Oklahoma Study of Native American Pain Risk III: Stress and Resilience

The Impact of Structural Racism and Discrimination (SRD) on Mechanisms of the Native American Pain Disparity

The goal of this observational study is to learn about the relationship between environmental structural racism and discrimination and chronic pain risk in Native American adults. The main questions it aims to answer are:

1. How does environmental structural racism and discrimination affect chronic pain-promoting mechanisms in Native Americans?
2. What psychosocial factors buffer the negative effects of environmental structural racism and discrimination on chronic pain-promoting mechanisms?

Native Americans experience higher rates of chronic pain than the general U.S. population, and previous research has shown that pain-free Native Americans transition to chronic pain at almost three times the rate of non-Hispanic Whites. Yet, little is known about the mechanisms that contribute to this pain disparity.

This study aims to better understand the role of environmental and society-wide stressors, like structural racism and discrimination, in contributing to this pain disparity. It is believed that these environmental and social stressors may contribute to chronic pain risk by increasing an individual's mental and physical stress levels. In turn, increased stress may alter how an individual responds to pain, both physically and emotionally, which may place them at greater risk for developing chronic pain in the future.

Inclusion Criteria:

• Self-identify as Native American/American Indian

Exclusion Criteria:

• <18 years of age
• Self-reported history of cardiovascular, neuroendocrine, musculoskeletal, or neurological disorders
• Surrent chronic pain, defined as persistent, bothersome pain on more days than not for at least 3 months)
• Self-reported current substance dependence
• Sse of medication that could interfere with testing (e.g., recent use of analgesics, antidepressants, or anti-anxiety medications)
• Inability to speak English
• Current psychosis (assessed by Psychosis Screening Questionnaire)
• Serious cognitive impairment (assessed by <20 score on the Montreal Cognitive Assessment [MoCA])
• Possible peripheral neuropathy (assessed by nerve conduction study)