Partners for Pain & Wellbeing Equity: A Randomized Trial of Community Supported Complementary and Integrative Health Self Management for Back Pain

疼痛合作伙伴

• 批准号: 10538202
• 负责人: RONI L. EVANS
• 金额: $ 152.82万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-19 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10538202
• 关键词: Address; Adherence; Affect; Agreement; Back; Back Pain; Behavioral; Biophysics; Black American; Caring; Chronic; Chronic disabling pain; Clinical Protocols; Clinical Trials; Cognitive; Communities; Community Trial; Complementary Health; Complex; Coping Skills; Data; Data Collection; Development; Drug Prescriptions; Education; Effectiveness; Enrollment; Exercise; Face; Feasibility Studies; Future; Guidelines; Health; Health education; Health system; Healthcare Systems; Helping to End Addiction Long-term; Hispanic Americans; Income; Individual; Injections; Institutional Review Boards; Integrative Medicine; Intervention; Low Back Pain; Measures; Methods; Modeling; Monitor; National Center for Complementary and Integrative Health; Neck Pain; Operative Surgical Procedures; Outcome; Outcome Measure; Pain; Pain Disorder; Pain intensity; Pain interference; Pain management; Personal Satisfaction; Persons; Phase; Population; Population Heterogeneity; Preparation; Protocols documentation; Provider; Psychological Factors; Randomized; Recommendation; Research; Research Support; Resources; Safety; Secure; Self Care; Self Efficacy; Self Management; Subgroup; System; Translations; United States; United States National Institutes of Health; Videoconferencing; active control; base; chronic painful condition; community organizations; community setting; cost; effectiveness evaluation; effectiveness implementation study; effectiveness implementation trial; effectiveness outcome; evidence base; experience; experimental group; feasibility testing; follow-up; health disparity; health organization; improved; intervention mapping; intervention program; mindfulness; pain outcome; pain self-management; pain-related disability; primary outcome; programs; psychologic; randomized trial; recruit; relative effectiveness; secondary outcome; self-management program; social; social factors; success; usability

PROJECT SUMMARY. Back pain (BP), including low back and neck pain, is one of the most prevalent and disabling pain disorders. Most cases remain poorly managed and known socio-ecological factors that pose barriers to equitable care have been especially under-addressed resulting in critical disparities in BP management. This is evidenced by Black and Hispanic Americans, and individuals with less education and income, consistently experiencing poorer outcomes. Importantly, BP, like other chronic conditions, requires ongoing self-management. Unfortunately, most care offered through health systems fails to support sufferers’ self-care, and instead focuses on costly and provider-dependent therapies with little supporting research evidence. The persistent use of these practices contradicts evidence-based BP guideline recommendations for less invasive complementary and integrative health (CIH) approaches which can support self-care. Importantly, our team has demonstrated CIH approaches can be safely and effectively delivered in non-clinical settings in both in person and video-conferencing formats which can overcome barriers contributing to disparities. The long-term objective is to bolster the widespread implementation of evidence-based CIH approaches that support whole person oriented, self-care for individuals with back pain and who are from populations that experience health disparities (BP-PEHD). We will use a two-phase project that applies established models and frameworks for facilitating long term sustainability to develop, feasibility test, and evaluate the effectiveness of a community supported CIH self- management program, Partners4Pain compared to an active control, Keys to Wellbeing. This project builds upon our team’s extensive background in BP and CIH self-management research and established partnerships with community and health organizations with broad and diverse reach including the YMCA, YWCA, and others. Phase I (R61) will involve planning and preparations leading to a randomized feasibility study (n=40) including co- development and assessment of Partners4Pain, a self-management program comprised of evidence based CIH approaches (e.g. pain education, mindfulness, cognitive behavioral/pain coping strategies, exercise). Phase II (R33) includes a full-scale multi-level randomized hybrid effectiveness implementation trial (n=376) of the community supported self-management program, Partners4Pain compared to the active control, Keys to Wellbeing, both of which will have been optimized and feasibility tested in Phase I. By co-developing scalable evidence based CIH interventions with community stakeholders that can be delivered in an accessible manner by community partner organizations with extensive reach, we will remove an important barrier that currently exists within the costly and burdensome health care systems. This approach has the potential for larger scale implementation across a range of community-based organizations and settings, improving equitable access to resources that will support BP sufferers’ ability to gain greater agency in their own pain care, leading to better health and wellbeing.

项目摘要：背痛 (BP)，包括腰痛和颈部疼痛，是最常见和最致残的疼痛之一。 大多数病例仍然管理不善且已知的社会生态因素对公平护理构成障碍。 Black 和 Black 都没有得到充分解决，导致 BP 管理存在严重差异。 西班牙裔美国人以及受教育程度和收入较低的个人，其结果始终较差。 重要的是，与其他慢性病一样，BP 需要持续的自我管理，不幸的是，大多数护理都是提供的。 通过卫生系统无法支持患者的自我护理，而是专注于昂贵且依赖提供者的治疗 几乎没有支持性的研究证据。这些做法的持续使用与基于证据的血压指南相矛盾。 针对可支持自我保健的侵入性较小的补充和综合健康（CIH）方法的建议。 重要的是，我们的团队已经证明 CIH 方法可以在非临床环境中安全有效地实施 无论是面对面会议还是视频会议形式，都可以克服造成差异的障碍。 长期目标是促进基于证据的 CIH 方法的广泛实施，以支持 以全人为导向，对背痛患者和健康人群进行自我护理 我们将使用一个两阶段的项目，应用已建立的模型和框架来促进。 长期可持续性发展、可行性测试和评估社区支持的 CIH 自我的有效性 管理计划 Partners4Pain 与主动控制 Keys to Wellbeing 相比，该项目建立在我们的基础之上。 团队在 BP 和 CIH 自我管理研究以及与社区和社区建立的合作伙伴关系方面拥有丰富的背景 具有广泛和多样化影响力的卫生组织，包括 YMCA、YWCA 等。 第一阶段（R61）将涉及随机可行性研究（n = 40）的规划和准备，包括共同 Partners4Pain 的开发和评估，这是一个由基于证据的 CIH 方法组成的自我管理计划 （例如疼痛教育、正念、认知行为/疼痛应对策略、锻炼）。 II 期 (R33) 包括一项全面的多层次随机混合有效性实施试验 (n=376) 社区支持的自我管理计划、Partners4Pain 与主动控制、Keys to Wellbeing 相比，两者 其中将在第一阶段进行优化和可行性测试。 通过与社区利益相关者共同开发可扩展的基于证据的 CIH 干预措施，这些干预措施可以在 通过具有广泛影响力的社区合作伙伴组织的可访问方式，我们将消除一个重要的障碍 目前存在于昂贵且繁重的医疗保健系统中，这种方法具有更大规模的潜力。 在一系列社区组织和环境中实施，改善资源的公平获取 这将支持血压患者在自己的疼痛护理中获得更大的代理权，从而改善健康和福祉。