The goal of the RAMP mind-body program is to provide Veterans with information and tools that can help them manage their pain. The program explores the important connection between our bodies and minds, and how to use this special connection to manage pain more effectively.

Our long-term objective is to improve pain management and reduce opioid use among rural patients in the VA. To accomplish this, we will conduct a randomized clinical trial (RCT) to test the effectiveness of an innovative multi-component complementary and integrative intervention, Reaching Rural Veterans: Applying Mind-Body Skills for Pain Using a Whole Health Telehealth Intervention (RAMP) delivered via group telehealth, for improving rural Veterans' pain management, function, and wellbeing, within the VA healthcare system. This project addresses the significant challenge of implementing effective, non-opioid interventions for chronic pain management among rural Veterans, who experience a disproportionate share of the national pain burden, with more chronicity, opioid harms, comorbid mental health conditions and substance abuse, and are prescribed more opioids and have less access to evidence-based, chronic pain care that addresses their "whole-person" or biopsychosocial needs. The RAMP program strategically coalesces multiple evidence based CIH self-management strategies to address rural Veterans' biopsychosocial needs and overcome existing barriers to implementation. Comprised of pain education, mindfulness, pain specific exercises, and cognitive behavioral strategies, the program is cohesive and scalable.

Inclusion Criteria:

• 18 years of age or older
• rural-dwelling based on U.S. Health Services Research Administration Criteria
• chronic pain based on two qualifying pain diagnoses in their electronic health record (EHR) within the same diagnostic category, at least 90 days apart, during the previous 2 years
• self-reported pain on at least most days in the past 3 months
• Brief Pain Inventory Interference subscale score ≥ 4/10
• access to a device with internet
• willingness to engage in intervention-specific procedures (e.g., meet remotely online for sessions)
• an email address listed in the EHR.

Exclusion Criteria:

• severe, poorly controlled psychiatric or substance use disorder (identified by chart review)
• active member of advisory panel for the study
• enrollment in another research study for pain
• enrollment in a similar study
• enrollment in a similar facilitated, multi-week, multi-modal complementary and integrative health program.

The study data will be submitted to the National Institute of Mental Health (NIMH) Data Archive (NDA). Demographic and clinical outcome measures will be collected and shared using common data elements (CDEs ) from the NIH / HEAL CDE repository. Variable naming and permissible response values will be harmonized according to CDEs data dictionary specifications. Documentation to be made publicly available to the research community and will include: 1. The study protocol; 2. information sheet (provided per waiver of documentation of informed consent); 3. data collection forms/case report forms; 4. data dictionary.

Scientific data included in published manuscripts will be available at the time of publication; all other generated scientific data will be shared with the NDA repository no later than the end of the award.

Publications from this research will be made available to the public through the National Library of Medicine PubMed Central website within one year after the date of publication. The research project team and PRISM/Collaboratory Program Coordinating Center will work together in order to offer deidentified or limited data sets that will be available to the public. Where practicable, Limited Datasets (LDSs) will be created and shared pursuant to a Data Use Agreement (DUA) appropriately limiting use of the dataset and prohibiting the recipient from identifying or reidentifying (or taking steps to identify or re-identify) any individual whose data are included in the dataset. No PHI or VA sensitive data will be shared, unless approved by VA Privacy Officers. Only authorized research personnel as approved by the ACOS in agreement with the MPIs, will have access to individually identifiable data.