Feasibility of Remote-Delivery Interventions: Tai Chi and Wellness for PTSD and Pain in Veterans

远程干预的可行性：太极拳和针对退伍军人创伤后应激障碍和疼痛的健康

• 批准号: 10454572
• 负责人: Deanna L. Mori
• 金额: $ 17.82万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-10 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10454572
• 关键词: Address; Adherence; Aerobic; Affect; Aftercare; Boston; COVID-19 intervention; COVID-19 pandemic; Cardiovascular system; Caring; Chinese; Chronic; Clinical Trials; Data; Development; Diagnosis; Disease; Eligibility Determination; Ensure; Exercise; Feasibility Studies; Feedback; Future; Goals; Health; Health Services Accessibility; Health care facility; Healthcare Systems; Home; Integrative Therapy; Intervention; Interview; Life; Measures; Memory; Mental Health; Mental disorders; Military Personnel; Mind; Mind-Body Intervention; Minority Participation; Muscle; Outcome; Outcome Measure; Pain; Participant; Patients; Perception; Phase; Physical Function; Population; Post-Traumatic Stress Disorders; Procedures; Protocols documentation; Public Health; Quality of life; Randomized; Reporting; Research; Severities; Social Distance; Standardization; Symptoms; Tai Ji; Trauma; Travel; Treatment Protocols; United States Department of Veterans Affairs; Veterans; Veterans Health Administration; Videoconferencing; Well in self; Woman; acceptability and feasibility; barrier to care; care seeking; chronic musculoskeletal pain; chronic pain; cohort; conditioning; cost; design; disability; effective therapy; efficacy evaluation; feasibility trial; flexibility; follow up assessment; follow-up; global health; improved; improved outcome; intervention delivery; military veteran; novel; participant retention; physical conditioning; post intervention; post-traumatic symptoms; psychosocial; randomized controlled study; randomized trial; recruit; remote delivery; satisfaction; standardize measure; stress related disorder; study population; success; symptom management

Project Summary Posttraumatic stress disorder (PTSD) affects almost one quarter of military Veterans seeking care from Veterans Administration healthcare facilities. PTSD is associated with many health-related issues, especially chronic musculoskeletal pain, and is increasingly considered a systemic disorder, affecting both mind and body. Accessible treatments that address PTSD and chronic pain are urgently needed. Tai Chi is an ancient Chinese exercise that uses an integrated mind-body approach to enhance quality of life. Tai Chi delivered in groups has been shown to improve both mental health and physical health in patients with a variety of chronic conditions. However, no studies to date have examined Tai Chi for PTSD and pain in Veterans. Since the onset of COVID-19, interventions that can be delivered without the need for face-to-face contact are greatly needed. Remote mind-body interventions delivered via videoconferencing platforms can reduce barriers to treatment for Veterans isolated by PTSD-related avoidance, travel related challenges, or public health social distancing restrictions. The proposed study will evaluate the feasibility of remotely delivered Tai Chi for PTSD and pain in Veterans. This trial represents first steps toward a long-term goal of establishing this mind-body treatment to address these maladies for Veterans via a remote videoconferencing platform. In Phase One, the research team will adapt and do a ‘dry run’ of two existing 12-week, twice per week interventions (Tai Chi and a Wellness control) for delivery via videoconferencing for the study population. In Phase One, the team will recruit 12 participants (6 in each group) and utilize quantitative and qualitative feedback to refine and standardize the interventions. In Phase Two, 36 participants will be randomly assigned over 3 cohorts (n = 12 for each cohort, n = 6 for each group) to either a Tai Chi or a Wellness group for 12 weeks with a three-month post-treatment follow up assessment. The feasibility and acceptability of a remotely delivered randomized trial of these two interventions and the assessment protocols will be determined. Feasibility will be quantified using rates of participant eligibility, recruitment, attrition, and adherence to the treatment and assessment protocols. Feasibility will be indicated (1) by the ability to meet recruitment goals, including women and minority participation, and (2) by having at least 75% of participants regularly attend sessions and engage in home practice and 70% complete post-intervention and follow-up assessments. Acceptability will be assessed via participants’ ratings on a standardized measure of treatment satisfaction, supplemented by qualitative exit interviews. Acceptability will be indicated by 70% of the participants reporting treatment satisfaction and credibility. Information from this trial will be utilized to design a large randomized control study evaluating the efficacy of Tai Chi for improving outcomes for Veterans with PTSD and chronic musculoskeletal pain. The proposed study will be pivotal to establish procedures to fully evaluate a novel, accessible, nonpharmacologic approach for symptom management of PTSD and chronic pain in a future large-scale trial of Tai Chi.

项目摘要 创伤后应激障碍（PTSD）影响了将近四分之一的退伍军人寻求护理 退伍军人管理医疗机构。 PTSD与许多与健康有关的问题有关，尤其是 慢性肌肉骨骼疼痛，越来越被认为是一种全身性疾病，影响着思想和 身体。迫切需要解决PTSD和慢性疼痛的无障碍治疗方法。太极志是古老的 中国运动采用综合思维方式来提高生活质量。太极拳交付了 已显示组可改善各种慢性的患者的心理健康和身体健康 状况。但是，迄今为止，还没有研究过Tai Chi的PTSD和退伍军人疼痛。自从 COVID-19的发作，可以进行的干预措施而无需面对面接触很棒 需要。通过视频会议平台提供的远程心身干预措施可以将障碍降低到 通过PTSD相关的避免，与旅行相关的挑战或公共卫生社会隔离的退伍军人的治疗 距离限制。拟议的研究将评估远程交付的TAI CHI的可行性 和退伍军人的痛苦。该试验代表了建立这种思维的长期目标的第一步 通过远程视频会议平台来解决退伍军人的这些疾病。在第一阶段， 研究团队将适应并进行两次现有12周的“干燥”，每周两次干预（Tai Chi和 保健控制），用于通过视频会议为研究人群提供。在第一阶段，团队将 招募12名参与者（每个组中有6名），并利用定量和定性反馈来完善和 标准化干预措施。在第二阶段，将在3个队列上随机分配36位参与者（n = 12 对于每个队列，每组n = 6）到Tai Chi或健康组12周，三个月 治疗后随访评估。远程交付的随机试验的可行性和可接受性 在这两种干预措施中，将确定评估方案。可行性将使用 参与资格，招募，流失和遵守治疗和评估方案的速度。 可行性将通过实现招聘目标（包括妇女和少数民族）的能力来指示（1） 参与，（2）至少有75％的参与者定期参加会议并参与家庭 练习和70％的完成后干预和随访评估。可接受性将通过 参与者对标准化治疗满意度的评分，并补充了定性退出 访谈。可接受性将由70％的参与者报告治疗满意度和 信誉。该试验的信息将用于设计一项大型随机对照研究，以评估 TAI CHI改善PTSD和慢性肌肉骨骼疼痛的退伍军人的结果。这 拟议的研究将是建立完全评估新颖，可访问的非药物的程序的关键 在未来的Tai Chi大规模试验中，PTSD和慢性疼痛的症状管理方法。