Evidence-Based Pain Intervention for Veterans: Leveraging Mobile & Social Media

针对退伍军人的循证疼痛干预：利用移动设备

• 批准号: 10098697
• 负责人: SARA S JOHNSON
• 金额: $ 9.8万
• 依托单位: PRO-CHANGE BEHAVIOR SYSTEMS, INC.
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-08-01 至 2022-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10098697
• 关键词: Address; Adopted; Adult; Advocate; Affect; American; Americas; Car Phone; Caring; Chronic; Cognitive Therapy; Communities; Computers; Coping Skills; Data; Death Rate; Decision Making; Development; Diabetes Mellitus; Disease; Economics; Educational Curriculum; Effectiveness; Elements; Feedback; Freedom; Frequencies; Funding; Goals; Health; Health behavior change; Healthcare; Healthcare Systems; Heart Diseases; Individual; Individual Differences; Institutes; Internet; Intervention; Life; Malignant Neoplasms; Maps; Mental Health; Modeling; Motivation; Musculoskeletal Diseases; Notification; Online Systems; Outcome; Pain; Pain intensity; Pain interference; Pain management; Participant; Patients; Personal Satisfaction; Phase; Play; Population; Post-Traumatic Stress Disorders; Prevalence; Primary Health Care; Problem Solving; Public Health; Randomized; Readiness; Recommendation; Reporting; Research; Resources; Role; Science; Self Management; Severities; Sleep Disorders; Small Business Innovation Research Grant; Social Network; Societies; Soldier; Subgroup; Subway; Suggestion; Symptoms; Syndrome; Tablet Computer; Testing; Text Messaging; Therapeutic Intervention; Traumatic Brain Injury; Underserved Population; Veterans; Vulnerable Populations; base; behavior change; chronic musculoskeletal pain; chronic pain; common treatment; community setting; comorbidity; coping; cost; cost effective; disparity reduction; evidence base; experience; follow-up; handheld mobile device; health administration; healthcare community; impression; improved; improved functioning; innovation; neglect; non-drug; operation; opioid epidemic; opioid overdose; pain reduction; pain relief; pain self-management; patient oriented; post intervention; preference; programs; prototype; randomized trial; recruit; secondary analysis; secondary outcome; self-management program; skills; sleep behavior; sleep health; social media; social networking website; stress management; usability

Chronic musculoskeletal pain creates a significant public health burden, and Veterans are disproportionately affected. The frequency and extent of co-occurrence of pain and PTSD, pain and Traumatic Brain Injury (TBI), all three conditions (Post-deployment Multi-symptom Disorder (PMD), and other multi-symptom syndromes can complicate and reduce the effectiveness of pain treatment. Furthermore, the majority of Veterans do not seek care in VA settings, requiring an approach that will be available to all Veterans. The Blueprint for Relieving Pain in America and National Pain Strategy call for the promotion of self-management; reducing disparities among vulnerable subgroups (e.g., Veterans); and the tailoring of pain care. Proponents of integrated treatment for common co-morbid conditions are advocating for interventions that address multiple conditions. This Phase II proposal builds on a successful NACTS-funded Phase I SBIR that developed and pilot tested a theoretically-grounded, mobile- optimized, interactive pain self-management intervention for Veterans with chronic musculoskeletal pain. Health eRide: Your Journey to Managing Pain 1) was tailored specifically to Veterans' readiness and preferred strategies for pain self-management; 2) leveraged SMS messaging, social networking, and gaming principles to increase engagement and retention; and 3) helped to address the co-occurrence of PTSD and TBI by including health behavior change messages for sleep hygiene and stress management. At 30-day follow-up, participants (n=44) reported significant reductions in pain and pain impact, as well as increased readiness to employ self-management strategies. Over 68% of participants reported favorable global impression of change. Phase II will involve 1) completing the development of Health eRide by transforming it into an app and enhancing its functionality for mobile browsers, enhancing the social networking and gaming features, and adding e-coaching capabilities; and 2) conducting a year- long randomized trial in which 540 Veterans with chronic pain recruited from both VA facilities and the community are randomly assigned to Health eRide or an online educational cognitive- behavioral therapy intervention. Differences in pain intensity and interference will be examined at 6 months (immediately post-intervention) and 12-months. A number of secondary analyses will be conducted to examine the impact Health eRide has on other outcomes (e.g., PTSD symptoms). A successful trial will set the stage for widespread dissemination of an efficacious, easily accessible tailored pain self-management intervention to address an urgent need among our nation's Veterans as well as an adaptation for general adult populations.

慢性肌肉骨骼疼痛造成了巨大的公共卫生负担，退伍军人是 受到不成比例的影响。疼痛和PTSD的同时出现的频率和程度，疼痛 和创伤性脑损伤（TBI），所有三个条件 疾病（PMD）和其他多肌综合症会使并减少复杂 疼痛治疗的有效性。此外，大多数退伍军人不寻求弗吉尼亚州的照顾 设置，需要所有退伍军人都可以使用的方法。缓解的蓝图 美国的痛苦和国家疼痛战略要求促进自我管理；减少 弱势子组之间的差异（例如退伍军人）；和疼痛护理的剪裁。 对常见合并状况的综合治疗的支持者提倡 解决多种条件的干预措施。该第二阶段提案以成功的 NACTS资助的I期SBIR开发和飞行员测试了理论上的移动 对患有慢性的退伍军人的优化，交互式疼痛自我管理干预 肌肉骨骼疼痛。 Health Ridide：您管理疼痛的旅程1）专门量身定制 向退伍军人的准备和痛苦自我管理的首选策略； 2）杠杆短信 消息传递，社交网络和游戏原则，以增加参与和保留；和 3）通过包括健康行为改变，帮助解决了PTSD和TBI的共发生 睡眠卫生和压力管理的消息。在30天的随访中，参与者（n = 44） 据报道，疼痛和疼痛影响大大减轻，并增加了使用的准备就绪 自我管理策略。超过68％的参与者报告了有利的全球印象 改变。第二阶段将涉及1）通过改变健康的发展，完成健康的发展 进入应用程序并增强其在移动浏览器中的功能，增强社交 网络和游戏功能，并添加电子教练功能； 2）进行一年 长期的随机试验，其中540名从两个VA设施招募了慢性疼痛的退伍军人 社区被随机分配到卫生急诊室或在线教育认知 - 行为疗法干预。将检查疼痛强度和干扰的差异 6个月（立即干预后）和12个月。许多次要分析 将进行研究急诊对其他结果的影响（例如PTSD） 症状）。成功的审判将为广泛传播有效的， 易于访问的量身定制的疼痛自我管理干预措施，以满足迫切需求 我们国家的退伍军人以及对一般成人人口的适应。