Abstract
Low literacy and chronic pain have been identified as significant problems in the rural USA. Cognitive behavioral therapy
(CBT) is a widely used efficacious psychosocial treatment for chronic pain; adaptations for low-literacy rural populations
are lacking. This paper reports on preparatory steps implemented to address this deficit. Adapting an existing group, CBT
patient workbook for rural adults with low literacy is described, and adaptations to reduce cognitive demand inherent in CBT
are explained via cognitive load theory. Adhering to health literacy guidelines, the patient workbook readability was lowered
to the fifth grade. Two key informant interviews and four focus groups provided the impetus for structural and procedural
adaptations. Using health literacy guidelines and participant feedback, the patient workbook and treatment approach were adapted
for implementation in low-literacy rural adult chronic pain populations, setting the stage for proceeding with a larger trial
using the adapted materials.
(CBT) is a widely used efficacious psychosocial treatment for chronic pain; adaptations for low-literacy rural populations
are lacking. This paper reports on preparatory steps implemented to address this deficit. Adapting an existing group, CBT
patient workbook for rural adults with low literacy is described, and adaptations to reduce cognitive demand inherent in CBT
are explained via cognitive load theory. Adhering to health literacy guidelines, the patient workbook readability was lowered
to the fifth grade. Two key informant interviews and four focus groups provided the impetus for structural and procedural
adaptations. Using health literacy guidelines and participant feedback, the patient workbook and treatment approach were adapted
for implementation in low-literacy rural adult chronic pain populations, setting the stage for proceeding with a larger trial
using the adapted materials.
- Content Type Journal Article
- Pages 1-8
- DOI 10.1007/s13142-011-0026-2
- Authors
- Melissa C Kuhajda, Department of Psychiatry and Behavioral Medicine, University of Alabama School of Medicine, Tuscaloosa Campus, P.O. Box 870326, Tuscaloosa, AL 35487-0326, USA
- Beverly E Thorn, Psychology Department, The University of Alabama, Tuscaloosa, AL USA
- Susan W Gaskins, Capstone College of Nursing, The University of Alabama, Tuscaloosa, AL USA
- Melissa A Day, Psychology Department, The University of Alabama, Tuscaloosa, AL USA
- Chalanda M Cabbil, Psychology Department, The University of Alabama, Tuscaloosa, AL USA
- Journal Translational Behavioral Medicine
- Online ISSN 1613-9860
- Print ISSN 1869-6716