Developing and Implementing a Culturally Appropriate Non-Opioid Pain Coping Skills Training Intervention for Spanish-Speaking Hispanic/Latinx Patients with Cancer Pain

为讲西班牙语的西班牙裔/拉丁裔癌症疼痛患者制定和实施适合文化的非阿片类疼痛应对技能培训干预

• 批准号: 10400340
• 负责人: GLENN J LESSER
• 金额: $ 58.12万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-08-01 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10400340
• 关键词: Absence of pain sensation; Achievement; Address; Administrative Supplement; Advocate; American; Area; Award; Behavioral; Budgets; Cancer Pain Management; Cancer Patient; Cancer Survivor; Caring; Cause of Death; Cellular Phone; Clinic Visits; Clinical Trials; Collaborations; Communities; Community Clinical Oncology Program; Coping Skills; Critiques; Data; Development; Devices; Diagnosis; Disease; Educational Intervention; Effectiveness; English Language; Ethnic Origin; Ethnic group; Focus Groups; Funding; Future; Health; Health Services Accessibility; Helping to End Addiction Long-term; Hispanics; Improve Access; Individual; Internet; Intervention; Interview; Language; Latinx; Limited English Proficiency; Linguistics; Long-Term Care; Malignant Neoplasms; Methodology; Modification; National Cancer Institute; Not Hispanic or Latino; Oncology; Online Systems; Outcome; Pain; Pain management; Patients; Persistent pain; Personal Computers; Persons; Pharmacological Treatment; Pilot Projects; Population; Process; Quality of life; Race; Reporting; Research; Risk; Sampling; Services; Specific qualifier value; Stoicism; Tablet Computer; Testing; Training Programs; Translating; Translation Process; Translations; Travel; United States; United States National Institutes of Health; Validation; Work; acceptability and feasibility; base; bilingualism; cancer care; cancer health disparity; cancer pain; care systems; chronic pain; community organizations; cost; design; drug misuse; effective intervention; emotional distress; experience; handheld mobile device; healing; health literacy; low socioeconomic status; marginalized population; non-opioid analgesic; opioid misuse; pain relief; patient population; patient-clinician communication; personalized intervention; pilot trial; prevent; programs; psychosocial; skills training; social; treatment comparison; treatment effect; trial design

ABSTRACT Though cancer remains a leading cause of death among Hispanic/Latinx populations in the United States and Hispanic/Latinx patients routinely experience disparities in cancer-related care, the overwhelming majority of behavioral and psychosocial oncology research continues to focus on non-Hispanic whites (NHW). Compared to NHW, individuals who identify as Hispanic and Latinx are more likely to: 1) be diagnosed with advanced stage disease, 2) experience poor quality of life, and 3) experience inadequate cancer-related care such as pain management. Hispanic/Latinx patients also endure greater levels of pain compared to other racial and ethnic groups, and are more likely to express concerns about cancer pain management due to inadequate analgesia, less pain relief, and poor patient-provider communication. Across all of pain management, Hispanic/Latinx populations have lower access to chronic pain treatments compared to others (particularly if they are primarily Spanish speaking), and inadequate access to suitable pain treatments, which may contribute to medication misuse, emotional distress, and diminished quality of life. In addition to socially determined disparities, language barriers are a key challenge limiting compliance with pharmacologic treatments and access to essential pain management services. The overwhelming lack of services available in Spanish, compounded by cultural discordance within available services, serves as an additional barrier to engagement with Hispanic/Latinx communities. Additionally, there is a need for internet-based cancer care services provided in Spanish and formatted for use via mobile devices, which must integrate unique features of culture into care programs. Our team has developed and validated a web-based pain coping skills training (PCST) intervention (painTRAINER), available via Internet-enabled devices and smart phones, that retains critical features of empirically validated and effective in-person PCST interventions. PainTRAINER is a maximally accessible, interactive and personalized intervention that does not require clinic visits or therapist involvement. PainTRAINER’s effectiveness for pain management is well-established via NIH-funded trials, but is only available in the English language which leaves a gap in the ability to extend care to Spanish-speaking patients with limited English proficiency. In collaboration with Hispanic and Latinx community organizations, community advisory boards, patient advocates, and bilingual health experts, we will follow a stepwise community-engaged and culturally-informed adaptation and translation of the painTRAINER program including: develop a community advisory board (CAB) and a community-based programmatic review panel (PRP); perform an initial intervention translation process; critically evaluate core functions and theoretical constructs of painTRAINER; engage the CAB and PRP to evaluate and further critique all translations; develop painTRAINER-Spanish to be both linguistically sensitive and culturally appropriate; beta test the program; and establish feasibility and acceptability of the newly generated intervention among Hispanic/Latinx patients with persistent cancer-related pain.

抽象的 尽管癌症仍然是美国西班牙裔/拉丁人种群中的主要死亡原因 西班牙裔/拉丁裔患者通常会在与癌症相关的护理中经历分布，绝大多数 行为和社会心理肿瘤学研究继续关注非西班牙裔白人（NHW）。比较的 对于NHW，确定为西班牙裔和拉丁裔的个人更有可能：1）被诊断为高级阶段 疾病，2）经历较差的生活质量，3）经历与癌症相关的护理不足，例如疼痛 管理。与其他种族和种族相比 小组，并且更有可能由于镇痛不足而对癌症疼痛管理的担忧， 减轻疼痛和患者治疗差的差分较差。在所有疼痛管理，西班牙裔/拉丁裔 与其他人相比，种群获得慢性疼痛治疗的机会较低（部分是主要的 西班牙语），并且无法获得适当的疼痛治疗，这可能有助于药物治疗 滥用，情绪困扰和生活质量下降。除了社会确定的差异，语言 障碍是限制药物治疗和获得必需疼痛的关键挑战 管理服务。西班牙语的绝大部分缺乏服务，复杂 在可用服务中的不一致是与西班牙裔/拉丁裔互动的额外障碍 社区。此外，需要西班牙语和 格式化供通过移动设备使用，该设备必须将文化的独特功能整合到护理程序中。 我们的团队已经开发并验证了基于网络的疼痛应对技能培训（PCST）干预 （止痛药）可通过启用互联网的设备和智能手机获得，保留了关键功能 经验验证和有效的面对面PCST干预措施。止痛器是一个最大接近的人， 不需要诊所就诊或治疗师参与的互动和个性化干预措施。 通过NIH资助的试验，止痛药对疼痛管理的有效性是完善的，但仅可用 用英语留下了差距，可以将护理扩展到有限的讲西班牙语的患者 英语水平。与西班牙裔和拉丁文社区组织合作，社区咨询 董事会，患者拥护者和双语健康专家，我们将遵循逐步的社区参与，并 止痛药计划的文化信息适应和翻译包括：建立一个社区 咨询委员会（CAB）和基于社区的程序化审查面板（PRP）；初步干预 翻译过程；批判性评估止痛药的核心功能和理论构造；参与 CAB和PRP评估和进一步的批判性所有翻译；开发止痛剂 - 西班牙 语言敏感和文化适当； Beta测试程序；并建立可行性和可接受性 西班牙裔/拉丁裔患者的新干预与持续的癌症相关疼痛。