{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T18:45:49Z","timestamp":1782585949433,"version":"3.54.5"},"reference-count":31,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100010249","name":"Indiana University School of Medicine","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100010249","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Advances in Integrative Medicine and Health"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic pain affects one in five Americans, yet rural patients face significant barriers to evidence-based interventions like biofeedback due to geographic isolation and provider shortages.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This pilot study evaluates the feasibility, acceptability, and preliminary effectiveness of Mind Meter, a virtual neuroscience-based biofeedback group intervention, for rural adults with chronic pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Twenty-nine rural-dwelling adults (mean age 44.9, SD 11.8) with chronic pain (\u22653\u00a0months) were recruited from a pain management program and twenty-one participants completed a single-session virtual Mind Meter group, integrating pain neuroscience education and biofeedback via affordable equipment (pulse oximeters, skin thermometers). Feasibility was assessed by enrollment (target \u226550%), adherence (\u226580%), and completion rates (\u226575%); acceptability via a 10-item questionnaire (target \u226580% rating \u22654\/5); and preliminary effectiveness via pre-post changes in heart rate, temperature, pain, and anxiety, analyzed with paired t-tests (adjusted\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Enrollment was 22% (29\/132 eligible), below target, while adherence reached 100%, exceeding goals. Acceptability was high, with 90.5% rating the intervention \u22654\/5 (mean 4.3, SD 0.9), particularly for clarity of directions (95.2% \u2265 4). Statistically significant pre-post improvements occurred in anxiety (mean change \u22122.2, SD 2.4,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001, Hedge\u2019s g = \u22120.886) and temperature (mean increase 4.6\u00b0F, SD 6.1,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.003, g = 0.726); pain decreased (mean \u22120.8, SD 1.5,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.025) but lost statistical significance after correction for multiple comparisons. Heart rate showed no change (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.615).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Virtual Mind Meter is feasible and highly acceptable for rural patients with chronic pain, with promising reductions in anxiety and temperature. Lower than hypothesized enrollment warrants recruitment strategy-adjustments, while preliminary outcomes support further development.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/27536130261456244","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T14:45:10Z","timestamp":1782398710000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Feasibility and Acceptability of a Virtual Single-Session Biofeedback Intervention Targeting Circulation, Heart Rate, and Anxiety for Rural Patients With Chronic Pain"],"prefix":"10.1177","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8757-0721","authenticated-orcid":false,"given":"Lindsay G.","family":"Flegge","sequence":"first","affiliation":[{"name":"Indiana University School of Medicine"},{"name":"Indiana University Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1406-2813","authenticated-orcid":false,"given":"Jill C.","family":"Penman","sequence":"additional","affiliation":[{"name":"Indiana University Health"},{"name":"Indiana University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Crystal","family":"Tracy","sequence":"additional","affiliation":[{"name":"Indiana State University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"Bushey","sequence":"additional","affiliation":[{"name":"Indiana University School of Medicine"},{"name":"Indiana University Health"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6736a2"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.15620\/cdc\/169630"},{"key":"e_1_3_5_4_2","unstructured":"Relieving pain in America: a blueprint for transforming prevention care education and research - PubMed. 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