Mindfulness-Based Cognitive Therapy for the chronic pain-depression co-morbidity among older Blacks in the community; The Quiet Focus study

针对社区老年黑人慢性疼痛抑郁共病的正念认知疗法；

• 批准号: 10644590
• 负责人: Tony V Pham
• 金额: $ 16.96万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-06 至 2028-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10644590
• 关键词: Abbreviations; Address; Adult; Aging; Award; Benchmarking; Biometry; Black Populations; Black race; Boston; Bypass; Capital; Caring; Characteristics; Chronic Disease; Clinical Trials; Communities; Complementary Health; Data; Dose; Educational workshop; Elderly; Elements; Emotional; Environment; Face; First Generation College Students; Focus Groups; Funding; Future; Goals; Health; Hour; Individual; Infrastructure; Institution; Institutional Racism; Integrative Medicine; Intervention; Interview; Link; Manuals; Medicine; Meditation; Mental Depression; Mental Health; Mentors; Mentorship; Methods; Mind-Body Intervention; Modeling; National Center for Complementary and Integrative Health; Outcome; Pain; Pain management; Persons; Physical Function; Prayers; Preparation; Procedures; Protocols documentation; Psychiatrist; Refugees; Research; Research Methodology; Research Personnel; Research Project Grants; Services; Son; Teacher Professional Development; Testing; Time; Training; Training Programs; Travel; Underrepresented Populations; Underserved Population; Vietnamese; Work; acceptability and feasibility; career; chronic depression; chronic musculoskeletal pain; chronic pain; chronic pain management; clinical practice; community engaged research; community engagement; comorbid depression; comorbidity; cost; efficacy evaluation; efficacy trial; emotional functioning; evidence base; experience; improved; instructor; interest; intervention refinement; meetings; mindfulness based cognitive therapy; pain outcome; people of color; preference; primary outcome; programs; public health priorities; recruit; research and development; social determinants; social stigma; therapy development; underserved community; volunteer; Abbreviations; Address; Adult; Aging; Award; Benchmarking; Biometry; Black Populations; Black race; Boston; Bypass; Capital; Caring; Characteristics; Chronic Disease; Clinical Trials; Communities; Complementary Health; Data; Dose; Educational workshop; Elderly; Elements; Emotional; Environment; Face; First Generation College Students; Focus Groups; Funding; Future; Goals; Health; Hour; Individual; Infrastructure; Institution; Institutional Racism; Integrative Medicine; Intervention; Interview; Link; Manuals; Medicine; Meditation; Mental Depression; Mental Health; Mentors; Mentorship; Methods; Mind-Body Intervention; Modeling; National Center for Complementary and Integrative Health; Outcome; Pain; Pain management; Persons; Physical Function; Prayers; Preparation; Procedures; Protocols documentation; Psychiatrist; Refugees; Research; Research Methodology; Research Personnel; Research Project Grants; Services; Son; Teacher Professional Development; Testing; Time; Training; Training Programs; Travel; Underrepresented Populations; Underserved Population; Vietnamese; Work; acceptability and feasibility; career; chronic depression; chronic musculoskeletal pain; chronic pain; chronic pain management; clinical practice; community engaged research; community engagement; comorbid depression; comorbidity; cost; efficacy evaluation; efficacy trial; emotional functioning; evidence base; experience; improved; instructor; interest; intervention refinement; meetings; mindfulness based cognitive therapy; pain outcome; people of color; preference; primary outcome; programs; public health priorities; recruit; research and development; social determinants; social stigma; therapy development; underserved community; volunteer

Research & Related Other Project Information Project Summary This K23 proposal details a comprehensive 5-year training program that will support the candidate’s transition towards becoming an independent investigator. The candidate (Dr. Tony V Pham), a first generation college student, underrepresented in medicine psychiatrist, will focus his career on developing and rigorously testing mind-body interventions with better access and relevance to underserved populations with chronic illnesses. In this application, the candidate proposes to address the chronic pain-depression co-morbidity in the older Black community by culturally adapting Mindfulness-Based Cognitive Therapy (MBCT). Among older Blacks, chronic pain co-occurs with depression, and this co-morbidity worsens physical and emotional function; however, Blacks face multiple barriers to evidence-based non-pharmacological pain and depression management including systemic racism, stigma, and the lack of culturally tailored care. A culturally tailored MBCT may be an effective and efficient solution to improve physical and emotional outcomes among this underserved population. This K23 will develop Quiet Focus, a cultural adaptation of MBCT for older Blacks with chronic musculoskeletal pain and co-occurring depression. My preliminary conversations with the community revealed strong interest in Quiet Focus, support for MBCT’s relevance to the community, and interest in participation only if the intervention is abbreviated and is delivered by a lay instructor from the Black community. In Aim 1, I will develop Quiet Focus using guidance from the older Black community with chronic pain and co-occurring depression. The starting point for Quiet Focus will be an abbreviated, evidence-based MBCT protocol (8 60-minute sessions) developed by co-mentor Shallcross. I will train lay instructors under the mentorship of co-mentor Joo and develop a fidelity protocol under the mentorship of primary mentor Vranceanu and co-mentor Shallcross. In Aim 2, I will train a Black lay individual to deliver Quiet Focus and assess preliminary feasibility and fidelity. In Aim 3, I will train a new Black lay individual to deliver Quiet Focus and another to deliver a time- and dose-matched control. I will then conduct a feasibility RCT of Quiet Focus and control and assess definitive feasibility benchmarks including fidelity. These proposed efforts will inform an efficacy trial through the R01 mechanism (primary outcome is physical function) as well as future studies aimed at generalizing this work to other underrepresented groups. These study aims are supported by 3 main training goals aimed at developing expertise in: (1) community engaged intervention development, (2) mixed methods research for intervention refinement, and (3) community-engaged clinical trials. These training goals are supported by (1) a team of expert mentors (Vranceanu, Jackson, Joo, and Shallcross), advisors (Mischoulon, Parker, Okereke), and a community advisory board (Jacqueline Hinton, Michael Kincade), (2) a rich institutional environment, and (3) targeted materials and meetings. For the past year, I have built the infrastructure for this proposal through formal and informal meetings with Black community leaders and groups of older Blacks with chronic pain and co-occurring depression. This K23 proposal is in line with NCCIH’s funding priorities to advance how Complementary and Integrative Health can improve pain outcomes, address the whole person, and increase diversity within the research workforce.

研究及相关其他项目信息 项目摘要 该K23提案详细介绍了一项全面的5年培训计划，该计划将支持候选人向候选人的过渡 成为独立研究者。候选人（Tony V博士Pham博士），第一代大学生， 在医学精神病医生中的代表性不足，他的职业将重点放在发展和严格测试身心的职业上 与服务不足的人群患有慢性疾病的人群具有更好的访问和相关性的干预措施。在此应用程序中 候选提议通过文化来解决较老的黑人社区的慢性痛苦抑郁症 调整基于正念的认知疗法（MBCT）。在年长的黑人中，慢性疼痛与抑郁症共生， 这种合并症会使身体和情感功能恶化。但是，黑人面临循证基于证据的多个障碍 非药理疼痛和抑郁管理，包括全身种族主义，污名和文化缺乏 量身定制的护理。根据文化量身定制的MBCT可能是改善身体和情感的有效解决方案 这项服务不足的人群的结果。这个K23将发展安静的焦点，这是MBCT的文化适应 慢性肌肉骨骼疼痛和同时出现的抑郁症的年长黑人。我与 社区揭示了对安静的关注，对MBCT与社区相关的支持以及对 仅当干预措施缩写并由黑人社区的外行讲师提供时才参与。目标 1，我将使用慢性疼痛和同时发生的旧黑人社区的指导来培养安静的重点 沮丧。安静重点的起点将是缩写的基于证据的MBCT协议（8 60分钟 会议）由Co-Mentor Shallcross开发。我将在Co-Encomentor Joo的指导下培训外行讲师和 在原发性精神弗朗切努和同事shallcross的心态下制定忠实协议。在AIM 2中，我会 训练黑色外行人，以提供安静的重点和评估初步的可行性和忠诚。在AIM 3中，我将训练A 新的黑色外行个人可以提供安静的焦点，另一个可以提供时间和剂量匹配的控制。然后我会 进行安静的重点，控制和评估的可行性RCT，确定性可行性基准，包括保真度。 这些拟议的努力将通过R01机制（主要结果是身体功能）为效率试验提供的，因为 以及未来的研究旨在将这项工作推广到其他代表性不足的群体。这些研究目标得到支持 通过3个主要培训目标，旨在发展专业知识：（1）社区参与干预开发，（2）混合 方法研究的方法研究，以及（3）社区参与的临床试验。这些培训目标是 由（1）由专家导师团队（Vranceanu，Jackson，Joo和Shallcross）组成的，顾问（Mischoulon，Parker， Okereke）和社区顾问委员会（Jacqueline Hinton，Michael Kincade），（2）一个丰富的机构环境， （3）有针对性的材料和会议。在过去的一年中，我通过正式建立了该提案的基础设施 与黑人社区领导人和慢性疼痛和同时发生的老年黑人团体的非正式会议 沮丧。该K23提案符合NCCIH的资金优先级，以提高互补和综合性的方式 健康可以改善疼痛结果，解决整个人，并增加研究人员的多样性。