Scaling-Up Integrative Pain Management in Federally Qualified Health Centers

在联邦合格的健康中心扩大综合疼痛管理

基本信息

批准号：
10449763
负责人：
Isabel Roth
金额：
$ 11.71万
依托单位：
UNIV OF NORTH CAROLINA CHAPEL HILL
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-07-20 至 2026-12-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10449763
关键词：
Academy Address Adherence Administrator Adoption Adult American Analgesics Applications Grants Award COVID-19 pandemic Clinic Clinical Clinical Sciences Cluster randomized trial Communities Cost Analysis Cost Measures Data Educational workshop Effectiveness Electronic Health Record Emergency department visit Enrollment Environment Epidemic Epidemiologist Epidemiology Evaluation Feasibility Studies Federally Qualified Health Center Feedback Foundations Future Geography Gills Goals Grant Guidelines Health Personnel Health Policy Health Services Accessibility Health care facility Hybrids Improve Access Institutes Integrative Medicine Intervention Interview K-Series Research Career Programs Low Income Population Low income Maintenance Measures Medical Medicine Mentors Mentorship Methods Neighborhood Health Center North Carolina Opioid Overdose Pain Pain management Patient Representative Patients Persons Pharmaceutical Preparations Pilot Projects Policy Maker Population Populations at Risk Preparation Provider Public Health Schools Publishing Quality of life Research Research Personnel Research Project Grants Research Training Risk Rural Scientist Self Efficacy Self Management Site Structure Surveys Techniques Training Training Activity Training Programs Training and Infrastructure Visit Writing Yoga arm base care providers career career development chronic pain chronic pain management chronic pain patient chronic painful condition college community based participatory research cost design effectiveness evaluation effectiveness implementation trial effectiveness measure effectiveness outcome experience health economics hybrid type 2 trial implementation cost implementation design implementation evaluation implementation outcomes implementation research implementation science implementation strategy instructor medical schools mindfulness mindfulness-based stress reduction opioid overdose opioid use overdose death pain reduction prescription opioid programs responsible research conduct retention rate safety net scale up skills teacher telehealth theories treatment as usual trial design

项目摘要

PROJECT SUMMARY Background: Chronic pain impacts a fifth of American adults. Integrative pain management (IPM) interventions including mindfulness-based stress reduction, yoga, and other methods have demonstrated improvements in pain and function, and are now included in clinical guidelines for chronic pain conditions. Despite evidence of efficacy, IPM is not reaching low-income populations at greatest risk for chronic pain and related opioid overdose. Low-income communities rely on safety-net healthcare facilities to access care, of which Federally Qualified Health Centers (FQHCs) are the primary providers. The Integrative Medical Group Visit (IMGV) for chronic pain is one of a few promising IPM interventions developed specifically for safety-net settings. The challenge now is to examine effectiveness and implementation of IMGV in FQHC settings, to address chronic pain and risks associated with opioid use. Goals and Objectives: Dr. Roth’s long-term career goal is to become an independent investigator evaluating effectiveness and implementation of IPM interventions to reduce the burden of chronic pain, particularly in low-income communities. This K01 career development award will allow Dr. Roth to gain advanced skills in conducting trials that can identify successful implementation strategies for IPM interventions. Career Development Activities: The K01 application will provide structured didactic and hands-on training that will build on Dr. Roth’s training in community-based participatory research and foundational implementation science skills, through training in cluster-randomized trial designs, cost measurement and evaluation, and conducting a multi-site pilot study with FQHCs. The plan will engage Dr. Roth in robust training activities including mentorship, coursework, research projects, publishing and presenting, workshops and seminars, grant-writing, and responsible conduct of research. Mentors: Dr. Roth’s mentorship team consists of accomplished scientists from implementation science, clinical integrative health research, intervention epidemiology, health economics, and FQHCs. Environment: Dr. Roth will benefit from a comprehensive research training program and infrastructure based at the UNC School of Medicine’s Program on Integrative Medicine, the top-ranked UNC Gillings School of Public Health, and the North Carolina Translational and Clinical and Sciences Institute. The North Carolina Community Health Center Association will provide training in working with FQHCs. Research: Dr. Roth’s proposed K01 research project will address the limited access to IPM in FQHC settings serving low-income patients. Dr. Roth will first engage key stakeholders through implementation mapping to identify and refine implementation strategies (Aim 1). She will then pilot measures of effectiveness and implementation for IMGV in two FQHCs (one rural, one urban) in North Carolina (Aim 2). This award will prepare Dr. Roth to submit a future competitive grant application for a hybrid type 2 effectiveness-implementation trial of IMGV for chronic pain in FQHC settings.

项目概要背景：慢性疼痛影响着五分之一的美国成年人。综合疼痛管理 (IPM)。包括正念减压、瑜伽和其他方法在内的干预措施已证明改善疼痛和功能，现已纳入慢性疼痛的临床指南。尽管有证据表明 IPM 有效，但 IPM 并未惠及慢性疼痛和慢性疼痛风险最大的低收入人群。相关的阿片类药物过量。低收入社区依靠安全网医疗设施来获得护理。联邦合格健康中心 (FQHC) 是主要提供者。慢性疼痛就诊 (IMGV) 是专为安全网开发的少数有前途的 IPM 干预措施之一现在的挑战是检查 FQHC 环境中 IMGV 的有效性和实施情况，以解决与阿片类药物使用相关的慢性疼痛和风险：罗斯博士的长期职业生涯。目标是成为一名独立调查员，评估 IPM 的有效性和实施情况减轻慢性疼痛负担的干预措施，特别是在低收入社区。开发奖将使罗斯博士能够获得进行试验的高级技能，从而确定成功的试验 IPM 干预措施的实施策略：K01 应用程序将。提供结构化的教学和实践培训，这些培训将以罗斯博士的社区培训为基础通过整群随机化培训，提高参与性研究和基础实施科学技能试验设计、成本测量和评估，以及与 FQHC 进行多地点试点研究。将使罗斯博士参与强有力的培训活动，包括指导、课程作业、研究项目、出版和展示、讲习班和研讨会、拨款写作以及负责任的研究行为。导师：Roth 博士的导师团队由来自实施科学、临床领域的杰出科学家组成综合健康研究、干预流行病学、健康经济学和 FQHC 环境：Roth 博士。将受益于北卡罗来纳大学医学院的综合研究培训计划和基础设施医学综合医学项目、排名第一的北卡罗来纳大学吉林斯公共卫生学院以及北卡罗来纳州转化与临床科学研究所。协会将提供与 FQHC 合作的培训：Roth 博士提出的 K01 研究项目。 Roth 博士将首先参与解决在 FQHC 环境中为低收入患者提供 IPM 的机会有限的问题。主要利益相关者通过绘制地图来确定和完善实施策略（目标 1）。然后，她将在两个 FQHC（一个农村、一个北卡罗来纳州的城市）（目标 2）。该奖项将为 Roth 博士提交未来的竞争性资助做好准备。申请 IMGV 在 FQHC 环境中治疗慢性疼痛的混合 2 型有效性实施试验。