{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T21:50:51Z","timestamp":1790286651637,"version":"4.1.0"},"reference-count":57,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T00:00:00Z","timestamp":1757548800000},"content-version":"unspecified","delay-in-days":253,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Prim Health Care Res Dev"],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S146342362510042X_as1\">\n\t    <jats:title>Aim:<\/jats:title>\n\t    <jats:p>The Pain Recognition and Evaluation to Validate Effective Neck and back Treatment (PREVENT) study aims to identify cognitive, behavioral, and treatmentrelated predictors of chronic musculoskeletal pain (CMP) development following emergency department (ED) care for acute neck or back pain after trauma.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S146342362510042X_as2\">\n\t    <jats:title>Background:<\/jats:title>\n\t    <jats:p>CMP is a leading cause of global disability, yet early risk factors for its development remain poorly characterized, particularly in ED settings. This prospective observational study will recruit 246 adult patients presenting with acute (\u2264 4 weeks) neck or back pain after a recent trauma. Pain beliefs \u2013 measured using pain and attitude questionnaires \u2013 serve as the primary independent variable. Mediating variables include catastrophic thinking, fear-avoidance behaviors, low physical activity, poor recovery expectations, and low self-efficacy for pain management. Covariates\u00a0include demographics, social determinants of health, mental health disorders, and high-risk substance use. The primary outcome is the presence of CMP at six months, defined as pain on most or every day for at least three months. Participants will complete follow-ups at 1, 3, and 6 months. Multivariable logistic regression, mediation analyses, and interaction testing will explore\u00a0effects of pain beliefs on CMP development. As a secondary aim, a subset of participants will complete Think Aloud cognitive interviews to assess response process validity for the Neck Pain Attitudes Questionnaire (Neck-PAQ), a region-specific adaptation of the Back Pain Attitude Questionnaire, analyzed using a deductive content analysis framework.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S146342362510042X_as3\">\n\t    <jats:title>Discussion:<\/jats:title>\n\t    <jats:p>This study is among the first to investigate the cognitive and behavioral predictors of pain chronification in the ED. Ethical approval has been obtained from The George Washington University Institutional Review Board. Findings will inform the design of targeted, ED-based screening and intervention strategies, including adaptation of a pain-specific Screening, Brief Intervention, and Referral to Treatment (SBIRT) model. Results will be disseminated through peer-reviewed publications, conferences, and stakeholder engagement.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/s146342362510042x","type":"journal-article","created":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T12:10:43Z","timestamp":1757592643000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["From acute to chronic: the PREVENT protocol for understanding pain progression after emergency department visits"],"prefix":"10.1017","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5224-6959","authenticated-orcid":false,"given":"Michael","family":"Ray","sequence":"first","affiliation":[{"name":"The George Washington University School of Medicine and Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5971-8314","authenticated-orcid":false,"given":"Andrew C.","family":"Meltzer","sequence":"additional","affiliation":[{"name":"The George Washington University School of Medicine and Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9275-1842","authenticated-orcid":false,"given":"Timothy C.","family":"McCall","sequence":"additional","affiliation":[{"name":"The George Washington University School of Medicine and Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3154-7116","authenticated-orcid":false,"given":"Keith","family":"Meldrum","sequence":"additional","affiliation":[{"name":"Unaffiliated"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,9,11]]},"reference":[{"key":"S146342362510042X_ref54","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2021.08.005"},{"key":"S146342362510042X_ref23","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2023.02.258"},{"key":"S146342362510042X_ref11","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6736a2"},{"key":"S146342362510042X_ref39","doi-asserted-by":"publisher","DOI":"10.1016\/j.msksp.2022.102591"},{"key":"S146342362510042X_ref10","doi-asserted-by":"publisher","DOI":"10.1007\/s11097-023-09896-0"},{"key":"S146342362510042X_ref18","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(96)70264-0"},{"key":"S146342362510042X_ref38","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e31815cf75b"},{"key":"S146342362510042X_ref30","doi-asserted-by":"publisher","DOI":"10.11613\/BM.2012.031"},{"key":"S146342362510042X_ref49","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-023-07537-2"},{"key":"S146342362510042X_ref46","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0b013e31824549d6"},{"key":"S146342362510042X_ref28","doi-asserted-by":"publisher","DOI":"10.1177\/1049732315617444"},{"key":"S146342362510042X_ref55","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2019.02.011"},{"key":"S146342362510042X_ref7","unstructured":"Centers for Medicare & Medicaid Services (CMS) (2021). 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