Renée El-Gabalawy, Brigitte Sabourin, Gregg A Tkachuk, Gabrielle S Logan, Kailey E Penner, Barbara Shay, Elena Bilevicius, Lesley A Graff, Ryan Skrabek, Jessica Senn, Steve Yurkiw, Ryan Amadeo, Jori Ganetsky, John Walker
An internet-based, self-directed ACT program appears feasible, with encouraging pain and psychosocial impact trends. The IMPACT program is currently widely available for free to Canadians through the Power Over Pain portal.
BACKGROUND: Chronic pain affects approximately 20% of Canadians and has profound health impacts, highlighting the need for accessible, evidence-based interventions like Acceptance and Commitment Therapy (ACT). Internet-based, self-directed programs may enhance access, though few have been tested in Canadian chronic pain populations.
AIMS: The primary objective involved assessing the feasibility of the IMPACT (Internet-delivered Multidisciplinary Pain Acceptance and Commitment Therapy) program, a 10-module, self-directed intervention co-developed by patient-partners and pain experts. Secondary objectives included examining pilot outcomes (pain and mental health).
METHODS: Adults referred for outpatient chronic pain care were invited to participate. Feasibility was assessed via participant ratings on Likert scales and open-ended feedback. Pain-related (e.g., catastrophizing, interference) and mental health-related (e.g., anxiety and depression) outcomes were assessed using validated measures at baseline, post-intervention, and at 6-month follow-up.
RESULTS: Of the 115 who expressed interest (25.2% response rate), 76 consented, and 68 activated the online program (89.5% participation rate). On average, 6.44 program modules (SD = 3.82) were completed out of 10 (7 core, 3 optional). Most rated the program as user-friendly (80.0%) and clear (92.0%). Time commitment was the most common barrier to participation. Pilot analyses suggested significant improvements across domains at the 6-month follow-up. Large effect sizes were observed for improvements in pain interference (g = -0.92), catastrophizing (g = -0.95), and psychosocial impact (g = -1.06) among full or partial program completers.
CONCLUSIONS: An internet-based, self-directed ACT program appears feasible, with encouraging pain and psychosocial impact trends. The IMPACT program is currently widely available for free to Canadians through the Power Over Pain portal.