Using Secondary Analyses to Test Novel Pathways Linking Family Stress and Pain Incidence and Persistence Among African Americans

使用二次分析来测试将家庭压力与非裔美国人疼痛发生率和持续时间联系起来的新途径

• 批准号: 10598724
• 负责人: Sarah B. Woods
• 金额: $ 46.19万
• 依托单位: UT SOUTHWESTERN MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-30 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10598724
• 关键词: Adult; African American; African American population; Aging; Anxiety; Caring; Censuses; Chronic stress; Climate; Data; Data Set; Development; Diagnosis; Disadvantaged; Discrimination; Effectiveness of Interventions; Emotional; Epidemiology; Family; Family Characteristics; Family Relationship; Fibrinogen; Goals; Health; Health and Retirement Study; Incidence; Inflammation; Intervention; Kinship Networks; Knowledge; Link; Measures; Mediating; Mediation; Mental Depression; Modeling; Outcome; Pain; Pain Research; Pain interference; Pain management; Participant; Pathogenesis; Pathway interactions; Patient Care; Phase; Physicians; Population; Positioning Attribute; Precision Health; Primary Health Care; Psychosocial Factor; Quality of life; Reporting; Research; Risk; Risk Factors; Role; Sampling; Severities; Source; Specific qualifier value; Stress; Stress Tests; Testing; Time; Translations; United States; Variant; Work; anxiety symptoms; base; biobehavior; biopsychosocial; chronic pain; commune; depressive symptoms; disability; experience; family support; healing; improved; innovation; middle age; modifiable risk; neighborhood disadvantage; novel; pain outcome; pain self-management; pain-related disability; peer; pre-clinical; psychosocial; public health relevance; racism; resilience; secondary analysis; socioeconomic disparity; stress reactivity

PROJECT SUMMARY/ABSTRACT DESCRIPTION: Chronic pain is a persistent source of disability and reduced quality of life for aging adults – outcomes that are disproportionately worse for aging African Americans, who report greater pain severity and worse pain-related disability compared to White peers. Among risk factors for pain, chronic stress is an especially potent pain precipitant, an effect made far worse for African Americans due to structural inequities. The same is true for family stress, which is exacerbated by these same inequities, yet it is infrequently examined as part of the stress-pain pathway. Family support is also ignored in pain research, despite the unique importance of family for African Americans, who identify family support as critical for pain self- management. Pain research must understand how family stress and support convey risk or resilience for chronic pain, as well as how family-pain pathways are influenced by structural inequities, in order to support the development of innovative pain management interventions. We propose to analyze existing data from African American participants in two well-established, representative projects on aging health, Midlife in the U.S. (MIDUS; N = 721) and the Health and Retirement Study (HRS; N = 2,698), to study how pain conditions develop and persist for aging African Americans. The 10-year waves of MIDUS provide the advantage of specific pain interference measures and physician-provided pain diagnoses; the biennial waves of HRS (2006- 2020) support testing temporal mediation and examining the timing of pain trajectories. We aim to (a) identify the specific characteristics of family emotional climate (i.e., support and stress in both marital and non-marital family relationships) that operate as risk or resilience factors for pain outcomes (i.e., pain development, persistence, interference, and severity), and (b) determine how family emotional climate influences pain pathogenesis via biobehavioral reactivity pathways (i.e., depression and anxiety symptoms, and inflammation). We propose a multidimensional conceptualization of structural inequity to explore the moderating effects of discrimination, socioeconomic disparity, and neighborhood disadvantage using Census tract-level data. The unique role of family stress and support for African Americans – an understudied population with a unique and important emphasis on family, kinship networks, and communal healing – is unknown. Our research will close this gap to establish how structural factors underlying pain disparities potentiate family-biobehavioral reactivity pain mechanisms. Findings can inform precision health and the identification of unique chronic pain signatures that account for both bio- and psychosocial factors. Our work will lay the groundwork for immediate translation to culturally-responsive family-based pain self-management interventions for aging African Americans.

项目摘要/摘要 描述：慢性疼痛是衰老成年人的残疾和生活质量降低的持续来源 - 对于衰老的非洲裔美国人来说，结果不成比例差，他们报告了更大的疼痛严重程度和 与白人同龄人相比，与疼痛有关的残疾较差。在疼痛的危险因素中，慢性压力是 尤其是潜在的疼痛抑制剂，由于结构性不平等而对非洲裔美国人的效果差得多。 家庭压力也是如此，这种压力受到这些相同的不平等的加剧，但很少 被检查为应力训练途径的一部分。在疼痛研究中也忽略了家庭支持，dospite 家庭对非洲裔美国人的独特重要性，他们认为家庭支持对痛苦自我至关重要 管理。疼痛研究必须了解家庭压力和支持如何传达风险或韧性 为了支持 创新疼痛管理干预措施的发展。我们建议从 非裔美国人参加了两个成熟的，有关衰老健康的代表项目，中年的参与者 美国（Midus; n = 721）和健康与退休研究（HRS; n = 2,698），以研究疼痛状况如何 发展并坚持衰老的非洲裔美国人。 Midus的10年浪潮提供了优势 特定的疼痛干扰措施和身体提供的疼痛诊断； HRS的两年一次波（2006-- 2020）支持测试临时调解并检查疼痛轨迹的时间。我们的目标是（a）确定 家庭情感气氛的特定特征（即婚姻和非婚姻中的支持和压力 家庭关系）作为疼痛结果的风险或韧性因素（即疼痛发展， 持久性，干扰和严重性）和（b）确定家庭情感氛围如何影响痛苦 通过生物行为反应途径（即抑郁和动画）通过发病机理。 我们提出了结构性不平等的多维概念化，以探讨 使用人口普查级数据的歧视，社会经济差异和邻里劣势。这 家庭压力和对非洲裔美国人的支持的独特作用 - 一个独特和独特的人口 对家庭，亲属网络和公共康复的重要强调是未知的。我们的研究将关闭 这一差距确定疼痛分布的结构因素如何潜在的家族狂热反应性潜在 疼痛机制。调查结果可以为精确的健康和识别独特的慢性疼痛特征提供信息 这是生物和社会心理因素的解释。我们的工作将为立即翻译奠定基础 对衰老的非洲裔美国人的基于文化响应的家庭疼痛自我管理干预措施。