329: Development and Validation of the Internalized Resource Availability (IRA) Questionnaire

Topic: Clinical Science
Subtopic: Non-specific to any diagnosis, Psychology, Developing methodology/technology, Assessment and Measurement of Pain/Nociception

Background and Aims: Social, economic, and institutional environments are increasingly recognized as important contributors to chronic pain vulnerability. Trust towards physicians, peers, and workplaces, along with financial stress, has been shown to play a role in the development of chronic pain (1-7). However, validated tools that measure how individuals internalize these socioecological factors remain limited. This study presents the development and validation of the Internalized Resource Availability (IRA) questionnaire, designed to quantify individuals' perceived access to resources relevant to pain management.

Methods: The IRA was administered to 1,366 English-speaking U.S. adults (≥18 years) in a cross-sectional survey assessing pain and socioeconomic stressors. After excluding incomplete and low-quality responses, 748 participants were included in the analysis. IRA scores were calculated as the mean of 15 sliding-scale items (0–100), with six reverse-coded. Item performance was evaluated using correlations with pain interference (PEG scale). Internal consistency was assessed using Cronbach’s alpha (α > 0.7 ). Principal components analysis examined structural validity. Test–retest reliability was assessed in 42 participants over two weeks using the intraclass correlation coefficient. Group differences were tested using ANOVA (p < 0.05).

Results: Five items with weak correlations to PEG scores were removed, yielding a 10-item scale with good internal consistency (α = 0.84). Test–retest reliability showed good agreement (ICC = 0.83, 95% CI 0.71–0.91). PCA identified two main components: financial stability (42%) and available support systems (14%). Participants with chronic pain reported lower IRA scores (p < 0.001). IRA scores were inversely correlated with pain catastrophizing (r = –0.406, p < 0.0001) and interference (r = –0.316, p < 0.001). Scores differed by race (p < 0.0001) and were associated with income and age (r = 0.379, p < 0.0001).

Conclusions: The IRA demonstrates strong reliability and structural validity as a measure of perceived resource availability related to pain. Our analysis found that lower IRA scores are associated with greater pain burden and psychosocial distress, indicating this survey’s potential use in pain research. This tool may help identify patients at risk of resource-related pain. Future studies will integrate IRA scores with neuroimaging to explore neural correlates and support screening for social and financial stressors in pain care.

References: 1. Reddan MC, Young H, Falkner J, et al. Soc Cogn Affect Neurosci. 2020;15(10):1064–75.
2. Collins CR. Rev Gen Psychol. 2025;29(3):293–310.
3. Penn TM, Trost Z, Parker R, et al. Pain Rep. 2019;4(2):e710.
4. Lee N, Sung H, Kim JH, et al. Soc Sci Med. 2017;177:198-204.
5. Morse T, Punnett L, Warren N, et al. Am J Ind Med. 2003;44(1):83-93.
6. Samuel CA, Mbah O, Schaal J, et al. Support Care Cancer. 2020;28(6):2615-2626.
7. Grol-Prokopczyk H. Pain. 2017;158(2):313-322.

Presenting Author: Sydney Gilmore
Submitting Author: Sydney Gilmore

Senior Author: Marianne Reddan

IASP 2026 Global Year theme of Neuropathic Pain: No

• Marianne Reddan: M.A., Ph.D. - University of Glasgow