Opioid overdose is now the leading cause of unintentional injury related mortality in the U.S. with two people dying each day as a result of opioid overdose in Arizona. Among patients treated for opioid use disorder, chronic pain is frequently cited as the reason for opioid use. Treatment of chronic pain with long-term use of opioids is linked to increased medication tolerance, worsened pain sensitivity, and psychological symptoms. Acceptance of chronic pain is the individual’s ability to be willing to endure pain and their ability and willingness to participate in activities despite experiencing chronic pain. Increased acceptance of chronic pain has been shown to lower pain intensity, promote recovery of individuals’ emotional and physical abilities, and lessen use of pain medication including opioids.

Purpose: The purpose of this evidence-based practice project was to examine the feasibility of using acceptance of chronic pain, pain severity, and pain interference as measures to evaluate the effectiveness of a multimodal residential treatment program for opioid abuse.

Methods: Two surveys, the CPAQ and BPI were administered shortly after admission (T1) and after 21-25 days (T2) to evaluate project feasibility.

Results: Six participants were enrolled. Three participants completed T1 and T2 surveys. Three participants were lost to follow-up. Mean scores for Chronic Pain Acceptance were T1 = 79 (SD = 17.0) and T2 = 78.67 (SD = 5.0). All surveys were easy to administer and participants answered all questions.

Conclusion: Chronic pain acceptance may be a feasible and meaningful measure with which to evaluate residential treatment programs. Further research is needed to evaluate acceptance of chronic pain with long-term opioid abstinence and overdose deaths.

Purpose: The purpose of this project was to implement health promotion education for overweight and obese adults with endocrine disorders. The overarching goal was to change dietary intake and improve exercise to reduce the incidence, prevalence, and impact of comorbidities associated with obesity.

Background/Synthesis: Obesity is a significant epidemic facing the nation today with multiple impacts on the national healthcare system. There is often an association between obesity and endocrine disorders such as type 2 diabetes and prediabetes. Both obesity and diabetes cost the nation billions of dollars annually in healthcare costs. Evidence shows that lifestyle modifications related to nutrition and physical activity are effective in weight reduction and prevention of chronic disease, especially when given by a healthcare provider.

Methods: Fifteen adult patients at an endocrinology office in Arizona received individual counseling using the teach-back method focusing on health promotion behaviors through nutrition and exercise with a two-week follow-up phone call. Short-term outcomes measured in this project included changes in dietary intake and exercise behaviors through a pre- and post-test adapted from an obesity-screening tool developed by Greenwood et al. (2008).

Outcomes/Results: Participants were primarily Caucasian and Hispanic, married, female, average age of 50 years, average BMI of 34.5, and some college education. There was a statistically significant increase in health promoting behavior on posttest scores (M=66, SD=6.23, range=58-76) compared to pretest scores (M=61, SD=4.72, range=50-66), t(14)=-2.55, p=0.023.

Conclusions and Implications: Overall, patient health promotion behaviors increased with this educational intervention. Clinical implications include a potential decrease in patient comorbidities related to overweight and obesity. Implications for the greater healthcare system include decreased comorbidities, utilization of healthcare resources, and costs associated with overweight and obesity. Future recommendations would include determining weight and BMI changes over a longer period of time for even better outcome measures.

Keywords: obesity, obese, overweight, health promotion, health education, diet, exercise, nutrition