Intervention Improves Pain‐Related Outcomes Among Rural Adults With Diabetes and Chronic Pain at 12‐Month Follow‐Up
Bibliographic record
Abstract
PURPOSE: Adults with diabetes mellitus (DM) suffer often from chronic pain, yet evidence-based interventions for comorbid pain and DM are scarce. We tested the effect of a peer-led cognitive behavioral training (CBT) intervention on pain self-efficacy (PSE), pain intensity, and pain-related functional limitations (PRFL) in adults with DM, 1 year after trial initiation. METHODS: The yearlong "Living Healthy" cluster-randomized trial included 230 residents of rural Alabama with DM, who reported pain in the past month; communities were treated as clusters. Intervention participants received a peer-delivered 8-session structured CBT intervention in the context of diabetes self-management; attention control arm participants received a peer-delivered 8-session general health education program. Outcomes included PSE (Arthritis Self-Efficacy Scale, range 10-100); pain intensity (McGill Pain Questionnaire, range 0-45); and PRFL (Western Ontario and McMaster Universities Osteoarthritis Index scale, range 0-100). We examined control-intervention differences in changes in outcome scores from baseline to 3-month and 12-month follow-up, adjusted for clustering. FINDINGS: The 195 participants with follow-up data were aged 59 ± 10.4 years, 96% were African American, 79% were women, and 80% reported pain on the day of baseline data collection. At 3-month follow-up, PSE increased more for intervention (21-point increase) than control (5-point increase) participants (P for control-intervention (C-I) difference in change < .001); pain intensity decreased for both groups; and PRFL decreased only for intervention participants (-11 score; P for C-I difference in change < .001). Results were sustained at 12 months, and pain intensity significantly improved in only the intervention arm (P for C-I difference in change = .01). CONCLUSIONS: This peer-delivered CBT intervention improved pain self-efficacy, pain-related functional limitations, and pain intensity over 12 months among rural participants with DM and chronic pain.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".