A Pilot Randomized Controlled Trial of Resilience Coaching for Adolescents with Chronic Musculoskeletal Pain

对患有慢性肌肉骨骼疼痛的青少年进行弹性训练的随机对照试验

• 批准号: 10668463
• 负责人: SABRINA ANDREA GMUCA
• 金额: $ 16.08万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10668463
• 关键词: Achievement; Address; Adolescent; Adolescent and Young Adult; Adult; Affect; Age; Anxiety; Caregivers; Caring; Child; Child Psychology; Childhood; Chronic Childhood Arthritis; Chronic Disease; Clinical; Clinical Trials; Clinical Trials Design; Cognitive; Cognitive Therapy; Collaborations; Complement; Data; Development; Educational Intervention; Effectiveness; Face; Feedback; Fostering; Future; Goals; Improve Access; Institution; Intervention; Interview; Investigation; Joints; K-Series Research Career Programs; Knowledge; Learning; Lupus; Medical Care Costs; Mental Depression; Mentorship; Methods; Multicenter Trials; Muscle; Occupational; Outcome; Pain; Pain Research; Pain intensity; Parents; Participant; Patients; Pediatric Hospitals; Pennsylvania; Persistent pain; Phase; Philadelphia; Population; Process; Provider; Psychosocial Factor; Randomized, Controlled Trials; Recommendation; Research; Research Methodology; Research Personnel; Resources; Rheumatology; Role; Scientist; Severities; Societies; Structure; Surveys; Symptoms; Teenagers; Training; Treatment Protocols; Treatment outcome; Universities; Work; Youth; acceptability and feasibility; aged; arm; behavioral health intervention; bone; burden of illness; career; career development; chronic musculoskeletal pain; chronic pain; chronic pain management; cohort; comorbidity; efficacy evaluation; enhanced care; experience; functional disability; future implementation; health care service utilization; implementation efforts; implementation evaluation; implementation intervention; implementation outcomes; implementation science; improved; innovation; insight; inter-individual variation; interdisciplinary approach; mindfulness; multidisciplinary; novel; patient population; pediatric rheumatic diseases; pilot trial; post intervention; preference; prevent; primary outcome; programs; promote resilience; psychologic; psychological distress; psychosocial; remote delivery; resilience; rheumatologist; routine care; secondary outcome; sex; skills; soft tissue; stress management; tertiary care; theories; treatment as usual; treatment responders; treatment response; Achievement; Address; Adolescent; Adolescent and Young Adult; Adult; Affect; Age; Anxiety; Caregivers; Caring; Child; Child Psychology; Childhood; Chronic Childhood Arthritis; Chronic Disease; Clinical; Clinical Trials; Clinical Trials Design; Cognitive; Cognitive Therapy; Collaborations; Complement; Data; Development; Educational Intervention; Effectiveness; Face; Feedback; Fostering; Future; Goals; Improve Access; Institution; Intervention; Interview; Investigation; Joints; K-Series Research Career Programs; Knowledge; Learning; Lupus; Medical Care Costs; Mental Depression; Mentorship; Methods; Multicenter Trials; Muscle; Occupational; Outcome; Pain; Pain Research; Pain intensity; Parents; Participant; Patients; Pediatric Hospitals; Pennsylvania; Persistent pain; Phase; Philadelphia; Population; Process; Provider; Psychosocial Factor; Randomized, Controlled Trials; Recommendation; Research; Research Methodology; Research Personnel; Resources; Rheumatology; Role; Scientist; Severities; Societies; Structure; Surveys; Symptoms; Teenagers; Training; Treatment Protocols; Treatment outcome; Universities; Work; Youth; acceptability and feasibility; aged; arm; behavioral health intervention; bone; burden of illness; career; career development; chronic musculoskeletal pain; chronic pain; chronic pain management; cohort; comorbidity; efficacy evaluation; enhanced care; experience; functional disability; future implementation; health care service utilization; implementation efforts; implementation evaluation; implementation intervention; implementation outcomes; implementation science; improved; innovation; insight; inter-individual variation; interdisciplinary approach; mindfulness; multidisciplinary; novel; patient population; pediatric rheumatic diseases; pilot trial; post intervention; preference; prevent; primary outcome; programs; promote resilience; psychologic; psychological distress; psychosocial; remote delivery; resilience; rheumatologist; routine care; secondary outcome; sex; skills; soft tissue; stress management; tertiary care; theories; treatment as usual; treatment responders; treatment response

PROJECT SUMMARY Chronic musculoskeletal pain (CMP) affects as many as 4 in 10 children, mostly adolescents, and accounts for the majority of new referrals to pediatric rheumatology. Long-term physical and psychosocial outcomes for adolescents with CMP are poor with increased healthcare utilization and psychological co-morbidities. Additionally, current treatment regimens for CMP have limited accessibility. Resilience is a dynamic process of positive adaptation or development in the context of significant adversity, such as living with excessive chronic pain. Promoting Resilience in Stress Management (PRISM) is a successful resilience-training intervention for adolescents and young adults with serious illness. Preliminary data for this proposal demonstrate a moderate correlation between self-perceived resilience and symptom severity among adolescents as well as high feasibility and acceptability of PRISM delivery among youth with CMP. Qualitative feedback was universally positive with the consistent recommendation to add a patient group session to the intervention. With an added patient group session to the intervention, we now aim to ascertain the impact of the adapted intervention (Promoting Resilience in Stress Management (PRISM) for adolescent Chronic musculoskeletal pain [PRISM-C]) on pain-related clinical outcomes in a randomized controlled trial. The overall objectives of the proposed project are to (1) determine the efficacy of PRISM-C in a population of youth with CMP, (2) explore moderators of the intervention to identify youth most likely to benefit from resilience coaching, and (3) assess implementation outcomes and identify barriers and facilitators to engagement in PRISM-C. Findings from this work will further our understanding of psychosocial factors important in adolescent CMP in order to reduce disease burden and improve long-term outcomes. Study results will serve as preliminary data for an R01 application to perform a multicenter randomized controlled trial of PRISM-C for adolescents with CMP. The proposed Career Development Award addresses how to improve access to and efficacy of interdisciplinary treatments for CMP. The exceptional resources and institutional support at Children’s Hospital of Philadelphia and the University of Pennsylvania, outstanding multidisciplinary mentorship team, and proposed career development activities will allow the candidate to achieve her long-term goal of becoming an independent investigator and nationally recognized pediatric rheumatologist with expertise in pediatric chronic pain, resilience, and behavioral health interventions with the goal of improving the long-term physical and psychosocial outcomes for adolescents with CMP.

项目摘要 慢性肌肉骨骼疼痛（CMP）影响了十分之一的儿童，主要是青少年，并说明 大多数新的转介到小儿风湿病学。长期的身体和社会心理成果 CMP的青少年随着医疗保健利用和心理合并症的增加而贫穷。 此外，CMP的当前治疗方案的可访问性有限。弹性是一个动态的过程 在重大逆境的背景下，积极的适应或发展，例如与慢性过多 疼痛。促进压力管理（PRISM）中的韧性是成功的弹性训练干预措施 青少年和患有严重疾病的年轻人。该提案的初步数据证明了现代 自我感知的韧性和青少年的症状严重程度与高可行性之间的相关性 CMP青年人的棱镜交付的可接受性。定性反馈普遍积极 一致的建议将患者小组会议添加到干预措施中。与增加的患者组 干预措施的会议，我们现在旨在确定改编干预的影响（促进弹性 在与疼痛相关的临床上 在随机对照试验中的结果。拟议项目的总体目标是（1）确定 Prism-C在CMP青年人群中的效率，（2）探索干预措施的主持人以识别 年轻人最有可能从弹性教练中受益，以及（3）评估实施结果并确定 参与Prism-C的障碍和促进者。这项工作的发现将进一步我们对 在青少年CMP中重要的社会心理因素，以减少疾病并改善长期 结果。研究结果将作为R01应用程序的初步数据，以执行多中心随机 Prism-C对CMP青少年的对照试验。拟议的职业发展奖解决了如何 为了提高CMP跨学科治疗的获取和效率。特殊资源和 费城儿童医院和宾夕法尼亚大学的机构支持， 多学科的心态团队以及拟议的职业发展活动将使候选人能够 实现她成为独立研究者和全国认可的儿科的长期目标 风湿病学家具有儿科慢性疼痛，韧性和行为健康干预措施的专业知识 改善CMP青少年的长期身体和社会心理成果的目标。