COMMUNITY HEALTH WORKER DELIVERED PAIN SELF MANAGEMENT IMPROVES FUNCTION IN OLDER ADULTS WITH COGNITIVE IMPAIRMENT - Abstract

Sep 29, 2026

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Older adults with chronic pain and mild cognitive impairment or Alzheimer’s disease–related dementias (MCI/ADRD) face dual challenges that erode function and quality of life, yet few interventions address both. STEPS-CI is a telephone-based pain self-management program delivered by community health workers and adapted for cognitive impairment. In a randomized pilot (n=52), participants receiving seven weekly CHW-led sessions showed significant post-program improvements in function, pain, quality of life, and social participation, alongside feasible implementation metrics and strong qualitative acceptability.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages1

Reading Time3 min

AccessFree to download

Background

Intervention design (STEPS-CI)

Study outcomes and feasibility

1164 Innovation in Aging, 2025, Vol. 9, No. S2 Abstract citation ID: igaf122.3900 COMMUNITY HEALTH WORKER DELIVERED PAIN SELF MANAGEMENT IMPROVES FUNCTION IN OLDER ADULTS WITH COGNITIVE IMPAIRMENT Jennifer Blackwood1, Donovan Maust2, Rachel Davis3, Elizabeth Brines3, Charity Hoffman4, Amanda Leggett5, Joan Ilardo6, and Mary Janevic7, 1. University of Michigan-Flint, Flint, Michigan, United States, 2. University of Michigan Medical School, Ann Arbor, Michigan, United States, 3. University of Michigan, Ann Arbor, Michigan, United States, 4. University of Michigan Health System, Ann Arbor, Michigan, United States, 5. Wayne State University, Detroit, Michigan, United States, 6. Michigan State University, East Lansing, Michigan, United States, 7. University of Michigan School of Public Health, Ann Arbor, Michigan, United States Older adults with chronic pain and mild cognitive impairment or Alzheimer’s disease–related dementias (MCI/ADRD) face dual challenges that undermine function and quality of life, yet few interventions address both conditions. We developed and tested STEPS-CI, a telephone-based pain self-management program delivered by community health workers (CHWs) and adapted for cognitive impairment. Fifty-two participants (mean age 67.1; 83% women; 46% African American; 27% rural, 44% Detroit-based) were randomized to intervention (n = 23) or control (n = 29) . Participants in the intervention arm received seven weekly CHW-led sessions, supported by tailored materials co-designed with an advisory council from the National Council of Dementia Minds. At post-program follow-up, Global Impression of Change ratings showed significant improvements in function, pain, and quality of life for intervention vs. control participants (all p <.01) as well as in social participation (PROMIS 4-item scale, p=.03) . These gains were accompanied by favorable trends in reduced pain interference and decreased self-reported pain medication use. The program was feasible and well-accepted, with 82% retention, >90% CHW fidelity to session protocols, and strong qualitative feedback highlighting relevance and accessibility. Findings suggest that CHWs can successfully deliver adapted behavioral pain management strategies to older adults with MCI/ADRD, producing functional benefits that matter to patients and families. This pilot study provides new data supporting advancement to a fully powered Behavioral Intervention Stage 3 trial to evaluate the efficacy of STEPS-CI for improving pain-related outcomes in diverse older adults living with both pain and dementia.

FAQs

What problem does STEPS-CI target for older adults?

STEPS-CI targets dual challenges of chronic pain and mild cognitive impairment or Alzheimer’s disease–related dementias (MCI/ADRD) by integrating pain self-management with adaptations for cognitive impairment.

How was STEPS-CI delivered and what did participants receive?

STEPS-CI was delivered by community health workers via seven weekly telephone-based sessions, supported by tailored materials co-designed with an advisory council.

What were the main results of the randomized pilot?

Post-program follow-up showed significant improvements in function, pain, and quality of life versus control, plus improved social participation, with favorable trends in pain interference and reduced self-reported pain medication use.

Sep 29, 2026

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