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；

基本信息

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
项目类别：
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

项目摘要

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概要该 K23 提案详细介绍了一项为期 5 年的综合培训计划，该计划将支持候选人过渡到成为一名独立调查员（Tony V Pham 博士），第一代大学生，在医学恐慌中代表性不足，将把他的职业生涯集中在开发和严格测试身心上为患有慢性疾病的服务不足的人群提供更好的机会和相关性的干预措施。候选人提议通过文化方式解决老年黑人社区的慢性疼痛与抑郁共病问题适应基于正念的认知疗法（MBCT）在老年黑人中，慢性疼痛与抑郁症同时发生，这种共病使身体和情感功能恶化；然而，黑人在循证方面面临多重障碍；非药物疼痛和抑郁症管理，包括系统性种族主义、耻辱和文化上的缺乏量身定制的护理可能是改善身体和情感的有效且高效的解决方案。 K23 将开发 Quiet Focus，这是针对 MBCT 的文化改编。我与患有慢性肌肉骨骼疼痛和并发抑郁症的老年黑人的初步对话。社区表现出对 Quiet Focus 的浓厚兴趣、对 MBCT 与社区相关性的支持以及对仅当干预是简短的并且由来自黑人社区的非专业讲师进行时才参与。 1，我将利用患有慢性疼痛和并发疼痛的老年黑人社区的指导来开发安静焦点 Quiet Focus 的起点将是一个简短的、基于证据的 MBCT 方案（8 60 分钟）。由联合导师 Shallcross 开发的课程）我将在联合导师 Joo 和的指导下培训非专业讲师。在主要导师 Vranceanu 和联合导师 Shallcross 的指导下，我将制定一份忠诚协议。训练一名黑人外行人员进行安静专注并评估初步可行性和保真度在目标 3 中，我将训练一名黑人。新的布莱克外行人员提供安静焦点，另一个人提供时间和剂量匹配的控制，然后我将。对 Quiet Focus 进行可行性随机对照试验，并控制和评估包括保真度在内的明确可行性基准。这些拟议的努力将通过 R01 机制为功效试验提供信息（主要结果是身体功能）：以及旨在将这项工作推广到其他代表性不足群体的未来研究。这些研究目标得到了支持。旨在发展以下方面专业知识的 3 个主要培训目标：(1) 社区参与干预发展，(2) 混合干预细化的方法研究，以及（3）社区参与的临床试验这些培训目标是。由 (1) 专家导师团队（Vranceanu、Jackson、Joo 和 Shallcross）、顾问（Mischoulon、Parker、 Okereke）和社区咨询委员会（Jacqueline Hinton、Michael Kincade），(2) 丰富的制度环境， (3) 有针对性的材料和会议在过去的一年里，我通过正式的方式为这个提案建立了基础设施。与黑人社区领袖和患有慢性疼痛和并发疼痛的老年黑人团体举行非正式会议这项 K23 提案符合 NCCIH 的资助重点，以推进互补性和综合性。健康可以改善疼痛结果，解决整个人的问题，并增加研究人员的多样性。