Prospective Study of Racial and Ethnic Disparities in Chronic Pain and Pain Burden

慢性疼痛和疼痛负担的种族和民族差异的前瞻性研究

基本信息

批准号：
9006361
负责人：
GRANT MARSHALL
金额：
$ 70.26万
依托单位：
RAND CORPORATION
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-07-08 至 2021-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9006361
关键词：
Accounting Acute Address Adult African American Data Development Ethnic Origin Goals Hospitalization Hospitals Individual Injury Intervention Interview Investigation Knowledge Latino Lead Link Longitudinal Studies Los Angeles Medical Records Minority Minority Groups Nature Outcome Pain Pain management Pharmaceutical Preparations Philadelphia Preventive Intervention Prospective Studies Public Health Quality of life Race Recovery Recruitment Activity Research Risk Sampling Severities Solid Survivors Trauma base chronic pain design ethnic minority population experience follow-up functional disability group intervention improved innovation insight member prospective public health relevance racial and ethnic racial and ethnic disparities racial minority research study therapy design therapy development trauma centers

Accounting Acute Address Adult African American Data Development Ethnic Origin Goals Hospitalization Hospitals Individual Injury Intervention Interview Investigation Knowledge Latino Lead Link Longitudinal Studies Los Angeles Medical Records Minority Minority Groups Nature Outcome Pain Pain management Pharmaceutical Preparations Philadelphia Preventive Intervention Prospective Studies Public Health Quality of life Race Recovery Recruitment Activity Research Risk Sampling Severities Solid Survivors Trauma base chronic pain design ethnic minority population experience follow-up functional disability group intervention improved innovation insight member prospective public health relevance racial and ethnic racial and ethnic disparities racial minority research study therapy design therapy development trauma centers

展开

项目摘要

DESCRIPTION (provided by applicant): Chronic pain poses a disproportionate public health burden on racial and ethnic minorities. Substantial inequities exist in the pain treatment received by African-Americans and Latinos relative to their non-Latino White counterparts. Data suggest that members of these minority groups are not only more likely to develop chronic pain but also to have this pain accompanied by greater pain burden, i.e., greater suffering, poorer life quality, and worse functional impairment. Only modest headway has been made in understanding why race and ethnicity confer pain inequities and how best to address these disparities. The long-term objective of the proposed research is to contribute to the reduction or outright elimination o racial and ethnic pain disparities. The near-term goal of the planned research is to identify a small set of the most promising intervention targets, from among the plethora of posited explanations, for reducing or eliminating racial/ethnic pain disparities. The planned study would be, to our knowledge, the first ever prospective examination of factors posited to underlie racial and ethnic disparities in the transition from acute to chronic pain. The study would also be the first to investigate these issues in the important context of recovery following serious physical injury requiring hospitalization. For the proposed research, a sample of 900 adult survivors of serious physical injury, comprised of roughly equal proportions of African-Americans, Latinos, and non-Latino Whites, will be recruited during hospitalization from large trauma centers in Los Angeles, CA and Philadelphia, PA. Interviews will be conducted during hospitalization and at 3-, and 12-month follow-up. Medical records will provide information on injury severity and medication use in-hospital which may influence the course of pain. The specific aims are (1) to determine whether African-American and Latino physical injury survivors experience more severe pain following injury relative to their non-Latino White counterparts; (2) to determine whether African-American and Latino injury survivors experience greater pain burden relative to their non- Latino White counterparts; (3) to determine whether African-American and Latino differences in pain severity or pain burden can be linked to a small set of promising candidates to serve as targets for interventions aimed at reduction or elimination of pain outcome disparities; and (4) To determine whether pain outcomes in at-risk minority groups can be linked to a small set of promising candidates to serve as targets for group-tailored interventions to reduce pain severity and pain burden irrespective of whether these candidates contribute to between-group pain disparities. The knowledge gained from the proposed research has high potential to accelerate efforts aimed at eliminating racial and ethnic pain disparities by identifying promising targets for prevention and intervention efforts to close the pain gap.

描述（由适用提供）：慢性疼痛在种族和少数民族上造成了不成比例的公共卫生伯恩。接受的疼痛治疗中存在严重的不平等现象非裔美国人和拉丁美洲人相对于他们的非拉丁裔白人对应物。数据表明，这些少数群体的成员不仅会出现慢性疼痛的可能性，而且伴随着更大的疼痛负担，即更大的痛苦，较大的痛苦，较差的生活质量，功能障碍和功能障碍。在理解为什么种族和种族会议痛苦不平等以及如何最好地解决这些分布的原因时，只有谦虚的进展。拟议研究的长期目标是为减少或彻底消除种族和种族疼痛分布做出贡献。计划研究的近期目标是从多个后验解释中确定一小部分最有承诺的干预目标，以减少或消除种族/种族疼痛差异。据我们所知，计划的研究将是对从急性到慢性疼痛过渡的种族和种族差异基础的因素的首次前瞻性检查。这项研究还将是第一个在需要住院的严重身体伤害后恢复的重要情况下研究这些问题的。对于拟议的研究，将在洛杉矶洛杉矶和宾夕法尼亚州洛杉矶和费城的大型创伤中心的住院期间招募900种严重身体损伤的成年人生存样本，该样本由大约相等的非裔美国人，拉丁裔和非拉丁裔白人组成。访谈将在住院期间以及3个月和12个月的随访期间进行。病历将提供有关损伤严重性和药物使用内医院的信息，这可能会影响疼痛的进程。具体目的是（1）确定非裔美国人和拉丁美洲人的身体损伤是否相对于非拉丁裔白色对应物而受伤后是否会更加严重疼痛；（2）确定非洲裔美国人和拉丁裔伤害的生存是否相对于非拉丁裔白人对应物的疼痛; （3）确定非裔美国人和拉丁裔在疼痛严重程度或疼痛伯恩的差异是否可以与一小部分承诺的候选人有关，以作为旨在减少或紧急疼痛结局分布的干预措施的目标；（4）确定高危少数群体中的疼痛结果是否可以与一小部分承诺的候选人相关联，以作为群体尾部干预措施的目标，以减轻疼痛的严重程度和疼痛，而伯恩伯恩（Pain Burnen）无论这些候选人是否有助于群体疼痛分布。从拟议的研究中获得的知识具有很高的潜力，即通过确定预防和干预措施的承诺目标来弥补疼痛差距，以加速旨在消除种族和种族疼痛分布的努力。