0530 When Pain Meets Place: Understanding Rurality’s Impact on Fatigue and Sleep Disturbances
Bibliographic record
Abstract
Abstract Introduction A long-standing body of research supports the intricate relationship between chronic pain, fatigue, and sleep, yet these complex variables are not uniform among different populations. Moreover, many rural individuals experience health disparities related to sleep, fatigue, and pain, which may be related to limited care access. Herein, we examined whether urbanity/rurality moderated the relationship between pain and sleep disturbance and pain and fatigue in women with pain complaints. Methods Women (N=261, Mage=41.8, SD=13.9, 61% urban) with sleep and pain complaints completed surveys during the baseline assessment of an RCT in mid-Missouri. Measures included sleep (PROMIS-Sleep Disturbance, fatigue (PROMIS-Fatigue), pain (McGill Pain Questionnaire), and rurality (Y/N, according to Census Bureau data for 2020 as reported by Rural Health Information Hub’s Am I Rural? tool). Using SPSS PROCESS, we examined moderation analyses while controlling for age, employment status (Y/N), and whether individuals live in a low-income area (Y/N) based on the Human Resources and Services Administration low-income city service area designation as specified by the Am I Rural? Tool. Results A significant interaction was found between pain and rurality predicting fatigue, F(1, 252)=8.72, p=.003. Greater pain was associated with greater fatigue in only rural individuals, β=0.21, t(252)=4.72, p<.001. Similarly, there was a significant interaction between pain and rurality predicting sleep disturbances, F(1, 252)=5.78, p=.012. This was only observed in rural individuals, β=0.34, t(252)=3.40, p<.001, such that increased pain was related to increased sleep disturbances. Conclusion Living in rural areas may increase the risk of experiencing increased pain, fatigue, and sleep disturbance. While this may be partly due to limited access to care, future studies should utilize longitudinal and experimental methodology to determine the causality of these relationships and examine physiological measures of sleep and pain. Further exploration is important for targeted support and consideration of disparities (including access to care) in women struggling with pain, sleep, and fatigue in rural areas. Support (if any) National Institute of Nursing Research (NR01768; Clinical trial: NCT03744156; PI: McCrae)
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| 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) | 0.000 | 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 teacher head, 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".