Participant Engagement With a Digital Behavioral Health App for Chronic Pain: Descriptive Secondary Analysis of a Feasibility Randomized Controlled Trial

Background: Chronic pain is a widespread condition that impairs quality of life and is often managed primarily with medications. National guidelines now recommend nonpharmacologic, mind-and-body, and behavioral approaches as first-line or complementary treatments. However, access to these evidence-based options remains limited. Digital health technologies offer a scalable way to deliver integrative, self-care interventions that empower patients to live well with pain. Objective: This study examined engagement with and perceived usefulness of a patient- and health care professional-informed mobile app designed to deliver behavioral and educational content to support pain self-management. Methods: Adult primary care patients with chronic pain were enrolled in a 12-week feasibility trial. The app included lessons addressing the physical, emotional, and social aspects of pain; tracking and personalized insights; self-screenings; and optional in-app coaching. Participants completed baseline and 3-month surveys assessing usability and satisfaction. Engagement was evaluated through app analytics and milestone completion. Results: Of 49 patients assigned to the app, 40 (81.6%) activated it. Participants used the app for an average of 27.3 (SD 25.2) unique days and completed an average of 25.5 (SD 22.5) core lessons. Engagement highlights included 42.5% (17/40) completion of the valued living module, 25.0% (10/40) completion of all lessons, and 50.0% (20/40) use of daily check-ins. Usability ratings were high, with 86.7% (26/30) reporting that the app helped them better understand or manage their pain and 90.0% (27/30) recommending it to others. Conclusions: Adults with chronic pain engaged with the program and reported high satisfaction with this evidence-informed digital mind-and-body intervention. Findings from this feasibility study suggest the potential for digital tools to support access to nonpharmacologic, integrative pain self-care and complement traditional clinical approaches.