Feasibility and Acceptability of Empowered Relief for American Indians With Pain During and After Cancer Treatment

• Empowered Relief (Behavioral): ER is a single-session, Zoom-based, 2-hour, skills-based pain management class delivered by certified instructors. Participants learn three core pain relief skills, develop a personalized plan, and receive access to a free binaural audio app for daily practice. ER has demonstrated moderate efficacy in individuals with chronic non-cancer pain, reducing pain intensity, pain interference, pain-related distress (pain catastrophizing), sleep disturbance, and anxiety at 3 and 6 months post-treatment.

Primary outcomes

• Feasibility of ER in American Indian populations [From participant accrual to the completion of their 3-mon follow up survey (approx. 4 months)]: Indexed by: * ≥70% attendance rate amongst all eligible participants * An average treatment satisfaction rating of ≥ 8 on a 0-10 scale (with 0 being completely dissatisfied and 10 being completely satisfied) * Successful recruitment and completion of 70 participants within one year Measures will be factored together to make an assessment on total feasibility.
• Identify areas for cultural tailoring and improvement of ER [Assessed as part of the optional (n=30) Qualitative Post-class interview. (approx. 30 minutes)]: We will use qualitative data from interviews to generate actionable recommendations to improve the cultural engagement, acceptability, and relevance of ER for American Indians with cancer.
• Pain Intensity [Data collected at the 1-, 2-, and 3-month follow up survey following the ER class]: Pain intensity will be reported on a scale from 1-10, with 1 being "No Pain" and 10 being "Worst Pain Imaginable."
• Pain Interference [Data collected at the 1-, 2-, and 3-month follow up survey following the ER class.]: Pain interference will be gauged using a series of questions decerning the impact of the participants participants pain on daily activities. Participants will rate the interference on a scale from 1-5, with 1 being "Not at All" and 5 being "Very Much."
• Emotional Distress [Data collected at the 1-, 2-, and 3-month follow up survey following the ER class.]: Emotional distress will be measured using a series of questionnaires asking participants about the frequency of certain emotional reactions. Participants will report frequency on a scale from 1-5, with 1 being "Never" and 5 being "Always."
• Sleep Disturbance [Data collected at the 1-, 2-, and 3-month follow up survey following the ER class.]: Sleep Disturbance will be recorded using a series of questions rating the quality and frequency of sleep. Participants will report on quality and frequency on a scale from 1-5, with 1 being "Very Poor/Not at All" and 5 being "Very Good/Very Much."
• Perceived Quality of Life [Data collected at the 1-, 2-, and 3-month follow up survey following the ER class.]: Perceived Quality of Life will be reported on a scale from 1-5, with 1 being "Poor" and 5 being "Excellent."

Sex: All, ages: 18 Years to any

Inclusion Criteria:

* Identifies as American Indian
* Has history of a cancer diagnosis
* Is currently undergoing or has completed active cancer treatment
* Experiences body pain most or every day
* Pain duration at least 3 months
* English fluency

Exclusion Criteria:

* Significant psychological and cognitive impairment that limits one's ability to complete study tasks (completion of online survey, attending the Zoom-based ER class)
* Life-threatening acute illness (e.g., infection, heart attack, injury)
* No access to a computer, a smartphone, or a tablet

• Sophia You, Principal investigator, University of Oklahoma