Ep. 14: Social Support in Group Medical Visits for Chronic Pain in Primary Care, Featuring Dr. Maria Chao and Jesse Wennik

In this episode, Maria Chao, DrPH, MPA, and Jesse Wennik, NP, join host Dr. Sherri Eldin to discuss their research study titled, “Social Support in Group Medical Visits for Chronic Pain in Primary Care,” which found that through deliberate facilitation and peer exchange, group medical visits mobilize four reinforcing forms of social support as core therapeutic processes and may serve as a model of biopsychosocial chronic pain management in primary care.

About the study: More than one in five U.S. adults lives with chronic pain. Isolation and stigma can make it worse, and primary care visits are often too short to address all needs. Group medical visits allow multiple patients with a common condition to receive medical care alongside health education and peer support. This study examined how group medical visits facilitate four types of social support: emotional, appraisal, informational, and instrumental. Qualitative data were collected within a randomized trial at San Francisco safety-net clinics. Patients were assigned to group visits consisting of 12 weekly two-hour sessions of clinical care, pain education, mindfulness, gentle movement, and discussion. Groups were co-faciliated by primary care and behavioral health clinicians and a movement and mindfulness instructor. Researchers observed 16 sessions with 26 patients and held two focus groups and 12 interviews. Most patients had low incomes; half identified as Black or African American, and average pain was 7.7 out of 10. Patients reported all four types of social support. The nonjudgemental space and trust built within the group encouraged emotional support, such as removing shame over late arrivals or absences, and also from naming and discussing grief. Facilitators gave appraisal support by disclosing their own setbacks and peers offered affirmations that encouraged self-compassion. Informational support came from the curriculum and from peers, who traded tips like using frozen water bottles for plantar fasciitis. Instrumental support included peers bringing food to share and facilitators referring participants for counseling and other care. 

Link to full, open access study: https://www.annfammed.org/content/24/5/422

Supporting Resources: 

Detailed information on the ongoing randomized controlled trial: Group-based Integrative Pain Management in Primary Care Safety Net Clinics 

Brief video on the integrative pain management program (IPMP) at the Tom Waddell Urban Health Clinic: https://vimeo.com/306277769 

Public box folder with publications on integrative pain management programs: https://ucsf.box.com/s/dqn10t4n5f6tqxuonwmj68uzlhqz9hy6