Scaling-Up Integrative Pain Management in Federally Qualified Health Centers

在联邦合格的健康中心扩大综合疼痛管理

基本信息

批准号：
10667465
负责人：
Isabel Roth
金额：
$ 11.71万
依托单位：
UNIV OF NORTH CAROLINA CHAPEL HILL
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-07-20 至 2026-12-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10667465
关键词：
Academy Address Adherence Administrator Adoption Adult American American College of Physicians Analgesics Applications Grants Award COVID-19 pandemic Clinic Clinical Cluster randomized trial Communities Cost Analysis Cost Measures Data Educational workshop Effectiveness Electronic Health Record Emergency department visit Enrollment Environment Epidemic Epidemiologist Epidemiology Feasibility Studies Federally Qualified Health Center Feedback Future Geography Gills Goals Grant Guidelines Health Personnel Health Policy Health Services Accessibility Health care facility Hybrids Improve Access Integrative Medicine Intervention Interview K-Series Research Career Programs Low Income Population Low income Maintenance Maps Measures Medical Medicine Mentors Mentorship Methods Neighborhood Health Center North Carolina Opioid Overdose Pain Pain management Patient Isolation Patient Representative Patients Persons Pharmaceutical Preparations Pilot Projects Policy Maker Population Populations at Risk Preparation Provider Public Health Schools Publishing Quality of life Recommendation Research Research Personnel Research Project Grants Research Training Risk Rural Science Scientist Self Efficacy Self Management Site Structure Surveys Techniques Training Training Activity Training Programs Training and Infrastructure Visit Writing Yoga arm career career development chronic pain chronic pain management chronic pain patient chronic painful condition community based participatory research cost design effectiveness evaluation effectiveness measure effectiveness outcome effectiveness/implementation trial experience health economics hybrid type 2 trial implementation cost implementation design implementation evaluation implementation outcomes implementation research implementation science implementation strategy implementation/effectiveness improved instructor medical schools mindfulness mindfulness-based stress reduction opioid overdose opioid use overdose death pain reduction prescription opioid primary care provider primary health center programs responsible research conduct retention rate risk mitigation safety net scale up skills teacher telehealth theories treatment as usual trial design

Academy Address Adherence Administrator Adoption Adult American American College of Physicians Analgesics Applications Grants Award COVID-19 pandemic Clinic Clinical Cluster randomized trial Communities Cost Analysis Cost Measures Data Educational workshop Effectiveness Electronic Health Record Emergency department visit Enrollment Environment Epidemic Epidemiologist Epidemiology Feasibility Studies Federally Qualified Health Center Feedback Future Geography Gills Goals Grant Guidelines Health Personnel Health Policy Health Services Accessibility Health care facility Hybrids Improve Access Integrative Medicine Intervention Interview K-Series Research Career Programs Low Income Population Low income Maintenance Maps Measures Medical Medicine Mentors Mentorship Methods Neighborhood Health Center North Carolina Opioid Overdose Pain Pain management Patient Isolation Patient Representative Patients Persons Pharmaceutical Preparations Pilot Projects Policy Maker Population Populations at Risk Preparation Provider Public Health Schools Publishing Quality of life Recommendation Research Research Personnel Research Project Grants Research Training Risk Rural Science Scientist Self Efficacy Self Management Site Structure Surveys Techniques Training Training Activity Training Programs Training and Infrastructure Visit Writing Yoga arm career career development chronic pain chronic pain management chronic pain patient chronic painful condition community based participatory research cost design effectiveness evaluation effectiveness measure effectiveness outcome effectiveness/implementation trial experience health economics hybrid type 2 trial implementation cost implementation design implementation evaluation implementation outcomes implementation research implementation science implementation strategy implementation/effectiveness improved instructor medical schools mindfulness mindfulness-based stress reduction opioid overdose opioid use overdose death pain reduction prescription opioid primary care provider primary health center programs responsible research conduct retention rate risk mitigation safety net scale up skills teacher telehealth theories treatment as usual trial design

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项目摘要

PROJECT SUMMARY Background: Chronic pain impacts a fifth of American adults. Integrative pain management (IPM) interventions including mindfulness-based stress reduction, yoga, and other methods have demonstrated improvements in pain and function, and are now included in clinical guidelines for chronic pain conditions. Despite evidence of efficacy, IPM is not reaching low-income populations at greatest risk for chronic pain and related opioid overdose. Low-income communities rely on safety-net healthcare facilities to access care, of which Federally Qualified Health Centers (FQHCs) are the primary providers. The Integrative Medical Group Visit (IMGV) for chronic pain is one of a few promising IPM interventions developed specifically for safety-net settings. The challenge now is to examine effectiveness and implementation of IMGV in FQHC settings, to address chronic pain and risks associated with opioid use. Goals and Objectives: Dr. Roth’s long-term career goal is to become an independent investigator evaluating effectiveness and implementation of IPM interventions to reduce the burden of chronic pain, particularly in low-income communities. This K01 career development award will allow Dr. Roth to gain advanced skills in conducting trials that can identify successful implementation strategies for IPM interventions. Career Development Activities: The K01 application will provide structured didactic and hands-on training that will build on Dr. Roth’s training in community-based participatory research and foundational implementation science skills, through training in cluster-randomized trial designs, cost measurement and evaluation, and conducting a multi-site pilot study with FQHCs. The plan will engage Dr. Roth in robust training activities including mentorship, coursework, research projects, publishing and presenting, workshops and seminars, grant-writing, and responsible conduct of research. Mentors: Dr. Roth’s mentorship team consists of accomplished scientists from implementation science, clinical integrative health research, intervention epidemiology, health economics, and FQHCs. Environment: Dr. Roth will benefit from a comprehensive research training program and infrastructure based at the UNC School of Medicine’s Program on Integrative Medicine, the top-ranked UNC Gillings School of Public Health, and the North Carolina Translational and Clinical and Sciences Institute. The North Carolina Community Health Center Association will provide training in working with FQHCs. Research: Dr. Roth’s proposed K01 research project will address the limited access to IPM in FQHC settings serving low-income patients. Dr. Roth will first engage key stakeholders through implementation mapping to identify and refine implementation strategies (Aim 1). She will then pilot measures of effectiveness and implementation for IMGV in two FQHCs (one rural, one urban) in North Carolina (Aim 2). This award will prepare Dr. Roth to submit a future competitive grant application for a hybrid type 2 effectiveness-implementation trial of IMGV for chronic pain in FQHC settings.

项目摘要背景：慢性疼痛会影响五分之一的美国成年人。综合疼痛管理（IPM）干预措施包括基于正念的压力减轻，瑜伽和其他方法已证明疼痛和功能的改善，现在已包含在慢性疼痛状况的临床指南中。尽管有效率的证据，但IPM仍未达到低收入人群，慢性疼痛和最大风险相关的阿片类药物过量。低收入社区依靠安全网医疗机构来获得护理哪个联邦资格卫生中心（FQHC）是主要提供者。综合医疗小组请参观（IMGV）慢性疼痛是专门为安全网制定的少数承诺的IPM干预措施之一设置。现在面临的挑战是检查IMGV在FQHC设置中的有效性和实施解决与阿片类药物使用相关的慢性疼痛和风险。目标和目标：罗斯博士的长期职业目标是成为评估IPM有效性和实施的独立调查员减少慢性疼痛燃烧的干预措施，尤其是在低收入社区中。这个K01职业开发奖将使罗斯博士能够在进行试验中获得高级技能，以确定成功 IPM干预措施的实施策略。职业发展活动：K01申请将提供结构化的教学和动手培训，以罗斯博士在社区的培训为基础参与研究和基础实施科学技能，通过群集随机培训试验设计，成本衡量和评估，并通过FQHC进行多站点的初步研究。计划将与Roth博士一起参加强大的培训活动，包括指导，课程工作，研究项目，出版和展示，讲习班和半身，赠款写作以及负责任的研究行为。导师：罗斯博士的心态团队由实施科学的有成就的科学家组成综合健康研究，干预流行病学，健康经济学和FQHC。环境：罗斯博士将受益于基于UNC学校的全面研究培训计划和基础设施医学方面的综合医学计划，排名最高的UNC Gillings公共卫生学院以及北卡罗来纳州译本，临床与科学研究所。北卡罗来纳州社区卫生中心协会将提供与FQHC合作的培训。研究：罗斯博士提议的K01研究项目将在为低收入患者的FQHC设置中解决有限的IPM访问权限。罗斯博士将首先参与主要利益相关者通过实施映射来识别和完善实施策略（AIM 1）。然后，她将在两个FQHC中进行IMGV的有效性和实施的衡量标准（一个粗糙，一个北卡罗来纳州的Urban）（AIM 2）。该奖项将使罗斯博士准备提交未来的竞争赠款 IMGV对FQHC设置中的慢性疼痛的混合2型有效性试验的应用。