Adherence in African Americans Being Treated for Cancer Pain

非裔美国人接受癌症疼痛治疗的依从性

• 批准号: 8618009
• 负责人: Katherine Aylward Yeager
• 金额: $ 9.18万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-27 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8618009
• 关键词: AIDS clinical trial group; Acquaintances; Address; Adherence; Affect; African American; Analgesics; Area; Behavior; Belief; Cancer Burden; Cancer Pain Management; Caregiver Burden; Censuses; Church; Communities; Crime; Education; Event; Friends; Gender; Geographic Locations; Goals; Grant; Health; Health behavior; Household; Household Heads; Individual; Knowledge; Link; Location; Malignant Neoplasms; Measures; Mental Depression; Mentors; Mentorship; Methods; Minority; Modeling; Monitor; Neighborhoods; Opiates; Outcome; Pain; Pain management; Patients; Persons; Pharmaceutical Preparations; Positioning Attribute; Poverty; Qualitative Methods; Quality of life; Questionnaires; Recommendation; Religion and Spirituality; Reporting; Research; Research Methodology; Research Personnel; Risk Factors; Sampling; Sickle Cell; Social Environment; Social Network; Social support; Socioeconomic Factors; Source; Spirituality; Symptoms; System; Time; Training; Treatment outcome; Unemployment; Universities; Vacuum; advanced disease; base; cancer pain; career; community intervention; compliance behavior; contextual factors; density; design; economic cost; experience; family influence; improved; indexing; medication compliance; novel; public health relevance; research study; segregation; skills; social; statistics; treatment adherence

African Americans experience a disproportionate burden of cancer pain, suffer worse treatment outcomes, and have overall poor adherence to pain medication. Unfortunately, past research on pain has not fully explored factors important to cancer pain relief and treatment adherence in an economically diverse group of African Americans. Knowledge of the reasons why individuals do not adhere to pain treatment is essential if we are to better understand why they receive inadequate pain relief when adequate treatments are available. The proposed application moves beyond previous understanding of adherence by exploring the context of individuals - the social network and neighborhood that surround them and influence their behavior. This examination of social contextual factors requires a mixed method multilevel approach to explore the "what" and "how" of opiate adherence. Framed in a social ecological model, the aims of this study are to examine the influence of individual (symptom profile including pain and depression, pain beliefs, education, and gender) interpersonal (religious and social support), and neighborhood factors (socioeconomic measures, segregation, and drug related crime) on "around the clock" opiate adherence in African Americans being treated for cancer pain. A parallel mixed method design approach will be used that includes a quantitative and qualitative strand. The quantitative strand will provide information on what factors influence opiate adherence and the qualitative strand will provide a rich description of how these factors affect adherence. Along with the execution of this research, a comprehensive training and career mentoring plan will be carried out at Emory University under the mentorship of experts in symptom outcomes, pain disparities, medication adherence, and community factors of sociodemographic outcomes of health. The candidate's training goals include: 1) develop expertise in mixed- method research focusing on a minority sample being treated for cancer pain; 2) acquire methodological skills in geospatial analysis and statistics in order to better understand sources of disparities in non-adherence to opiates; and 3) build skills to position for next steps in the research trajectory. The goal of this project is to enhance understanding of pain medication adherence in African Americans. The long-range goal is to identify effective mechanisms to improve cancer pain relief, especially for those suffering the highest burden of cancer, African Americans. This training grant will prepare the candidate to be a successful independent researcher with preliminary information to improve pain management through treatment/assessment recommendations and/or patient and community interventions to ultimately improve pain management in African Americans with cancer pain.

非裔美国人承受着不成比例的癌症疼痛负担，遭受更差的治疗结果，并且 对止痛药的总体依从性较差。不幸的是，过去关于疼痛的研究尚未充分探索 在经济多样化的非洲群体中，对缓解癌症疼痛和坚持治疗很重要的因素 美国人。如果我们想要做到这一点，了解个人不坚持疼痛治疗的原因至关重要 更好地理解为什么在有足够的治疗时他们的疼痛缓解效果不够。这 所提出的应用程序通过探索以下内容超越了以前对依从性的理解 个人——围绕他们并影响他们行为的社交网络和社区。这 对社会背景因素的检查需要采用混合方法多层次的方法来探索“什么”和 阿片类药物依从性“如何”。本研究的目的是在社会生态模型的框架内检验 个体的影响（症状特征包括疼痛和抑郁、疼痛信念、教育和性别） 人际因素（宗教和社会支持）和邻里因素（社会经济措施、隔离、 和毒品相关犯罪）对接受癌症治疗的非裔美国人“全天候”使用阿片类药物的影响 疼痛。将使用并行混合方法设计方法，包括定量和定性链。 定量部分将提供有关影响阿片类药物依从性的因素和定性部分的信息。 链将提供关于这些因素如何影响依从性的丰富描述。随着本次的执行 研究，综合培训和职业指导计划将在埃默里大学进行 专家对症状结果、疼痛差异、药物依从性和社区因素的指导 健康的社会人口统计结果。候选人的培训目标包括：1）发展混合领域的专业知识 方法研究侧重于少数接受癌性疼痛治疗的样本； 2）获得方法论技能 进行地理空间分析和统计，以便更好地了解不遵守规定的差异来源 阿片类药物； 3）培养技能，为研究轨迹的下一步做好准备。该项目的目标是 增强对非裔美国人止痛药依从性的了解。长期目标是确定 改善癌症疼痛缓解的有效机制，特别是对于那些遭受癌症负担最重的人来说， 非裔美国人。该培训补助金将使候选人成为一名成功的独立研究员 提供初步信息，通过治疗/评估建议改善疼痛管理 和/或患者和社区干预措施，以最终改善非裔美国人的疼痛管理 癌症疼痛。