Chronic musculoskeletal pain experiences in marginalized populations: a mixed methods study protocol to understand the influence of geopolitical, historical, and societal factors.

Background: Chronic musculoskeletal pain (CMP), an invisible disease, is due to complex biological and psychological processing. A CMP epidemic occurs concurrently during historically high global population movement. Nationalistic geopolitical rhetoric arises, in part, in response to perceptions of increased immigration rates and healthcare policies. Limited evidence exists about the impact of the current geopolitical climate on the CMP experience amongst migrant populations. Strategies to improve inequitable CMP management in marginalized populations may include improving the clinical conversation. Effective communication is a critical part of pain management and successful interactions between patients and their healthcare providers. Aims: The primary aims are to 1) develop subgroups of self-reported pain experiences in people who have CMP and experience marginalization and 2) interpret the pain experience of marginalized populations with CMP in the context of geopolitical, historical, and societal influences. Methods: A mixed methods sequential explanatory design study will be used. The first quantitative phase will be a survey, to be completed in three languages, with questions related to pain status, patient beliefs, and perspectives on healthcare. Latent class analysis will be used to generate experience-based subgroups. Focus groups will provide nuanced descriptions of the patient experience. Discussion: Results from this study will inform the understanding of the influence of geopolitical, historical, and societal influences on CMP in people who experience marginalization. This understanding will be used to develop a framework to educate clinicians on the broader factors in the CMP experience and to consider steps that can mitigate inequitable CMP outcomes in marginalized populations. Marginalized patient populations may have different experiences in CMP. Societal and historical policies may influence clinical conversations and outcomes. CMP management may be impacted by the contemporary geopolitical environment. A mixed-method protocol is established to interpret patients' CMP experiences in people who may experience marginalization. [ABSTRACT FROM AUTHOR]