Evaluation of a Spanish-language Adaptation of Brief Mindfulness-Oriented Recovery Enhancement for Chronic Pain: A Pilot Randomized Controlled Trial

BACKGROUND: Spanish-speaking individuals in the U.S. face a number of barriers to quality pain care and limited access to culturally adapted treatments. While mindfulness-based interventions are effective for chronic pain, few have been translated for Spanish-speaking populations. This pilot study tested a brief, Spanish-language adaptation of Mindfulness-Oriented Recovery Enhancement (Spanish B-MORE) for Spanish-speaking adults with chronic pain. METHODS: A single-site, waitlist-controlled randomized clinical trial was conducted to assess the feasibility, acceptability, and preliminary efficacy of Spanish B-MORE. Spanish-speaking adults with chronic pain (N = 20) were randomized 1:1 to receive the Spanish B-MORE intervention or a waitlist control. Outcomes were assessed at baseline, 2-week, and 6-week follow-up. Primary outcome was chronic pain symptoms (PEG-3); secondary and tertiary outcomes included participant-rated intervention acceptability, depression, anxiety, well-being, pain catastrophizing, and proposed therapeutic mechanisms (self-transcendence, mindful reappraisal of pain). Acute effects were also assessed immediately before and after the intervention sessions. RESULTS: All participants completed both sessions and all follow-ups. Participants rated the intervention as highly acceptable (M = 9.4/10) and would recommend it to others (M = 9.67/10). Immediately following the intervention, B-MORE significantly reduced pain intensity, pain unpleasantness, and anxiety, all with large Cohen's d effect sizes (d = 1.32-1.48). At six weeks, relative to those in the waitlist-controlled condition, B-MORE participants showed greater improvements on all clinical outcomes. CONCLUSIONS: Spanish B-MORE may represent a brief, scalable, and culturally responsive intervention for chronic pain in Spanish-speaking populations. These promising findings support further evaluation in larger trials. CLINICAL TRIAL REGISTRATION: NCT06316713.