Improving Veteran Access to Integrated Management of Back Pain (AIM-Back): Protocol for an Embedded Pragmatic Cluster-Randomized Trial.

Dr. George’s primary interest is research involving biopsychosocial models for the prevention and treatment of chronic musculoskeletal pain disorders.  His long term goals are to 1) improve accuracy for predicting who is going to develop chronic pain; and 2) identify non-pharmacological treatment options that limit the development of chronic pain conditions.  Dr. George is an active member of the American Physical Therapy Association, United States Association of the Study of Pain, and International Association for the Study of Pain. 

Dr. George’s research projects have been supported by the National Institutes of Health, Department of Defense, and Orthopaedic Academy of the American Physical Therapy Association.  Dr. George and his collaborators have authored over 330 peer-reviewed publications in leading medical, orthopaedic surgery, physical therapy, rehabilitation, and pain research journals.  He currently serves as Editor-in-Chief for the Physical Therapy & Rehabilitation Journal. Dr. George has also been involved with clinical practice guideline development for the Academy of Orthopaedic Physical Therapy and the American Psychological Association. 

Dr. George has been recognized with prestigious research awards from the American Physical Therapy Association, American Pain Society, and International Association for the Study of Pain. For example from the American Physical Therapy Association: he was named the  21^st John H.P. Maley Lecturer, recognized as a Catherine Worthingham Fellow in 2017, and selected for the Marian Williams Award for Research in Physical Therapy in 2022.    

• Improving care and outcomes for individuals with osteoarthritis and other musculoskeletal conditions with an emphasis on non-pharmacological therapies including physical activity, weight management, rehabilitation services, and pain coping
  * Understanding rand reducing disparities in musculoskeletal conditions
  * Musculoskeletal conditions in U.S. military Veterans
  * Pragmatic clinical trials
  * Adaptive interventions

Dr. Goode is an Associate Professor in the Department of Orthopedic Surgery. He is a physical therapist by clinical training and epidemiologist by scientific training. His focus is on understanding the etiology of low back pain and other chronic musculoskeletal conditions and improving the delivery of care for patients with acute and chronic musculoskeletal conditions.  In his research he has published in the areas of the relationship between individual radiographic features in the lumbar spine and clinical symptoms, biomarkers and peripheral joint osteoarthritis. 

Areas of expertise: Implementation Science, Health Services Research, and Health Measurement

Dr. Cook is a clinical researcher, physical therapist, and profession advocate with a long-term history of clinical care excellence and service. His passions include refining and improving the patient examination process and validating tools used in day-to-day physical therapist practice. Dr. Cook has authored or co-authored 3 textbooks, has published over 315 peer reviewed manuscripts and lectures internationally on orthopedic examination and treatment.

I am Director of the Duke Pain Prevention and Treatment Research Program, an active NIH funded clinical research program focused on developing new and more effective ways of assessing and treating patients having acute and persistent pain.  I have been active in nationally and internationally in shaping the pain research agenda.  For the past 10 years I served as Editor in Chief of PAIN the premier journal in pain research.  I also have served as the Chair of a number of NIH Study Sections.   Finally, I was a member of the Institute of Medicine committee that published a report in 2011 (Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research) that has played a key role in shaping national policies in pain research and pain care.

Over my career, I have played a key role in the development of clinical pain services and pain research programs at Duke Medical Center.  For over 20 years, I directed the Duke Pain Management Program and was a leader in the development of Duke Medical Center's multidisciplinary pain programs (both out-patient and in-patient.)  I collaborate actively with investigators in other countries (e.g. United Kingdom, South Africa, China, and Australia). 

Over the course of my career, I have collaborated closely with investigators both in and outside my lab.  Together we have developed and refined a number of treatment protocols for persistent pain conditions (e.g. pain in patients with advanced cancer; sickle cell disease, and persistent joint pain due to osteo- and rheumatoid arthritis) including partner and caregiver-assisted pain coping skills training interventions.  We have conducted a number of NIH- and foundation- funded randomized clinical trials testing the efficacy of these and other behavioral interventions (e.g. aerobic exercise protocols, yoga based interventions, mindfulness-based interventions, forgiveness-based interventions, loving kindness meditation, and emotional disclosure). 

I currently serve as a Co-Investigator on a number of NIH grants, a number of which are funded by the HEAL Initiative.  Many of these grants are testing novel strategies for delivering training in pain coping skills (e.g. video over internet, web-based training, virtual reality interventions, and apps for mobile devices).  Along these lines, I collaborated with Dr. Chris Rini to develop an internet-based program for training in pain coping skills called painTRAINER (available at mypaintrainer.org). This program is free to any individuals or health professionals who wish to use it.  I have a keen interest in exploring the efficacy of these and other strategies (e.g. training physical therapists, social workers, and nurses) promise to increase access to behavioral pain management interventions making them more widely available to the large population of patients and caregivers who might benefit from them.

I have published over 490 papers on topics ranging from pain coping strategies used during mammography to behavioral approaches to managing acute pain and pain at end of life.  I have a longstanding interest in mentoring students and early career professionals interested in developing, testing, and disseminating novel protocols for managing pain, stress, and medical symptoms.