Racial and weight discrimination associations with pain intensity and pain interference in an ethnically diverse sample of adults with obesity: a baseline analysis of the clustered randomized-controlled clinical trial the goals for eating and moving (GEM) study

Abstract Background Everyday experiences with racial (RD) and weight discrimination (WD) are risk factors for chronic pain in ethnically diverse adults with obesity. However, the individual or combined effects of RD and WD on pain in adults with obesity is not well understood. There are gender differences and sexual dimorphisms in nociception and pain, but the effect of gender on relationships between RD, WD, and pain outcomes in ethnically diverse adults with obesity is unclear. Thus, the purposes of this study were to: 1) examine whether RD and WD are associated with pain intensity and interference, and 2) explore gender as a moderator of the associations between RD, WD, and pain. Methods This is a baseline data analysis from a randomized, controlled clinical trial of a lifestyle weight-management intervention. Eligible participants were English or Spanish-speaking (ages 18–69 years) and had either a body mass index of ≥30 kg/m2 or ≥ 25 kg/m2 with weight-related comorbidity. RD and WD were measured using questions derived from the Experiences of Discrimination questionnaire (EOD). Pain interference and intensity were measured using the PROMIS 29 adult profile V2.1. Linear regression models were performed to determine the associations between WD, RD, gender, and pain outcomes. Results Participants (n = 483) reported mild pain interference (T-score: 52.65 ± 10.29) and moderate pain intensity (4.23 ± 3.15). RD was more strongly associated with pain interference in women (b = .47, SE = .08, p < 001), compared to men (b = .14, SE = .07, p = .06). Also, there were no significant interaction effects between RD and gender on pain intensity, or between WD and gender on pain interference or pain intensity. Conclusions Pain is highly prevalent in adults with obesity, and is impacted by the frequencies of experiences with RD and WD. Further, discrimination against adults with obesity and chronic pain could exacerbate existing racial disparities in pain and weight management. Asking ethnically diverse adults with obesity about their pain and their experiences of RD and WD could help clinicians make culturally informed assessment and intervention decisions that address barriers to pain relief and weight loss. Trial registration NCT03006328

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Racial and Weight Discrimination Associations with Pain Intensity and Pain Interference in An Ethnically Diverse Sample of Adults with Obesity: A Baseline Analysis of the Clustered Randomized-Controlled Clinical Trial the Goals for Eating and Moving (GEM) Study

10.21203/rs.3.rs-610924/v1 ◽

2021 ◽

Author(s):

Ericka Merriwether ◽

Sandra Wittleder ◽

Gawon Cho ◽

Eushavia Bogan ◽

Rachel Thomas ◽

...

Keyword(s):

Chronic Pain ◽

Pain Intensity ◽

Weight Management ◽

Significant Interaction ◽

Ethnically Diverse ◽

Pain Interference ◽

Controlled Clinical Trial ◽

Weight Discrimination ◽

Randomized Controlled ◽

And Gender

Abstract Background: Everyday experiences with racial (RD) and weight discrimination (WD) are risk factors for chronic pain in ethnically diverse adults with obesity. However, the individual or combined effects of RD or WD on pain in adults with obesity is not well understood. There are gender differences and sexual dimorphisms in nociception and pain, but the effect of gender on relationships between RD and WD in ethnically diverse adults with obesity has not been examined. The goals of this study were to: 1) examine whether weight and racial discrimination are associated with pain intensity and interference, and 2) explore gender as a moderator of the effects of WD and RD on pain.Methods: This is a baseline data analysis from a randomized controlled weight-management trial. Eligible participants were English or Spanish-speaking (ages 18-69 years) and had either a body mass index of ≥ 30 kg/m2 or ≥ 25 kg/m2 with weight-related comorbidity. WD and RD were measured using the Experiences of Discrimination questionnaire (EOD). Pain outcome (pain interference and intensity) were measured using the PROMIS 29 adult profile V2.1. Linear regression models were performed to determine the associations between WD, RD, and gender, with pain outcomes.Results. On average participants reported mild pain interference (T-score: 52.65±10.29) and moderate pain intensity (4.23±3.15, scale: 0-10). There was a significant interaction effect of RD and gender on pain interference. RD was more strongly associated with pain interference in women (b = .47, SE = .08, p < 001), compared to men (b = .14, SE = .07, p = .06). There were no significant interaction effects between RD and gender on pain intensity, or between WD and gender on pain interference or intensity. Conclusions: Pain is highly prevalent in adults with obesity, and is impacted by experiences of racial and weight discrimination. Further, discrimination against adults with obesity and chronic pain could exacerbate existing racial disparities in pain and weight management. Asking ethnically diverse adults with obesity about their pain and their experiences of racial and weight discrimination could help clinicians make culturally informed decisions that address barriers to pain relief and weight loss.Trial Registration: NCT03006328

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The Effect of Isometric Exercises on Primary Dysmenorrhea: A Randomized Controlled Clinical Trial

Galen Medical Journal ◽

10.31661/gmj.v4i1.168 ◽

2015 ◽

Vol 4 (1) ◽

pp. 26-32

Author(s):

Sara Azima ◽

Hajar Rajaei Bakhshayesh ◽

Keramatollah Abbasnia ◽

Maasumeh Kaviani ◽

Mehrab Sayadi

Keyword(s):

Clinical Trial ◽

Pain Intensity ◽

Repeated Measures ◽

Intervention Group ◽

Controlled Clinical Trial ◽

Primary Dysmenorrhea ◽

Randomized Controlled Clinical Trial ◽

Randomized Controlled ◽

Significant Difference ◽

Pharmacological Method

Background: Primary dysmenorrhea is the most common cyclic pelvic pain and is also the most common gynecological problem worldwide and affects quality of life. The present study aimed to investigate the effect of isometric exercises on intensity and duration of pain and level of anxiety in the students with primary dysmenorrhea.Materials and Methods: In this randomized controlled clinical trial, 68 students living in dormitories of Shiraz University with primary dysmenorrhea were randomly assigned to isometric exercises and control groups. The intervention group performed isometric exercises since the third day of the menstrual cycle for 8 weeks. Pain intensity was measured using Visual Analog Scale (VAS). In addition, the anxiety level was assessed using Spielberger questionnaire. The data were analyzed using independent t-test, repeated measures ANOVA, and Bonferroni Post hoc test at the end of the second and third months of the study. Besides, P<0.05 was considered as statistically significant.Results: Pain intensity and duration of pain was significantly reduced in exercises group (p<0.001). However, no significant difference was found between the two groups concerning the mean anxiety levels.Conclusion: Primary dysmenorrhea is a common complaint among young women. Isometric exercises seem to be an easy, non-pharmacological method for reducing primary dysmenorrheal.

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