Investigating Movement-evoked Pain in osteoArthritic Conditions (IMPACT): An Observational Study to Inform Culturally-Tailored Intervention Development

调查骨关节炎疾病中运动诱发的疼痛 (IMPACT)：一项观察性研究，为文化定制干预措施的开发提供信息

• 批准号: 10092109
• 负责人: Staja Booker
• 金额: $ 12.64万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-02-01 至 2023-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10092109
• 关键词: Accelerometer; Achievement; Activities of Daily Living; Address; African American; Aging; Arthralgia; Arthritis; Articular Range of Motion; Attenuated; Automobile Driving; Behavior; Behavioral; Behavioral Mechanisms; Behavioral Research; Biology; Brain; Chronic; Clinical Trials; Communities; Connecticut; Decision Making; Degenerative polyarthritis; Development; Discipline of Nursing; Ecological momentary assessment; Economics; Education; Elderly; Environment; Epidemiology; Evidence based intervention; Exercise; Exhibits; Experimental Designs; Florida; Foundations; Fright; Gait; Goals; High Chair; Home; Impairment; Incubators; Intervention; Investigation; Joints; Knee Osteoarthritis; Knowledge; Laboratories; Measures; Mentored Patient-Oriented Research Career Development Award; Mentorship; Methods; Minority Groups; Motion; Motivation; Movement; Musculoskeletal Diseases; Musculoskeletal Pain; Not Hispanic or Latino; Observational Study; Older Population; Outcome; Pain; Pain Measurement; Pain Research; Patient Self-Report; Pattern; Performance; Phase; Phenotype; Physical Function; Physical Performance; Physical activity; Preventive; Psychology; Quality of life; Questionnaires; Race; Rehabilitation therapy; Reporting; Research; Research Activity; Research Personnel; Rest; Risk Factors; Sampling; Science; Self Management; Senior Scientist; Sensory; Source; Spirituality; Standardization; Subgroup; Testing; Therapeutic Intervention; Training; Training Activity; Translational Research; Universities; Walking; Work; base; biopsychosocial; career; chronic pain; community engagement; design; disability; effectiveness testing; ethnic difference; experience; feasibility testing; functional disability; functional outcomes; health disparity; health literacy; healthy aging; inter-individual variation; knee pain; knowledge base; mHealth; middle age; osteoarthritis pain; pain relief; pain self-management; premature; programs; protective factors; psychologic; racial minority; reduced muscle strength; skills; social; therapy development

Knee osteoarthritis (OA) is one the most problematic sources of persistent musculoskeletal pain, impaired function and mobility, and reduced quality of life in older adults. Although these are common outcomes associated with OA, they are disproportionately worse in older African Americans. These threats to healthy aging demand further investigation into the most significant driver of OA pain and disability, which is movement. The experience of pain due to movement, known as movement-evoked pain (MEP), often prohibits full participation in daily living activities and self-management actions such as physical activity/exercise. MEP is consequently a substantial contributor to high-impact chronic pain and disability in people with OA; yet, our understanding of the mechanisms contributing to MEP and its management in older African Americans is severely limited. Therefore, the overall goals for this two-phased Mentored Patient-Oriented Research Career Development Award (K23) is to fill this knowledge gap by (1) characterizing the biopsychosocial-behavioral mechanisms of MEP and function and (2) develop a mechanism-based self-management intervention (Pain Relief for OsteoArthritis using Culturally-Tailored InterVentions for Black Elders [PROACTIVE]). This intervention will address the most pivotal and culturally-relevant predictors of MEP and impaired function in older African Americans. Our methods represent a new and substantive departure from current static pain assessments in chronic musculoskeletal disorders by measuring pain with movement. This K23 proposes training and research activities that will launch a program of research which advances the science of pain and disability in African American older adults. To this end, I have assembled an interdisciplinary team of senior scientists representing nursing, psychology/pain science, aging, and epidemiology/community engagement who will provide mentorship to help me achieve proposed training goals and facilitate my transition to an independent research career. Primary training goals essential to my research program include: (1) advance understanding of biopsychosocial and behavioral- environmental mechanisms of OA pain, (2) develop a comprehensive knowledge base in the application of community-engaged participatory research within experimental designs, and (3) enhance translational research skills to function as an independent investigator capable of conducting rigorous clinical trials testing the effectiveness of non-pharmacological, behavioral chronic pain self-management interventions within a cultured community (e.g., southern African Americans). Phase 2 of the K23 will apply community-based participatory mixed-methods to collaboratively create the PROACTIVE intervention. The University of Florida and University of Connecticut are strong incubators for pain research and provide ideal environments to extend the PI’s prior work and forge a path towards understanding multiple biopsychosocial and behavioral mechanisms uniquely involved in the intra-ethnic experience of chronic pain, which are key to the discovery of better therapeutic interventions and self-management behaviors.

膝骨关节炎 (OA) 是持续性肌肉骨骼疼痛、功能障碍的最成问题的根源之一 功能和活动能力下降，以及老年人的生活质量下降，尽管这些都是常见的结果。 与 OA 相关的老年非裔美国人的健康状况尤其严重。 需要进一步调查 OA 疼痛和残疾的最重要驱动因素，即运动。 由于运动而产生的疼痛体验，称为运动诱发疼痛 (MEP)，通常会阻碍充分参与 因此，MEP 是日常生活活动和自我管理行为（例如体力活动/锻炼）的一部分。 然而，我们对 OA 患者慢性疼痛和残疾的重大影响； 因此，有助于 MEP 及其对老年非裔美国人的管理的机制受到严重限制。 这个两阶段的指导性以患者为导向的研究职业发展奖（K23）的总体目标是 通过 (1) 描述 MEP 和功能的生物心理社会行为机制来填补这一知识空白 (2) 制定基于机制的自我管理干预措施（使用骨关节炎缓解疼痛） 针对黑人长者的文化定制干预措施[主动]）这项干预措施将解决最关键的问题。 以及老年非裔美国人 MEP 和功能受损的文化相关预测因子。 代表了对慢性肌肉骨骼疾病当前静态疼痛评估的新的实质性偏离 该 K23 提出了将启动的培训和研究活动。 一项旨在推进非裔美国老年人疼痛和残疾科学的研究计划。 为此，我组建了一个由代表护理、心理学/疼痛的资深科学家组成的跨学科团队 科学、老龄化和流行病学/社区参与谁将提供指导以帮助我实现 提出培训目标并促进我向独立研究职业的过渡。 对我的研究计划至关重要的包括：（1）加深对生物心理社会和行为的理解- OA疼痛的环境机制，（2）开发应用的综合知识库 实验设计中社区参与的参与式研究，以及（3）加强转化研究 作为独立研究者的技能，能够进行严格的临床试验测试 非药物、行为慢性疼痛自我管理干预措施在文化环境中的有效性 K23 的第二阶段将采用基于社区的参与式。 佛罗里达大学和大学合作创建主动干预的混合方法。 康涅狄格州是疼痛研究的强大孵化器，并为扩展 PI 的先前研究提供了理想的环境 努力并开辟一条独特地理解多种生物心理社会和行为机制的道路 参与慢性疼痛的种族内部经验，这是发现更好的治疗方法的关键 干预和自我管理行为。