Using Technology to Deliver Evidence-Based Interventions for Pain to Patients with Sickle Cell Disease

利用技术为镰状细胞病患者提供循证疼痛干预措施

基本信息

批准号：
9224339
负责人：
Charles Richard Jonassaint
金额：
$ 16.52万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-02-01 至 2020-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9224339
关键词：
Acute Pain Address Adolescent Adult Adverse effects Affect African African American Anxiety Applications Grants Award Behavior Behavior Therapy Car Phone Caring Cellular Phone Cessation of life Child Chronic Clinical Clinical Oncology Supplement (K12)Clinical Trials Cognitive Therapy Conduct Clinical Trials Coping Skills Custom Data Development Distress Drug Addiction E-learning Education Effectiveness Effectiveness of Interventions Evidence based intervention Exercise Family member Feedback Foundations Future Generic Drugs Goals Gold Health Individual Institution Intervention Intervention Trial Leadership Learning Learning Module Low income Medical Mental Depression Mental Health Mentored Patient-Oriented Research Career Development Award Mentors Methodology Minority Moods Multimedia Opioid Outcome Pain Pain management Patient Recruitments Patients Pharmaceutical Preparations Population Pragmatic clinical trial Provider Psychologist Qualitative Methods Qualitative Research Quality of life Randomized Recruitment Activity Recurrence Research Research Methodology Research Personnel SECTM1 gene Sickle Cell Sickle Cell Anemia Technology Testing Time Training Training Support Translating Underserved Population Work base behavioral health career career development chronic pain cognitive testing community organizations computerized coping cost design disability effective therapy efficacy testing ethnic minority population evidence base experience follow-up health care service utilization health disparity implementation science improved literacy medical attention mobile application negative affect pain symptom patient advocacy group patient oriented patient population payment physical conditioning premature primary outcome programs psychologic racial minority skills success therapy design user centered design

项目摘要

PROJECT ABSTRACT The overarching goal of this candidate's program of research is to improve behavioral and physical health and reduce health disparities by using multimedia technology to deliver evidence-based interventions to underserved populations. The focus is sickle cell disease (SCD), a condition that disproportionately affects those of African descent. Many people living with SCD suffer from daily chronic pain as well as recurrent acute pain episodes that require medical attention. Opioid medication is the primary treatment for pain in SCD, despite its limited effectiveness and negative side-effects. The proposed K23 attempts to address the need for an alternative, non-pharmacological pain treatment in SCD. Computerized cognitive behavioral therapy (cCBT) has been found effective for reducing chronic pain and may be a low cost, easily accessible and scalable pain treatment in SCD. The candidate's K12 project tested a cCBT program for anxiety and depression; preliminary results suggest that patients liked using the program, but found that much of its content did not relate to their lives. To address this limitation, the proposed K23 project will adapt an existing cCBT program for pain management to create ReThink Pain SCD, a culturally-tailored, mobile-phone delivered behavioral intervention designed specifically to help African American patients self-manage chronic sickle cell pain. Aim 1: Modify and tailor the generic cCBT pain program, using qualitative research methods to understand the needs and barriers to pain management in patients with SCD, as well as the opportunities to engage this population using multimedia. These data will inform the development of the features and content of ReThink Pain SCD. Aim 2: Conduct a pilot pragmatic clinical trial to test the feasibility and acceptability of implementing this pain intervention into routine SCD care. Forty patients with SCD will be randomized to either receive 8 sessions of the cCBT program or 8 online education modules on a smartphone. Primary outcomes of the trial include feasibility (recruitment, retention, provider and patient feedback) and acceptability (sessions completed) of the ReThink Pain SCD program. In order to achieve the goals of this research plan and transition to independence, the candidate requires further training in user-centered design, implementation science, design and conduct of pragmatic clinical trials, and team management and leadership. This proposal includes an exceptional team of mentors and consultants. Primary mentor Dr. Bruce Rollman is founding Director of the Center for Behavioral Health and Smart Technology. Co-mentor Dr. Robert Noll is a clinical psychologist with expertise in behavioral intervention trials. Co-mentor Dr. Laura De Castro is a nationally recognized trialist and expert in sickle cell disease. This training and research plan will form the basis for a future multicenter clinical trial testing the efficacy of ReThink Pain SCD for improving pain outcomes among adults with SCD, to be proposed in an R01 grant application before the end of the K23 award.

项目摘要该候选人研究计划的总体目标是改善行为和身体健康，通过使用多媒体技术提供基于证据的干预措施来减少健康差距服务不足的人群。重点是镰状细胞病（SCD），这种疾病对那些非洲人后裔。许多患有 SCD 的人每天都遭受慢性疼痛以及反复发作的急性疼痛需要医疗护理的疼痛发作。阿片类药物是 SCD 疼痛的主要治疗方法，尽管其有效性有限且有负面副作用。拟议的 K23 试图满足以下需求： SCD 的另一种非药物疼痛治疗方法。计算机化认知行为疗法（cCBT）已被发现可有效减轻慢性疼痛，并且可能是一种低成本、易于获得和可扩展的疼痛 SCD 的治疗。候选人的 K12 项目测试了针对焦虑和抑郁的 cCBT 项目；初步的结果表明，患者喜欢使用该程序，但发现其大部分内容与他们的情况无关生活。为了解决这一限制，拟议的 K23 项目将采用现有的 cCBT 计划来应对疼痛管理层创建 ReThink Pain SCD，这是一种根据文化量身定制的手机提供的行为干预措施专为帮助非裔美国患者自我管理慢性镰状细胞疼痛而设计。目标 1：修改并定制通用 cCBT 疼痛计划，使用定性研究方法来了解需求和障碍 SCD 患者的疼痛管理，以及让该人群参与的机会多媒体。这些数据将为 ReThink Pain SCD 的功能和内容的开发提供信息。目标 2：进行试点务实临床试验，测试实施这一痛点的可行性和可接受性干预常规 SCD 护理。 40 名 SCD 患者将被随机分配接受 8 次治疗 cCBT 程序或智能手机上的 8 个在线教育模块。试验的主要结果包括可行性（招募、保留、提供者和患者反馈）和可接受性（已完成的会议） ReThink Pain SCD 计划。为了实现本研究计划的目标并过渡到独立，候选人需要以用户为中心的设计、实施科学、实用临床设计和实施的进一步培训试验、团队管理和领导力。该提案包括一支出色的导师团队和顾问。主要导师 Bruce Rollman 博士是行为健康中心的创始主任智能技术。共同导师 Robert Noll 博士是一位具有行为干预专业知识的临床心理学家试验。共同导师 Laura De Castro 博士是全国公认的镰状细胞病试验专家和专家。这培训和研究计划将为未来测试 ReThink 功效的多中心临床试验奠定基础疼痛 SCD 用于改善 SCD 成人的疼痛结果，将在 R01 拨款申请中提出 K23颁奖结束前。