{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T23:43:56Z","timestamp":1780616636815,"version":"3.54.1"},"reference-count":70,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T00:00:00Z","timestamp":1738368000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T00:00:00Z","timestamp":1738368000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["Overdose Data to Action"],"award-info":[{"award-number":["Overdose Data to Action"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"name":"University of Florida College of Medicine \u2013 Jacksonville"},{"name":"Florida Medical Malpractice Joint Underwriting Association","award":["Alvin E. Smith Safety of Health Care Services Gran"],"award-info":[{"award-number":["Alvin E. Smith Safety of Health Care Services Gran"]}]},{"DOI":"10.13039\/100000058","name":"Substance Abuse and Mental Health Services Administration","doi-asserted-by":"publisher","award":["Emergency Department Alternatives to Opioids Demon"],"award-info":[{"award-number":["Emergency Department Alternatives to Opioids Demon"]}],"id":[{"id":"10.13039\/100000058","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100018488","name":"Clinical and Translational Science Institute, University of Florida","doi-asserted-by":"publisher","award":["UL1TR001427"],"award-info":[{"award-number":["UL1TR001427"]}],"id":[{"id":"10.13039\/100018488","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Implementation Research and Practice"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The ongoing opioid epidemic and rising number of patients with chronic pain highlight the need for alternative and integrative pain management approaches as a strategy to reduce opioid use and misuse. Evidence-based nonpharmacologic pain management strategies are available; however, they remain underutilized due to barriers including time limitations, cost, and lack of training. To address these barriers, we implemented a pain coach educator pilot program and nonpharmacologic patient toolkit in the emergency department of a large safety-net hospital. This paper describes the implementation process and preliminary evaluation of the first year of the program.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>We implemented a multimodal pain coach educator program that included education on pain neuroscience and over-the-counter analgesic options, demonstration of integrative techniques, and dissemination of nonpharmacologic toolkits for home use in January 2021. Implementation strategies included changing the electronic health record infrastructure, developing stakeholder interrelationships, and ongoing education and training. We used the RE-AIM framework to guide evaluation of the first year of program implementation using data from the electronic health record, program records, and patient-reported outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the first year of program implementation, 550 pain coach educator sessions were conducted. Upon session completion, 61% of patients felt the program was helpful, 39% were unsure at the time, and none reported session was not helpful. Clinician feedback was overwhelmingly positive. Program cost per patient was $344.35. Adaptations to intervention and implementation strategies included modifications of session delivery timing to accommodate clinical workflows, additions to program content to align with patient characteristics, and changes to patient identification strategies in response to the COVID-19 pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our pain coach educator program provides a model for implementing nonpharmacologic pain management opioid alternatives which can be scaled and adapted for other settings. This work demonstrates the importance of intervention and implementation strategy adaptations to enhance program reach and effectiveness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/26334895251330511","type":"journal-article","created":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T07:44:12Z","timestamp":1743752652000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Implementation of a novel pain coach educator program in a safety-net emergency department"],"prefix":"10.1177","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5615-723X","authenticated-orcid":false,"given":"Jennifer H.","family":"LeLaurin","sequence":"first","affiliation":[{"name":"University of Florida College of Medicine"},{"name":"Clinical and Translational Science Institute"},{"name":"University of Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9628-8584","authenticated-orcid":false,"given":"Magda","family":"Montague","sequence":"additional","affiliation":[{"name":"University of Florida College of Medicine \u2013 Jacksonville"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan E.","family":"Curtis","sequence":"additional","affiliation":[{"name":"University of Florida College of Medicine \u2013 Jacksonville"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8139-2418","authenticated-orcid":false,"given":"Ramzi G.","family":"Salloum","sequence":"additional","affiliation":[{"name":"University of Florida College of Medicine"},{"name":"Clinical and Translational Science Institute"},{"name":"University of Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1939-3126","authenticated-orcid":false,"given":"Sophia","family":"Sheikh","sequence":"additional","affiliation":[{"name":"University of Florida College of Medicine \u2013 Jacksonville"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4881-5159","authenticated-orcid":false,"given":"Phyllis L.","family":"Hendry","sequence":"additional","affiliation":[{"name":"University of Florida College of Medicine \u2013 Jacksonville"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,4,4]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0227966"},{"key":"e_1_3_2_3_1","unstructured":"American Chronic Pain Association. (2018 July 17). Car with four flat tires. Retrieved January 9 2023 from https:\/\/www.theacpa.org\/videos\/car-with-four-flat-tires\/"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40258-016-0268-8"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40359-015-0089-9"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12875-017-0608-2"},{"key":"e_1_3_2_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2012.06.013"},{"key":"e_1_3_2_8_1","unstructured":"Centers for Disease Control and Prevention. (2022). COVID-19 integrated county view. US Department of Health and Human Services CDC. Retrieved October 30 2022 from https:\/\/covid.cdc.gov\/covid-data-tracker"},{"key":"e_1_3_2_9_1","unstructured":"Centers for Disease Control and Prevention National Center for Health Statistics. (2021). Wide-ranging online data for epidemiologic research (WONDER). http:\/\/wonder.cdc.gov"},{"key":"e_1_3_2_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s43058-022-00306-1"},{"key":"e_1_3_2_11_1","volume-title":"Relieving pain in America: A blueprint for transforming prevention, care, education, and research","author":"Institute of Medicine","year":"2011","unstructured":"Institute of Medicine, Board on Health Sciences Policy, & Committee on Advancing Pain Research, Care, and Education. (2011). Relieving pain in America: A blueprint for transforming prevention, care, education, and research. National Academies Press (US). https:\/\/doi.org\/10.17226\/13172"},{"key":"e_1_3_2_12_1","doi-asserted-by":"publisher","DOI":"10.1053\/ajem.2002.32643"},{"key":"e_1_3_2_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.13401"},{"key":"e_1_3_2_14_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.rr7103a1"},{"key":"e_1_3_2_15_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2016.0448"},{"key":"e_1_3_2_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40122-020-00190-4"},{"key":"e_1_3_2_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2020.108350"},{"key":"e_1_3_2_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2004.04.011"},{"key":"e_1_3_2_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pnx220"},{"key":"e_1_3_2_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pnaa003"},{"key":"e_1_3_2_21_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.89.9.1322"},{"key":"e_1_3_2_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.22303"},{"key":"e_1_3_2_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.46697"},{"key":"e_1_3_2_24_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18158172"},{"key":"e_1_3_2_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"issue":"426","key":"e_1_3_2_26_1","first-page":"1","article-title":"Drug overdose deaths in the United States, 1999-2020","author":"Hedegaard H.","year":"2021","unstructured":"Hedegaard H., Minino A. M., Spencer M. R., Warner M. (2021). Drug overdose deaths in the United States, 1999-2020. NCHS Data Brief (426), 1\u20138. https:\/\/doi.org\/10.15620\/cdc:112081","journal-title":"NCHS Data Brief"},{"issue":"1","key":"e_1_3_2_27_1","first-page":"7","article-title":"(O-K4) Two-year results from a new model pain coach educator program and integrative discharge toolkit for pain management in an urban US teaching hospital and emergency department during COVID-19 pandemic","volume":"25","author":"Hendry P. L.","year":"2024","unstructured":"Hendry P. L., Sheikh S., Perl K., Montague M., Curtis-Gonzalez M., Bartow V., Menze N., Lott M., Webb K., Norse A. B., Crisp A. B., Fishe J. B. (2024). (O-K4) Two-year results from a new model pain coach educator program and integrative discharge toolkit for pain management in an urban US teaching hospital and emergency department during COVID-19 pandemic. Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health, 25(1.1), 7\u20138. https:\/\/doi.org\/10.5811\/westjem.63024","journal-title":"Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health"},{"key":"e_1_3_2_28_1","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S202376"},{"key":"e_1_3_2_29_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2710.2002.00416.x"},{"key":"e_1_3_2_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40122-018-0097-6"},{"key":"e_1_3_2_31_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-3524"},{"key":"e_1_3_2_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2019.06.014"},{"key":"e_1_3_2_33_1","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2019-105849"},{"key":"e_1_3_2_34_1","first-page":"29","article-title":"Rewards, recognition, and caregiver engagement at Cleveland Clinic","volume":"6","author":"Majernik M. E.","year":"2014","unstructured":"Majernik M. E., Patrnchak J. M. (2014). Rewards, recognition, and caregiver engagement at Cleveland Clinic. Journal of Healthcare Leadership, 6, 29\u201337. https:\/\/doi.org\/10.2147\/JHL.S57063","journal-title":"Journal of Healthcare Leadership"},{"key":"e_1_3_2_35_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7006a4"},{"key":"e_1_3_2_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2011.06.006"},{"key":"e_1_3_2_37_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-021-01105-3"},{"key":"e_1_3_2_38_1","first-page":"221","article-title":"RE-AIM: \u201cReach, effectiveness, adoption, implementation, and maintenance\u201d evaluation of an emergency department pain coaching program","volume":"30","author":"Montague M.","year":"2023","unstructured":"Montague M., Sheikh S., Hendry P., Menze N., Perl K., Bartow V., Curtis M. E., Fishe J., Webb K., Norse A (2023). RE-AIM: \u201cReach, effectiveness, adoption, implementation, and maintenance\u201d evaluation of an emergency department pain coaching program. Academic Emergency Medicine, 30(S1), 221\u2013222. https:\/\/doi.org\/10.1111\/acem.14718","journal-title":"Academic Emergency Medicine"},{"key":"e_1_3_2_39_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-011-1770-9"},{"key":"e_1_3_2_40_1","first-page":"5","article-title":"Problems and barriers of pain management in the emergency department: Are we ever going to get better?","volume":"2","author":"Motov S. M.","year":"2009","unstructured":"Motov S. M., Khan A. N. (2009). Problems and barriers of pain management in the emergency department: Are we ever going to get better? Journal of Pain Research, 2, 5. https:\/\/doi.org\/10.2147\/JPR.S4324","journal-title":"Journal of Pain Research"},{"key":"e_1_3_2_41_1","doi-asserted-by":"publisher","DOI":"10.1155\/2019\/6462472"},{"key":"e_1_3_2_42_1","unstructured":"Pain Assessment and Management Initiative (PAMI). (2022a). Retrieved December 28 2022 from https:\/\/pami.emergency.med.jax.ufl.edu\/"},{"key":"e_1_3_2_43_1","unstructured":"Pain Assessment and Management Initiative (PAMI). (2022b). Pain coach and toolkit guide. Retrieved December 29 2022 from https:\/\/pami.emergency.med.jax.ufl.edu\/resources\/pain-coach-and-toolkit-guide\/"},{"key":"e_1_3_2_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmn.2006.09.003"},{"key":"e_1_3_2_45_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-015-0209-1"},{"key":"e_1_3_2_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmn.2014.08.015"},{"key":"e_1_3_2_47_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9072195"},{"issue":"135","key":"e_1_3_2_48_1","first-page":"1","article-title":"Trends in opioids prescribed at discharge from emergency departments among adults: United States, 2006-2017","author":"Rui P.","year":"2020","unstructured":"Rui P., Santo K., Ashman J. J. (2020). Trends in opioids prescribed at discharge from emergency departments among adults: United States, 2006-2017. National Health Statistics Reports, 135, 1\u201312.","journal-title":"National Health Statistics Reports"},{"key":"e_1_3_2_49_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40122-018-0103-z"},{"key":"e_1_3_2_50_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000002308"},{"key":"e_1_3_2_51_1","volume-title":"Noninvasive nonpharmacological treatment for chronic pain: A systematic review update","author":"Skelly A. C.","year":"2020","unstructured":"Skelly A. C., Chou R., Dettori J. R., Turner J. A., Friedly J. L., Rundell S. D., Fu R., Brodt E. D., Wasson N., Kantner S., Ferguson A. J. R. (2020). Noninvasive nonpharmacological treatment for chronic pain: A systematic review update. https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/32338846"},{"key":"e_1_3_2_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2021.03.013"},{"key":"e_1_3_2_53_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000002403"},{"issue":"457","key":"e_1_3_2_54_1","first-page":"1","article-title":"Drug overdose deaths in the United States, 2001-2021","author":"Spencer M. R.","year":"2022","unstructured":"Spencer M. R., Minino A. M., Warner M. (2022). Drug overdose deaths in the United States, 2001-2021. NCHS Data Brief (457), 1\u20138. https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/36598401","journal-title":"NCHS Data Brief"},{"key":"e_1_3_2_55_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamahealthforum.2020.0026"},{"key":"e_1_3_2_56_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.ss6901a1"},{"key":"e_1_3_2_57_1","unstructured":"Substance Abuse and Mental Health Services Administration. (2022). Key substance use and mental health indicators in the United States: Results from the 2021 National Survey on Drug Use and Health (HHS Publication No. PEP22-07-01-005 Issue). https:\/\/www.samhsa.gov\/data\/report\/2021-nsduh-annual-national-report"},{"key":"e_1_3_2_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2017.11.010"},{"key":"e_1_3_2_59_1","doi-asserted-by":"publisher","DOI":"10.1136\/amiajnl-2013-001856"},{"key":"e_1_3_2_60_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2006.12.005"},{"key":"e_1_3_2_61_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-5-26"},{"key":"e_1_3_2_62_1","doi-asserted-by":"publisher","DOI":"10.2165\/00115677-200513010-00003"},{"key":"e_1_3_2_63_1","unstructured":"U.S. Bureau of Labor Statistics. (2021 March 31). Occupational employment and wage statistics. Retrieved December 28 2022 from https:\/\/www.bls.gov\/oes\/current\/oessrcma.htm"},{"key":"e_1_3_2_64_1","unstructured":"U.S. Department of Health and Human Services. (2019). Pain management best practices inter-agency task force report: Updates Gaps inconsistencies and recommendations. https:\/\/www.hhs.gov\/sites\/default\/files\/pmtf-final-report-2019-05-23.pdf"},{"key":"e_1_3_2_65_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-015-0295-0"},{"key":"e_1_3_2_66_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2019.02.011"},{"key":"e_1_3_2_67_1","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pnw352"},{"key":"e_1_3_2_68_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.13-0886"},{"key":"e_1_3_2_69_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2007.05.005"},{"key":"e_1_3_2_70_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-019-0898-y"},{"key":"e_1_3_2_71_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-018-3227-2"}],"container-title":["Implementation Research and Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/26334895251330511","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/26334895251330511","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/26334895251330511","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T11:40:43Z","timestamp":1777462843000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/26334895251330511"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2]]},"references-count":70,"alternative-id":["10.1177\/26334895251330511"],"URL":"https:\/\/doi.org\/10.1177\/26334895251330511","relation":{},"ISSN":["2633-4895","2633-4895"],"issn-type":[{"value":"2633-4895","type":"print"},{"value":"2633-4895","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2]]},"article-number":"26334895251330511"}}