Implementing a Cognitive/Exercise Therapy for Back Pain in The Community Setting

在社区环境中实施背痛认知/运动疗法

• 批准号: 7173221
• 负责人: Manney Carrington Reid
• 金额: $ 8.4万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-01-12 至 2008-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7173221
• 关键词: Acetaminophen; Adherence; Administrator; Adopted; Adoption; Affect; African American; Age; Analgesics; Anti-Inflammatory Agents; Anti-inflammatory; Area; Back; Back Pain; Behavioral; Chronic; Cognitive; Cognitive Therapy; Communities; Community Surveys; Condition; Degenerative polyarthritis; Development; Diagnosis; Disadvantaged; Disease; Drug Prescriptions; Elderly; Epidemiology; Ethnic group; Evaluation; Exercise; Expenditure; Future; Geriatrics; Health; Health Services; Health Services Accessibility; Hispanic Americans; Home environment; Individual; Inpatients; Intervention; Knowledge; Low Back Pain; Lower Extremity; Mental Depression; Methods; Minority; Minority Groups; Morbidity - disease rate; Not Hispanic or Latino; Numbers; Office Visits; Operative Surgical Procedures; Opioid; Outcome; Outpatients; Pain; Pain management; Participant; Persons; Pharmaceutical Preparations; Physical Function; Physical therapy; Physical therapy exercises; Physicians' Offices; Population; Prevalence; Prospective Studies; Protocols documentation; Qualifying; Range; Readiness; Reporting; Research; Research Personnel; Respiratory Tract Infections; Risk; Self Efficacy; Self Management; Social isolation; Sociology; Spinal Fractures; Spinal Stenosis; Sprain; Support System; Surveys; Testing; Time; Treatment Protocols; Woman; Work; base; behavior measurement; caucasian American; chronic pain; community based participatory research; cost; design; disability; functional disability; human old age (65+); improved functioning; instrumental activity of daily living; men; nondrug therapy; older women; osteoporosis with pathological fracture; programs; prospective; psychologic; racial and ethnic; socioeconomics

DESCRIPTION (provided by applicant): Among older persons, chronic back pain (CBP) is a common, morbid, and costly disorder. Non-drug therapies for CBP including cognitive-behavioral and exercise treatments can be feasibly performed by older adults with CBP, have proven efficacy, but are seldom used by affected individuals. This gap between our current pain-management knowledge and limited use of the therapies by older persons with CBP provides strong support for efforts designed to test and implement strategies that facilitate adoption among individuals adversely affected by CBP. Given that prior research has documented significant racial disparities with respect to pain management, targeting at-risk racial/ethnic minorities appears particularly warranted at this time. The investigators have developed an age-appropriate intervention - i.e., an integrated, cognitive- behavioral and exercise therapy (CBET) protocol - for the treatment of CBP among older adults, and now seek to partner with future stakeholders to conduct pre-implementation testing in a community-based setting. The specific aims of this project are to use a community-based participatory research approach to refine our intervention prior to implementation by: (1) surveying community partners (i.e., prospective consumers of the intervention and directors of senior centers where the program will be administered) about their readiness to adopt a self-management program for CBP and perceived barriers to program adoption; and by (2) field testing the intervention in senior centers that serve three specific racial/ethnic groups: Hispanic American, African American, and non-Hispanic White Americans. Products of this research will include a field-tested and modified protocol, as well as stakeholder informed strategies for future program implementation. The long-term aim of this work is to develop an effective and sustainable implementation strategy for the above intervention, targeting community-dwelling older persons. The multi-disciplinary investigative team assembled for this project consists of individuals with complementary expertise in the areas of geriatric medicine and pain management (Dr. M. Carrington Reid), sociology and measurement of behavioral phenomena (Dr. Elaine Wethington), and geriatric physical therapy and instructional development and evaluation (Dr. Katherine Beissner), and are highly qualified to conduct the planned research.

描述（由申请人提供）：在老年人中，慢性背痛 (CBP) 是一种常见、病态且昂贵的疾病。 CBP 的非药物疗法，包括认知行为和运动治疗，可以由患有 CBP 的老年人进行，已被证明有效，但受影响的个体很少使用。我们目前的疼痛管理知识与患有 CBP 的老年人对治疗方法的有限使用之间的差距，为旨在测试和实施促进受 CBP 不利影响的个人采用的策略的努力提供了强有力的支持。鉴于之前的研究已经记录了疼痛管理方面存在显着的种族差异，因此目前针对高危种族/族裔群体似乎特别有必要。研究人员开发了一种适合年龄的干预措施，即综合认知行为和运动疗法（CBET）方案，用于治疗老年人的 CBP，现在寻求与未来的利益相关者合作，在以下领域进行实施前测试：以社区为基础的环境。该项目的具体目标是使用基于社区的参与性研究方法，在实施之前通过以下方式完善我们的干预措施：(1) 调查社区合作伙伴（即干预措施的潜在消费者和项目将管理的老年中心的主任） ) 关于他们为 CBP 采用自我管理计划的准备情况以及发现的计划采用障碍； (2) 在为三个特定种族/族裔群体服务的老年中心进行现场测试干预措施：西班牙裔美国人、非裔美国人和非西班牙裔美国白人。这项研究的产品将包括经过现场测试和修改的协议，以及利益相关者知情的未来计划实施策略。这项工作的长期目标是针对上述干预措施制定有效且可持续的实施战略，以社区老年人为目标。为该项目组建的多学科调查团队由在老年医学和疼痛管理（M. Carrington Reid 博士）、社会学和行为现象测量（Elaine Wethington 博士）以及老年物理领域具有互补专业知识的个人组成。治疗和教学开发和评估（凯瑟琳·贝斯纳博士），并且非常有资格进行计划的研究。