Objective:

To explain key adaptations made to a depression and pain intervention that addresses inequities in pain outcomes among older women.

Approach:

• Study Design: The DAPPER pilot study and the Women in PRIME study were randomized controlled trials using waitlist control designs.
• Participant Focus: DAPPER focused on middle-aged and older African American women who were pre-frail or frail, while Women in PRIME included women of all races with physical disabilities.
• Data Collection: Qualitative data from participant interviews were analyzed using deductive qualitative content analysis; quantitative data included descriptive statistics.

Key Findings:

• SevenchangesweremadefromtheDAPPERStudytotheWomeninPRIMEStudy.Thesechangesincluded1)Re-namingtheintervention;2)Addingretentionpractices;3)Expandingtoincludewomenofallraces;4)Switchingcriterionof(pre)frailtytophysicaldisability;5)AddinggroupAcceptance&CommitmentTherapy(ACT)sessions;6)Reducingindividualnursevisitsfrom8to5visits;and7)Switchingfromsalivatosweatpatchforbiomarkermeasurement.

Interpretation:

The changes resulted in greater retention, participation in the intervention, and participation in data collection timepoints.

Limitations:

• The study focused on specific populations, which may limit generalizability.
• The qualitative nature of participant feedback may not capture all perspectives.

Conclusion:

Participant input and guidance were critical in shaping modifications for the intervention's advancement toward larger scale trials.