The WHT intervention arm includes four core elements: 1) An interdisciplinary WHT collaborating with primary care; 2) Personalized Health Planning with prioritization of multi-modal non-pharmacological and CIH pain management approaches; 3) Whole Health Coaching sessions to assist patients in developing and implementing a Personalized Health Plan for chronic pain care; and 4) the web/mobile Whole Health Resource Directory provided to patient participants (in addition to their providers) to support non-pharmacologic/CIH chronic pain care.

Primary Care Group Education (PC-GE) iss the comparator arm, which is an abbreviated form of Cognitive Behavioral Therapy for Chronic Pain (CBT-CP) adapted for group use in primary care.

In VA, patient-aligned care teams (PACTs) or primary care is step 1 of VA's Stepped Care Model in the treatment of chronic pain. PCPs are expected to possess the requisite skill set for management of common chronic pain-causing conditions, which includes biopsychosocial assessment, multi-modal treatment, and coordination of specialty pain care after shared-decision making that incorporates patient preferences and values. Participants randomized to this arm will continue to have their PCP and PACT serve in this role.

Reference Group: Primary Care Group Education (PC-GE) Intervention Arm

Adjusted for baseline BPI, time, time*treatment, randomization stratification variables.

To control for multiple comparisons, P<0.03 was used as a significance threshold for comparing whole health team vs. cognitive behavioral therapy.

Values are differences in least-squares means.

The WHT intervention arm includes four core elements: 1) An interdisciplinary WHT collaborating with primary care; 2) Personalized Health Planning with prioritization of multi-modal non-pharmacological and CIH pain management approaches; 3) Whole Health Coaching sessions to assist patients in developing and implementing a Personalized Health Plan for chronic pain care; and 4) the web/mobile Whole Health Resource Directory provided to patient participants (in addition to their providers) to support non-pharmacologic/CIH chronic pain care.

Primary Care Group Education (PC-GE) iss the comparator arm, which is an abbreviated form of Cognitive Behavioral Therapy for Chronic Pain (CBT-CP) adapted for group use in primary care.

The WHT intervention arm includes four core elements: 1) An interdisciplinary WHT collaborating with primary care; 2) Personalized Health Planning with prioritization of multi-modal non-pharmacological and CIH pain management approaches; 3) Whole Health Coaching sessions to assist patients in developing and implementing a Personalized Health Plan for chronic pain care; and 4) the web/mobile Whole Health Resource Directory provided to patient participants (in addition to their providers) to support non-pharmacologic/CIH chronic pain care.

WHT was an interdisciplinary, individualized pain care intervention informed by the VA Whole Health Model. The WHT included three members: a physician or nurse practitioner who could prescribe pain medication and refer patients to non-pharmacologic pain care; another clinician who could directly provide integrative pain care such as a physical therapist or chiropractor; and one wellness coach. WHT members met briefly each week to coordinate patients' care. Coaches met with patients first and educated them about the eight domains of Whole Health: sleep, nutrition, physical activity, emotional health, personal development, environment, spirituality, and social support. Coaches asked patients to consider "what matters most to them" and what they would be willing to change that might improve pain (such as weight loss for knee pain in overweight patients). Next, during an initial visit, clinicians assessed patients' pain complaints and medical history, provided integrative pain care, and collaboratively developed treatment plans aligned with patients' personal values and life goals. After these initial visits, coaches delivered at least eight weekly telephone coaching sessions to support patients' goal attainment. Over the 12-month follow-up period, patients completed at least three clinician follow-up visits for pain management, and one final discharge planning visit. Patients could attend additional coaching and clinician visits if needed over the 12-month follow-up period.

The WHT intervention arm includes four core elements: 1) An interdisciplinary WHT collaborating with primary care; 2) Personalized Health Planning with prioritization of multi-modal non-pharmacological and CIH pain management approaches; 3) Whole Health Coaching sessions to assist patients in developing and implementing a Personalized Health Plan for chronic pain care; and 4) the web/mobile Whole Health Resource Directory provided to patient participants (in addition to their providers) to support non-pharmacologic/CIH chronic pain care.

Primary Care Group Education (PC-GE) iss the comparator arm, which is an abbreviated form of Cognitive Behavioral Therapy for Chronic Pain (CBT-CP) adapted for group use in primary care.

The WHT intervention arm includes four core elements: 1) An interdisciplinary WHT collaborating with primary care; 2) Personalized Health Planning with prioritization of multi-modal non-pharmacological and CIH pain management approaches; 3) Whole Health Coaching sessions to assist patients in developing and implementing a Personalized Health Plan for chronic pain care; and 4) the web/mobile Whole Health Resource Directory provided to patient participants (in addition to their providers) to support non-pharmacologic/CIH chronic pain care.

WHT was an interdisciplinary, individualized pain care intervention informed by the VA Whole Health Model. The WHT included three members: a physician or nurse practitioner who could prescribe pain medication and refer patients to non-pharmacologic pain care; another clinician who could directly provide integrative pain care such as a physical therapist or chiropractor; and one wellness coach. WHT members met briefly each week to coordinate patients' care. Coaches met with patients first and educated them about the eight domains of Whole Health: sleep, nutrition, physical activity, emotional health, personal development, environment, spirituality, and social support. Coaches asked patients to consider "what matters most to them" and what they would be willing to change that might improve pain (such as weight loss for knee pain in overweight patients). Next, during an initial visit, clinicians assessed patients' pain complaints and medical history, provided integrative pain care, and collaboratively developed treatment plans aligned with patients' personal values and life goals. After these initial visits, coaches delivered at least eight weekly telephone coaching sessions to support patients' goal attainment. Over the 12-month follow-up period, patients completed at least three clinician follow-up visits for pain management, and one final discharge planning visit. Patients could attend additional coaching and clinician visits if needed over the 12-month follow-up period.

The WHT intervention arm includes four core elements: 1) An interdisciplinary WHT collaborating with primary care; 2) Personalized Health Planning with prioritization of multi-modal non-pharmacological and CIH pain management approaches; 3) Whole Health Coaching sessions to assist patients in developing and implementing a Personalized Health Plan for chronic pain care; and 4) the web/mobile Whole Health Resource Directory provided to patient participants (in addition to their providers) to support non-pharmacologic/CIH chronic pain care.

Primary Care Group Education (PC-GE) iss the comparator arm, which is an abbreviated form of Cognitive Behavioral Therapy for Chronic Pain (CBT-CP) adapted for group use in primary care.

WHT was an interdisciplinary, individualized pain care intervention informed by the VA Whole Health Model. The WHT included three members: a physician or nurse practitioner who could prescribe pain medication and refer patients to non-pharmacologic pain care; another clinician who could directly provide integrative pain care such as a physical therapist or chiropractor; and one wellness coach. WHT members met briefly each week to coordinate patients' care. Coaches met with patients first and educated them about the eight domains of Whole Health: sleep, nutrition, physical activity, emotional health, personal development, environment, spirituality, and social support. Coaches asked patients to consider "what matters most to them" and what they would be willing to change that might improve pain (such as weight loss for knee pain in overweight patients). Next, during an initial visit, clinicians assessed patients' pain complaints and medical history, provided integrative pain care, and collaboratively developed treatment plans aligned with patients' personal values and life goals. After these initial visits, coaches delivered at least eight weekly telephone coaching sessions to support patients' goal attainment. Over the 12-month follow-up period, patients completed at least three clinician follow-up visits for pain management, and one final discharge planning visit. Patients could attend additional coaching and clinician visits if needed over the 12-month follow-up period.

The WHT intervention arm includes four core elements: 1) An interdisciplinary WHT collaborating with primary care; 2) Personalized Health Planning with prioritization of multi-modal non-pharmacological and CIH pain management approaches; 3) Whole Health Coaching sessions to assist patients in developing and implementing a Personalized Health Plan for chronic pain care; and 4) the web/mobile Whole Health Resource Directory provided to patient participants (in addition to their providers) to support non-pharmacologic/CIH chronic pain care.

Primary Care Group Education (PC-GE) iss the comparator arm, which is an abbreviated form of Cognitive Behavioral Therapy for Chronic Pain (CBT-CP) adapted for group use in primary care.

WHT was an interdisciplinary, individualized pain care intervention informed by the VA Whole Health Model. The WHT included three members: a physician or nurse practitioner who could prescribe pain medication and refer patients to non-pharmacologic pain care; another clinician who could directly provide integrative pain care such as a physical therapist or chiropractor; and one wellness coach. WHT members met briefly each week to coordinate patients' care. Coaches met with patients first and educated them about the eight domains of Whole Health: sleep, nutrition, physical activity, emotional health, personal development, environment, spirituality, and social support. Coaches asked patients to consider "what matters most to them" and what they would be willing to change that might improve pain (such as weight loss for knee pain in overweight patients). Next, during an initial visit, clinicians assessed patients' pain complaints and medical history, provided integrative pain care, and collaboratively developed treatment plans aligned with patients' personal values and life goals. After these initial visits, coaches delivered at least eight weekly telephone coaching sessions to support patients' goal attainment. Over the 12-month follow-up period, patients completed at least three clinician follow-up visits for pain management, and one final discharge planning visit. Patients could attend additional coaching and clinician visits if needed over the 12-month follow-up period.

WHT was an interdisciplinary, individualized pain care intervention informed by the VA Whole Health Model. The WHT included three members: a physician or nurse practitioner who could prescribe pain medication and refer patients to non-pharmacologic pain care; another clinician who could directly provide integrative pain care such as a physical therapist or chiropractor; and one wellness coach. WHT members met briefly each week to coordinate patients' care. Coaches met with patients first and educated them about the eight domains of Whole Health: sleep, nutrition, physical activity, emotional health, personal development, environment, spirituality, and social support. Coaches asked patients to consider "what matters most to them" and what they would be willing to change that might improve pain (such as weight loss for knee pain in overweight patients). Next, during an initial visit, clinicians assessed patients' pain complaints and medical history, provided integrative pain care, and collaboratively developed treatment plans aligned with patients' personal values and life goals. After these initial visits, coaches delivered at least eight weekly telephone coaching sessions to support patients' goal attainment. Over the 12-month follow-up period, patients completed at least three clinician follow-up visits for pain management, and one final discharge planning visit. Patients could attend additional coaching and clinician visits if needed over the 12-month follow-up period.

WHT was an interdisciplinary, individualized pain care intervention informed by the VA Whole Health Model. The WHT included three members: a physician or nurse practitioner who could prescribe pain medication and refer patients to non-pharmacologic pain care; another clinician who could directly provide integrative pain care such as a physical therapist or chiropractor; and one wellness coach. WHT members met briefly each week to coordinate patients' care. Coaches met with patients first and educated them about the eight domains of Whole Health: sleep, nutrition, physical activity, emotional health, personal development, environment, spirituality, and social support. Coaches asked patients to consider "what matters most to them" and what they would be willing to change that might improve pain (such as weight loss for knee pain in overweight patients). Next, during an initial visit, clinicians assessed patients' pain complaints and medical history, provided integrative pain care, and collaboratively developed treatment plans aligned with patients' personal values and life goals. After these initial visits, coaches delivered at least eight weekly telephone coaching sessions to support patients' goal attainment. Over the 12-month follow-up period, patients completed at least three clinician follow-up visits for pain management, and one final discharge planning visit. Patients could attend additional coaching and clinician visits if needed over the 12-month follow-up period.

WHT was an interdisciplinary, individualized pain care intervention informed by the VA Whole Health Model. The WHT included three members: a physician or nurse practitioner who could prescribe pain medication and refer patients to non-pharmacologic pain care; another clinician who could directly provide integrative pain care such as a physical therapist or chiropractor; and one wellness coach. WHT members met briefly each week to coordinate patients' care. Coaches met with patients first and educated them about the eight domains of Whole Health: sleep, nutrition, physical activity, emotional health, personal development, environment, spirituality, and social support. Coaches asked patients to consider "what matters most to them" and what they would be willing to change that might improve pain (such as weight loss for knee pain in overweight patients). Next, during an initial visit, clinicians assessed patients' pain complaints and medical history, provided integrative pain care, and collaboratively developed treatment plans aligned with patients' personal values and life goals. After these initial visits, coaches delivered at least eight weekly telephone coaching sessions to support patients' goal attainment. Over the 12-month follow-up period, patients completed at least three clinician follow-up visits for pain management, and one final discharge planning visit. Patients could attend additional coaching and clinician visits if needed over the 12-month follow-up period.

WHT was an interdisciplinary, individualized pain care intervention informed by the VA Whole Health Model. The WHT included three members: a physician or nurse practitioner who could prescribe pain medication and refer patients to non-pharmacologic pain care; another clinician who could directly provide integrative pain care such as a physical therapist or chiropractor; and one wellness coach. WHT members met briefly each week to coordinate patients' care. Coaches met with patients first and educated them about the eight domains of Whole Health: sleep, nutrition, physical activity, emotional health, personal development, environment, spirituality, and social support. Coaches asked patients to consider "what matters most to them" and what they would be willing to change that might improve pain (such as weight loss for knee pain in overweight patients). Next, during an initial visit, clinicians assessed patients' pain complaints and medical history, provided integrative pain care, and collaboratively developed treatment plans aligned with patients' personal values and life goals. After these initial visits, coaches delivered at least eight weekly telephone coaching sessions to support patients' goal attainment. Over the 12-month follow-up period, patients completed at least three clinician follow-up visits for pain management, and one final discharge planning visit. Patients could attend additional coaching and clinician visits if needed over the 12-month follow-up period.