{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:01:33Z","timestamp":1785283293129,"version":"3.55.0"},"reference-count":58,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T00:00:00Z","timestamp":1783728000000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UH3AR076387, UM1AR063381"],"award-info":[{"award-number":["UH3AR076387, UM1AR063381"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UM1TR004403"],"award-info":[{"award-number":["UM1TR004403"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Fibromyalgia is characterized by a broad spectrum of symptoms such as pain, fatigue, and psychosocial impairments that collectively contribute to disease severity. This study aims to investigate the influence of living in rural versus urban settings on fibromyalgia severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a secondary analysis of baseline data from 685 participants combined from 2 clinical trials. Survey data collected at baseline included sociodemographic characteristics (sex, age, rurality, race, ethnicity, income, education, employment status), pain and pain interference, fatigue, pain catastrophizing, and the Fibromyalgia Impact Questionnaire-Revised (FIQR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Study participants were 50.6\u2009\u00b1\u200914.2\u2009years, 96% female, and 44% resided in rural areas. FIQR was significantly associated with age (F\u2009=\u20095.511, P\u2009&amp;lt;\u20090.001), race (t = \u22123.628, P\u2009&amp;lt;\u20090.001), marital status (t\u2009=\u20093.410, P\u2009&amp;lt;\u20090.001), education status (F\u2009=\u20095.887, P\u2009=\u20090.003), employment status (t = \u22123.153, P\u2009=\u20090.002), and income (F\u2009=\u200913.147, P\u2009&amp;lt;\u20090.001) but not rurality (t = \u22120.350, P\u2009=\u20090.726). Cluster analysis based on rurality and sociodemographic variables resulted in 2 groups that differed by age, race, employment status, and income; FIQR was higher among those who were older, non-White, unemployed and with lower income. Using linear regression, sociodemographic variables contributed less than 10% of the variance in disease severity as measured by FIQR (R2 = 0.09) while rurality did not contribute. Additionally, sociodemographic variables contributed minimally to pain severity (9%) and interference (8%), widespread pain (4%), fatigue (6%), and pain catastrophizing (12%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Rurality and sociodemographic characteristics had limited influence on pain, fatigue, and pain catastrophizing, suggesting that fibromyalgia disease severity is minimally influenced by sociodemographic variables and not by rurality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trials Registration<\/jats:title>\n                    <jats:p>This study is a secondary analysis of baseline data from the Fibromyalgia Activity Study with TENS (FAST, NCT01888640, https:\/\/clinicaltrials.gov\/study\/NCT01888640) and the Fibromyalgia Transcutaneous Electrical Nerve Stimulation in Physical Therapy Study (FM-TIPS, NCT04683042, https:\/\/clinicaltrials.gov\/study\/NCT04683042) trial protocols. Patient enrolment started on September 30, 2013, for FAST and on January 22, 2021, for FM-TIPS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/pm\/pnag088","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T11:52:30Z","timestamp":1783684350000},"source":"Crossref","is-referenced-by-count":0,"title":["Sociodemographic factors, but not rurality, explain limited variance in fibromyalgia severity: a secondary analysis of 2 randomized clinical trials"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2065-1703","authenticated-orcid":false,"given":"Ezgi","family":"Yarasir Gillette","sequence":"first","affiliation":[{"name":"Department of Physical Therapy and Rehabilitation Science, Roy J. and Lucille A. Carver College of Medicine, The University of Iowa , Iowa City, IA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kari G","family":"Vance","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy and Rehabilitation Science, Roy J. and Lucille A. Carver College of Medicine, The University of Iowa , Iowa City, IA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2615-0915","authenticated-orcid":false,"given":"Emine O","family":"Bayman","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, The University of Iowa , Iowa City, IA,","place":["United States"]},{"name":"Department of Anesthesia, The University of Iowa , Iowa City, IA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana L","family":"Dailey","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy and Rehabilitation Science, Roy J. and Lucille A. Carver College of Medicine, The University of Iowa , Iowa City, IA,","place":["United States"]},{"name":"Department of Physical Therapy, St Ambrose University , Davenport, IA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol G T","family":"Vance","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy and Rehabilitation Science, Roy J. and Lucille A. Carver College of Medicine, The University of Iowa , Iowa City, IA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0514-739X","authenticated-orcid":false,"given":"Ruth L","family":"Chimenti","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy and Rehabilitation Science, Roy J. and Lucille A. Carver College of Medicine, The University of Iowa , Iowa City, IA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie J","family":"Crofford","sequence":"additional","affiliation":[{"name":"Division of Rheumatology and Immunology, Medical Center, Vanderbilt University , Nashville, TN,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara J","family":"Van Gorp","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy and Rehabilitation Science, Roy J. and Lucille A. Carver College of Medicine, The University of Iowa , Iowa City, IA,","place":["United States"]},{"name":"Iowa Orthopedics Sports Medicine and Rehabilitation, University of Iowa Health Care , Iowa City, IA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth M","family":"Johnson","sequence":"additional","affiliation":[{"name":"Division of Rheumatology and Immunology, Medical Center, Vanderbilt University , Nashville, TN,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0433-1942","authenticated-orcid":false,"given":"Kristin R","family":"Archer","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Vanderbilt University Medical Center , Nashville, TN,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Schacht Reisinger","sequence":"additional","affiliation":[{"name":"Institute for Clinical and Translational Science, The University of Iowa , Iowa City, IA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam Bridget","family":"Zimmerman","sequence":"additional","affiliation":[{"name":"Biostatistics Consulting Center, Department of Biostatistics, College of Public Health, The University of Iowa , Iowa City, IA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0207-8728","authenticated-orcid":false,"given":"Kathleen A","family":"Sluka","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy and Rehabilitation Science, Roy J. and Lucille A. 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