Development of a Personalized Feedback Intervention Targeting Pain-Related Anxiety for Hazardous Drinkers with Chronic Pain

针对患有慢性疼痛的危险饮酒者的疼痛相关焦虑开发个性化反馈干预措施

• 批准号: 10219553
• 负责人: Andrew H. Rogers
• 金额: $ 3.4万
• 依托单位: UNIVERSITY OF HOUSTON
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-03-15 至 2024-03-14
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10219553
• 关键词: Absence of pain sensation; Address; Affective; Alcohol abuse; Alcohol consumption; Alcohols; Anxiety; Basic Science; Behavior; Behavior Therapy; Caring; Chronic; Clinical Trials Design; Computers; Coping Behavior; Data; Development; Expectancy; Feedback; Focus Groups; Frequencies; General Population; Guidelines; Health; Individual; Intention; Intervention; Knowledge; Lead; Mediating; Mediator of activation protein; Medical; Mental Health; Methods; Modeling; Motivation; Opioid; Outcome; Pain; Pain management; Participant; Phase; Planning Theory; Population; Protocols documentation; Public Health; Randomized; Randomized Clinical Trials; Randomized Controlled Trials; Reporting; Research; Risk; Sampling; Standardization; Testing; Translating; Underserved Population; United States National Institutes of Health; Work; acceptability and feasibility; alcohol behavior; alcohol expectancy; base; behavior change; brief intervention; chronic pain; comorbidity; coping; disability; drinking; effective intervention; efficacy evaluation; follow up assessment; follow-up; hazardous drinking; health care settings; high risk; innovation; novel; pain reduction; physical conditioning; premature; primary outcome; prospective; public health priorities; secondary outcome; sex; social; therapy design; therapy development

Project Summary/Abstract Hazardous alcohol use contributes to mental and physical health problems, disability, and may lead to increased risk of premature death3,4. Among individuals with chronic pain the rate of hazardous alcohol use is elevated compared to the general population5, yet, hazardous alcohol users with chronic pain remain an underserved group. There is a critical need to test alternative and complimentary approaches to the implementation of effective interventions to reduce hazardous alcohol use among this high-risk segment of the general population; doing so in an integrated fashion (i.e., jointly targeting alcohol and affective mechanisms that may maintain pain-alcohol associations) may provide a more efficient and targeted intervention approach. Targeting pain-related anxiety, a transdiagnostic vulnerability factor that is prospectively associated with both hazardous drinking and chronic pain6,7, may be beneficial. Thus, more work is needed to evaluate the benefit of targeting elevated pain-related anxiety among hazardous drinkers with chronic pain. Our approach will follow a staged model consistent with NIH guidelines for developing and standardizing behavioral interventions. Phase IA activities will involve collecting qualitative feedback from iterative focus groups (N = 10) to refine intervention content and evaluate treatment acceptability and feasibility. Phase IB activities will include a proof-of-concept and highly rigorous randomized clinical trial designed to compare pain-related anxiety/alcohol PFI (PA-PFI) to control PFI (C-PFI) among a sample of 130 hazardous drinkers with chronic pain who have elevated levels of pain-related anxiety. This study represents an important and pivotal step in the larger landscape of translating basic research to more efficacious strategies for reducing hazardous drinking among underserved populations with medical comorbidities. The proposed intervention would be highly disseminable and relevant to millions of hazardous drinkers with chronic pain. Given the collective public health impact of chronic pain and hazardous drinking, the proposed study will yield findings that enhance scientific knowledge, enhance our understanding of mechanisms in reciprocal pain-alcohol relations, and inform the development of novel treatments for hazardous drinkers with chronic pain with elevated pain-related anxiety that are adaptable and easily implemented across a variety of healthcare settings.

项目摘要/摘要 危险的饮酒会导致心理和身体健康问题，残疾，并可能导致 过早死亡的风险增加3,4。在患有慢性疼痛的个体中，危险酒精的使用率是 与一般人口相比，升高的升高。但是，慢性疼痛的危险酒精使用者仍然是 服务不足的组。迫切需要测试替代方法和免费的方法 实施有效的干预措施，以减少这一高风险部分的危险饮酒 一般人群；以综合方式进行（即共同针对酒精和情感机制 可以维持疼痛酒精的关联）可以提供更有效和有针对性的干预方法。 靶向与疼痛相关的焦虑，这是一种转诊脆弱性因素，前瞻性地相关 危险饮酒和慢性疼痛6,7，可能是有益的。因此，需要更多的工作来评估 靶向慢性疼痛的危险饮酒者靶向疼痛相关的焦虑的好处。我们的 方法将遵循与NIH的制定和标准化行为的指南一致的分阶段模型 干预措施。 IA阶段活动将涉及从迭代焦点组收集定性反馈（n = 10） 完善干预含量并评估治疗可接受性和可行性。 IB期活动将包括 概念验证和高度严格的随机临床试验，旨在比较疼痛有关 焦虑/酒精PFI（PA-PFI）控制PFI（C-PFI）的130种有害饮酒者的样本中 与疼痛相关的焦虑水平升高的疼痛。这项研究代表了重要而关键的一步 将基础研究转化为更有效的策略来减少危险的更大景观 在服务不足的人群中饮酒。拟议的干预将是 高度分散的，与数百万危险饮酒者有慢性疼痛。鉴于集体公众 慢性疼痛和危险饮酒对健康的影响，拟议的研究将产生增强的发现 科学知识，增强我们对相互疼痛与酒精关系机制的理解，以及 告知开发慢性疼痛的危险饮酒者的新型治疗方法，与疼痛有关 适应性且在各种医疗机构中很容易实施的焦虑。