APA-SM

October 6, 2026: Engagement With Rural Partners Leads to Codesign of APA-SM Intervention

Posted on by Damon Seils
Headshots of the APA-SM Investigators
Dr. Jennifer Kawi, Dr. Jane Bolin, and Dr. Hulin Wu, principal investigators for APA-SM

A strategy of engagement with rural partners in the APA-SM trial led to codesign of a feasible, culturally relevant study intervention for use in rural settings.

The results were published online in Frontiers in Pain Research.

APA-SM, an NIH Collaboratory Trial, is testing a 4-week auricular point acupressure telehealth intervention for self-management of chronic pain in rural communities in South Carolina and Texas. The study also includes implementation outcomes, a cost-effectiveness analysis, and an evaluation of predictive factors for treatment response.

During the planning phase of the project, the researchers tailored the study intervention for rural settings after hosting community advisory board meetings, holding focus group interviews with rural partners, and conducting a pilot feasibility study. These complementary approaches “improved the program’s cultural relevance, feasibility, and acceptability in rural settings.”

Read the full article.

APA-SM is led by principal investigators Jennifer Kawi and Hulin Wu of UTHealth Houston and Jane Bolin of Texas A&M University. The study is supported within the NIH Pragmatic Trials Collaboratory through the NIH HEAL Initiative by the National Center for Complementary and Integrative Health, with additional oversight from the National Institute of Neurological Disorders and Stroke.

August 3, 2026: APA-SM Team Consults Rural Research Partners to Refine Study Intervention

Posted on by Damon Seils
Headshots of the APA-SM Investigators
Dr. Jennifer Kawi, Dr. Jane Bolin, and Dr. Hulin Wu, principal investigators for APA-SM

In a qualitative study, the APA-SM team gained insights from research partners in rural areas to inform refinements of the trial’s smartphone-based intervention for self-management of chronic musculoskeletal pain.

The results of the qualitative study were published online in Health Services Insights.

APA-SM, an NIH Collaboratory Trial, is testing a 4-week auricular point acupressure telehealth intervention for self-management of chronic pain in rural areas. The pragmatic trial also includes implementation outcomes, a cost-effectiveness analysis, and an evaluation of predictive factors for treatment response. See our recent interview with co–principal investigator Jennifer Kawi.

The study team conducted semistructured focus group interviews with 3 categories of participants in rural areas in South Carolina and Texas:

  • patients with chronic musculoskeletal pain
  • healthcare providers, community health workers, and patients’ significant others
  • healthcare administrators, policymakers, and staff

The findings of the focus group interviews clustered around 4 themes: building trust and engagement; communicating the value of the APA-SM intervention and providing support; ensuring the intervention’s accessibility and usability; and fostering partnerships with rural healthcare systems.

These findings provided the research team with guidance for refining the APA-SM program to better fit the contexts of patients and other research partners in rural communities.

Read the full report.

APA-SM is being led by principal investigators Jennifer Kawi and Hulin Wu of UTHealth Houston and Jane Bolin of Texas A&M University. The trial is supported through the NIH HEAL Initiative by the National Center for Complementary and Integrative Health, with additional oversight from the National Institute of Neurological Disorders and Stroke.

June 18, 2026: Updates From the APA-SM Trial: An Interview With Jennifer Kawi

Posted on by Damon Seils

APA-SM is an NIH Collaboratory Trial testing a 4-week auricular point acupressure telehealth intervention for self-management of chronic pain in rural communities in South Carolina and Texas. The study also includes implementation outcomes, a cost-effectiveness analysis, and an evaluation of predictive factors for treatment response.

Learn more about APA-SM, including the project’s recently published study design.

At the NIH Collaboratory’s 2026 Annual Steering Committee Meeting, we spoke with co–principal investigator Jennifer Kawi to learn more about APA-SM.

“One of the things that was impressed on us from the very beginning was making sure that we extend our reach…into the communities,” Kawi said. Kawi is the Maria C. and Christopher J. Pappas Family Distinguished Chair in Nursing and a professor in the department of research at UTHealth Houston’s Cizik School of Nursing.

“[Community health workers] have really been very instrumental in engaging our participants, because they know the local people, they know the communities, and they’re able to help us expand our reach in rural areas,” she explained.

Go to the full video.

“As researchers, sometimes we work in silos, we focus on our own projects and don’t always have the opportunity to have interactions with others,” Kawi said.

“So having this annual meeting with the [NIH Collaboratory Steering Committee] has been really very helpful in networking, in getting advice, getting support, and really expanding our ability to do what we can do, and maybe looking at other options if there are barriers or challenges that we’re facing,” she said.

In the coming weeks, we will share more highlights from the 2026 Annual Steering Committee Meeting. Access the complete meeting materials.

Still from a video interview with Dr. Jennifer Kawi
Dr. Jennifer Kawi, co–principal investigator for APA-SM

June 15, 2026: Study Design Paper Published for APA-SM

Posted on by Damon Seils
Headshots of the APA-SM Investigators
Dr. Jennifer Kawi, Dr. Jane Bolin, and Dr. Hulin Wu, principal investigators for APA-SM

The study design paper for APA-SM has been published online in BMJ Open. Congratulations to the study team on reaching this important milestone for all NIH Collaboratory Trials!

The APA-SM trial is testing a 4-week auricular point acupressure intervention for self-management of chronic pain in rural communities in South Carolina and Texas. The study will also include implementation outcomes, a cost-effectiveness analysis, and an evaluation of predictive factors for treatment response.

The study is being led by principal investigators Jennifer Kawi and Hulin Wu of UTHealth Houston and Jane Bolin of Texas A&M University and is supported through the NIH HEAL Initiative by the National Center for Complementary and Integrative Health, with additional oversight from the National Institute of Neurological Disorders and Stroke.

Read the full study design paper.

April 22, 2026: Key Insights From APA-SM, in This Week’s Rethinking Clinical Trials Grand Rounds

Posted on by Sophia Ramirez

In this Friday’s Rethinking Clinical Trials Grand Rounds, Jennifer Kawi, Hulin Wu, and Jane Bolin will present “Key Insights From the UG3, Personalized Auricular Point Acupressure for Chronic Pain Self-Management in Rural Populations (APA-SM), and the Path Forward for the UH3.”

The Grand Rounds session will be held on Friday, April 24, 2026, at 1:00 pm eastern.

APA-SM, an NIH Collaboratory Trial, is testing a 4-week auricular point acupressure intervention for self-management of chronic pain in rural communities in South Carolina and Texas. The study will also include implementation outcomes, a cost-effectiveness analysis, and an evaluation of predictive factors for treatment response.

Kawi is the Lee and Joseph Jamail Distinguished Professor in the Cizik School of Nursing at UTHealth Houston. Wu is the Betty Wheless Trotter Professor in the School of Public Health at UTHealth Houston. Bolin is a Regents Professor Emeritus at the Texas A&M School of Nursing.

Join the online meeting

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December 22, 2025: Rural Health Symposium Opens Registration, Announces Call for Abstracts

Posted on by Damon Seils

The Duke University School of Nursing will convene healthcare professionals, educators, researchers, community leaders, and policymakers for a 1-day symposium dedicated to reducing rural health disparities across North Carolina through collaboration and innovation.

On April 20, 2026, from 9:00 am to 3:00 pm at Duke University in Durham, North Carolina (and virtually via livestream), participants will come together for dynamic presentations, panels, poster sessions, and discussions with guests, including leaders from ECU Health, Sanford Health, UT-Arlington, and the NC Department of Health and Human Services. A reception will follow the program.

The deadline for abstract submission is February 9, 2026. See more information about the program below.

Did you know the NIH Pragmatic Trials Collaboratory supports several innovative pragmatic clinical trials to improve healthcare for rural and remote populations? Learn more about:

  • AIM-CP: Adapting and Implementing a Nurse Care Management Model to Care for Rural Patients with Chronic Pain
  • APA-SM: Personalized Auricular Point Acupressure for Chronic Pain Self-Management in Rural Populations
  • ARBOR-Telehealth: Advancing Rural Back Pain Outcomes Through Rehabilitation Telehealth
  • BeatPain Utah: Nonpharmacologic Pain Management in Federally Qualified Health Centers Primary Care Clinics
  • LungSMART: Population Health Management Approaches to Increase Lung Cancer Screening in Community Health Centers
  • RAMP: Reaching Rural Veterans: Applying Mind-Body Skills for Pain Using a Whole Health Telehealth Intervention

1st Annual Duke University School of Nursing Rural Health Symposium: Innovative Solutions to Addressing Rural Health Disparities

1st Annual Duke University School of Nursing Rural Health Symposium: Innovative Solutions to Addressing Rural Health Disparities

Monday, April 20, 9am-3pm, with Reception to Follow

Duke University Campus and Livestream Webinar

Register Now and Submit Abstracts by February 9

You are warmly invited to participate in the 1st Annual Duke University School of Nursing Rural Health Symposium, a one-day event that will convene healthcare professionals, educators, researchers, community leaders, and policymakers to address rural health disparities across North Carolina through collaboration and innovation.

Date: April 20, 2025
Time: 9:00 AM – 3:00 PM
Location: Duke University (with virtual livestream option)

The symposium will feature dynamic presentations, panel discussions, poster sessions, and networking opportunities, including a closing reception. Distinguished speakers will include:

  • Trisha Baise, ECU Health
  • Erica DeBoer, Sanford Health
  • Elizabeth Merwin, University of Texas at Arlington
  • Maggie Sauer, North Carolina Department of Health and Human Services

We invite you to submit abstracts by February 9 to share your research, innovations, and best practices that advance rural health.

Register today: https://duke.is/ruralhealth

Your participation will help foster meaningful dialogue and actionable strategies to improve health outcomes in rural communities. We look forward to your contributions and engagement in this important event.

November 6, 2025: Enrollment Begins for APA-SM and iPATH Trials

Posted on by Damon Seils

Two of the newest NIH Collaboratory Trials have begun enrollment. Congratulations to the study teams from APA-SM and iPATH for reaching this important project milestone!

APA-SM Investigators

APA-SM is enrolling patients in a 4-week auricular point acupressure intervention for self-management of chronic pain in rural communities in South Carolina and Texas. The study will also include implementation outcomes, a cost-effectiveness analysis, and an evaluation of predictive factors for treatment response. The study is led by principal investigators Jennifer Kawi and Hulin Wu of UTHealth Houston and Jane Bolin of Texas A&M University.

APA-SM is supported within the NIH Pragmatic Trials Collaboratory by the National Center for Complementary and Integrative Health, with additional oversight from the National Institute of Neurological Disorders and Stroke. Learn more about APA-SM.

Headshot of Dr. Sara Singer

iPATH, led by principal investigator Sara Singer of Stanford University, is enrolling federally qualified health centers in California, Massachusetts, Ohio, and Puerto Rico in a stepped-wedge, cluster randomized, hybrid effectiveness-implementation trial of a practice transformation strategy for type 2 diabetes. The study will evaluate the impact of the practice transformation strategy and identify process elements that influence implementation effectiveness.

iPATH is supported within the NIH Pragmatic Trials Collaboratory by the National Institute on Minority Health and Health Disparities. Learn more about iPATH.

October 27, 2025: Study Snapshot and Updated Ethics Documentation Available for APA-SM Study

Posted on by Damon Seils
APA-SM Investigators
Dr. Jennifer Kawi, Dr. Jane Bolin, and Dr. Hulin Wu, principal investigators for APA-SM

A new study snapshot and updated ethics and regulatory documentation are now available for the APA-SM study. A year into the project, the research team reviewed and updated the minutes of their initial consultation with the Ethics and Regulatory Core.

New resources for APA-SM include:

APA-SM is testing a 4-week auricular point acupressure intervention for self-management of chronic pain in rural communities in South Carolina and Texas. The study will also include implementation outcomes, a cost-effectiveness analysis, and an evaluation of predictive factors for treatment response.

APA-SM is supported within the NIH Pragmatic Trials Collaboratory by the National Center for Complementary and Integrative Health, with additional oversight from the National Institute of Neurological Disorders and Stroke. Learn more about APA-SM.

July 14, 2025: Researchers Share Tips for Building Relationships With Communities in Pragmatic Research

Posted on by Elizabeth Mccamic

Engaging with community partners can enrich and inform research through the lifespan of a trial. In a session at the NIH Pragmatic Trials Collaboratory’s 2025 Annual Steering Committee Meeting, Cherise Harrington, cochair of the program’s Community Health Improvement Core, led a discussion about building relationships with communities in pragmatic research.

The panelists included Jennifer Kawi, principal investigator (PI) for APA-SM; Kathleen Sluka, PI for FM-TIPS; Sebastian Tong, PI for AIM-CP; and David Wetter, PI for LungSMART. They shared examples of how community relationships have enriched their trials, along with impediments to meaningful community engagement and successful methods for building relationships with communities.

Key Strategies for Engaging With Communities

  • Build long-standing relationships with community partners, develop shared goals, and practice shared decision-making.
  • Design for sustainability. Design research projects with minimal disruption to the clinical workflow; utilize existing community health workers and programs; and integrate behavioral economics principles (nudges) into study design.
  • Budget for community engagement and include community members in study planning from the beginning.
  • Engage in the preferred language of the community. Ensure there are research staff who are fluent in the community’s preferred language and embedded in the community so they can provide key perspectives and help build trust.
  • Provide community health workers and research staff with training on community engagement.
  • Connect with community members where they spend time, such as community events and fairs, and visit local clinics to share information for referrals.

About the Trials

  • AIM-CP, supported by the National Institute of Nursing Research, is testing the implementation of a care management program to address disparate access to nonpharmacological treatments for chronic pain in rural populations.
  • APA-SM, supported by the National Center for Complementary and Integrative Health and the National Institute of Neurological Disorders and Stroke, is testing a 4-week auricular point acupressure intervention for self-management of chronic pain in rural communities in South Carolina and Texas.
  • FM-TIPS, supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases, is examining whether the addition of transcutaneous electrical nerve stimulation to routine physical therapy improves movement-evoked pain compared with physical therapy alone among patients with fibromyalgia.
  • LungSMART, supported by the National Cancer Institute, is testing telehealth interventions designed to address logistical barriers and hesitancy around completing lung cancer screening among patients receiving care in community health centers in Utah.

This summer, we are sharing highlights from the 2025 Annual Steering Committee Meeting. Access the complete collection of meeting materials.

June 16, 2025: NIH Pragmatic Trials Collaboratory Holds Annual Steering Committee Meeting

Posted on by Damon Seils

The NIH Pragmatic Trials Collaboratory held its 2025 Annual Steering Committee Meeting in Bethesda, Maryland, on May 28 and 29. The program’s leadership discussed evolving approaches to pragmatic clinical trials and considered the latest developments in the landscape of pragmatic research.

All materials from the meeting are now available online.

The NIH Pragmatic Trials Collaboratory added 3 new trials in the past year. The Annual Steering Committee Meeting was a time for new and experienced NIH Collaboratory Trial investigators and program leaders to share challenges and lessons learned in conducting their pragmatic trials.

“The addition of trials to the NIH Collaboratory portfolio is always a highlight of our annual meeting, and this year we were thrilled to welcome 3 new trials,” said Lesley Curtis, chair of the Steering Committee and chair and professor of population health sciences at Duke University.

The LungSMART trial will test telehealth interventions to address barriers to lung cancer screening. The STEP-2 trial will assess the effectiveness of self-testing for cervical cancer. The APA-SM trial will evaluate the effectiveness of self-management of pain using auricular point acupressure.

“These new trials address important public health questions and do so in rural communities and other priority populations,” Curtis noted. Learn more about the NIH Collaboratory Trials.

At the meeting, investigators shared methods for building relationships with communities in pragmatic research, designing and conducting pragmatic trials to support broad implementation, and monitoring and navigating changes in usual care. Investigators and program leaders also considered posttrial obligations, selection of data repositories, and optimal use of digital tools in research.

In the coming weeks, we will share more highlights from the 2025 Annual Steering Committee Meeting. Access the complete meeting materials.