Evidence-Based Pain Intervention for Veterans: Leveraging Mobile & Social Media

针对退伍军人的循证疼痛干预：利用移动设备

基本信息

批准号：
8590715
负责人：
SARA S JOHNSON
金额：
$ 23.12万
依托单位：
PRO-CHANGE BEHAVIOR SYSTEMS, INC.
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-08-01 至 2016-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8590715
关键词：
Address Adopted Advocate Affect Aftercare American Americas Behavioral Cardiovascular Diseases Caring Chronic Chronic low back pain Cognitive Collaborations Comorbidity Computers Connecticut Coping Skills Data Devices Diabetes Mellitus Disease Economic Burden Emotional Ensure Equilibrium Evaluation Exercise Feedback Focus Groups Freedom Frequencies Friends General Population Health Healthcare Systems Hygiene Individual Institute of Medicine (U.S.)Internet Intervention Language Malignant Neoplasms Mental Health Modification Musculoskeletal Diseases Musculoskeletal Pain Nature Numeric Rating Scale Opioid Outcome Pain Pain intensity Pain management Participant Patient Education Patients Personal Satisfaction Phase Pilot Projects Population Post-Traumatic Stress Disorders Prevalence Program Development Protocols documentation Public Health Readiness Recommendation Recruitment Activity Relaxation Relaxation Therapy Reporting Research Risk Role Schedule Science Self Management Sleep Social Network Societies Solutions Staging Stress Subgroup Symptoms System Techniques Testing Text Traumatic Brain Injury Treatment Effectiveness Veterans base behavior change chronic pain commercialization coping cost cost effective design effectiveness trial evidence base follow-up health administration impression improved improved functioning indexing innovation operation population based preference programs prototype public health relevance response satisfaction social social networking website stress management usability

项目摘要

DESCRIPTION (provided by applicant): Chronic musculoskeletal pain creates a significant public health burden. Veterans are disproportionately affected by chronic musculoskeletal pain, and in particular, chronic low back pain (CLBP). The frequency and extent of co-occurrence of pain and PTSD, pain and Traumatic Brain Injury (TBI), and all three conditions (Post-deployment Multi-symptom Disorder (PMD)) can complicate and reduce the effectiveness of treatment for pain. The 2011 Institute of Medicine Blueprint for Relieving Pain in America calls for the promotion of self- management; reducing disparities among vulnerable subgroups (including Veterans); and the tailoring of pain care to each patient. Proponents of integrated treatment for PMD or the co-occurrence of pain with either TBI or PTSD are advocating for delivery of interventions that address multiple conditions. The proposed research represents an innovative response to those recommendations in that it will develop and examine the feasibility, acceptability, and preliminary effects of Sx3: Self Management of Pain, Sleep, & Stress Management a theoretically-grounded, mobile-optimized, Internet-based, interactive pain self-management program for chronic musculoskeletal pain. Unlike any existing pain intervention, Sx3: 1) is tailored specifically for Veterans' readiness to adopt self-management and preference for pain management strategies; 2) incorporates two of the core components of promising integrated treatments for PMD that are appropriate for Veterans with co-morbidities: sleep hygiene and stress management (relaxation training); and 3) leverages social networking, gaming principles, and SMS messaging to increase engagement and retention. Developed in collaboration with national pain self-management expert Dr. Robert Kerns, the computer- tailored intervention (CTI) will include a dynamic personal activity center, principles of gaming for health, social networking features, and optional text messages. Extensive end user and stakeholder input will ensure Sx3 is designed for rapid dissemination. Participants for formative focus groups (n=60); usability testing (n=20); and a pilot test (n=50) will be recruited from VA Connecticut Healthcare System. Formative focus group feedback will be combined with expert input to develop a prototype of an engaging self-management program tailored to readiness to adopt and preference for pain coping skills that incorporates sleep hygiene and stress management. Usability testing will allow the prototype to be refined before a 30-day pilot. Pilot participants will provide quantitative and qualitative acceptability data, and utilization data wil be examined. Pre-post comparisons of pain intensity; physical and emotional functioning; Patient Global Impression of Change; and readiness to adopt pain coping skills will provide preliminary data on the effects of the program. These data will inform program modifications needed to proceed with the Phase II effectiveness trial. Phase II will provide the impetus for commercialization of a cost-effective, evidence-based, population-based program that has the potential to improve pain self-management, functioning, and well-being.

描述（由申请人提供）：慢性肌肉骨骼疼痛造成了巨大的公共卫生负担。退伍军人受到慢性肌肉骨骼疼痛的影响，尤其是慢性腰痛（CLBP）。疼痛和PTSD，疼痛和脑损伤（TBI）以及所有三种疾病的频率和程度（DEPLOYMENT多突击症（PMD））可能会使疼痛治疗的有效性复杂化并降低治疗的有效性。 2011年医学研究所蓝图缓解美国疼痛呼吁促进自我管理；减少弱势亚组（包括退伍军人）之间的差异；以及为每个患者的疼痛护理量身定制。支持PMD的综合治疗或与TBI或PTSD疼痛共同出现的人正在主张提供解决多种疾病的干预措施。拟议的研究代表了对这些建议的创新反应，因为它将发展和检查SX3的可行性，可接受性和初步影响：疼痛，睡眠和压力管理的自我管理理论上，基于移动的，基于Internet的，基于Internet的，基于Internet的，基于Internet的，互动的，互动的疼痛自我管理程序，用于长期肌肉骨骼骨骼骨骼疼痛。与任何现有的疼痛干预不同，SX3：1）专门针对退伍军人准备采取自我管理和偏爱疼痛管理策略； 2）结合了适用于合并症的退伍军人：睡眠卫生和压力管理（放松训练）的两个有希望的综合处理的核心组成部分； 3）利用社交网络，游戏原则和SMS消息传递来增加参与度和保留。与国家疼痛自我管理专家罗伯特·克恩斯（Robert Kerns）博士合作，计算机量身定制的干预措施（CTI）将包括动态的个人活动中心，游戏原理，健康原理，社交网络功能和可选的文本消息。广泛的最终用户和利益相关者的输入将确保为快速传播而设计SX3。形成性焦点小组的参与者（n = 60）；可用性测试（n = 20）;并将从VA Connecticut Healthcare系统招募试点测试（n = 50）。形成性焦点小组的反馈将与专家投入相结合，以制定量身定制的引人入胜的自我管理计划的原型，该计划量身定制，以采用和偏爱纳入睡眠卫生和压力管理的疼痛应对能力。可用性测试将使原型在30天的飞行员之前进行完善。试点参与者将提供定量和定性的可接受性数据，将检查利用数据。疼痛强度的前比较；身体和情感功能；患者全球变化的印象；准备采用疼痛应对能力的准备将提供有关该计划影响的初步数据。这些数据将为进行II期有效性试验所需的计划修改提供信息。第二阶段将为一项具有成本效益的，基于循证的人群计划的商业化提供动力，该计划有可能改善疼痛的自我管理，功能和福祉。