Transition from Acute to Chronic Pain After Thoracic Surgery

胸外科手术后从急性疼痛转变为慢性疼痛

• 批准号: 10614222
• 负责人: Chad M Brummett
• 金额: $ 58.04万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-01 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10614222
• 关键词: Acute; Acute Pain; Address; Administrative Supplement; Anesthesiology; Area; Behavioral; Biological Markers; Black race; Blood; Brain imaging; Caring; Characteristics; Chronic; Chronic low back pain; Cities; Clinic; Clinical; Clinical Research; Clinical Trials; Cohort Studies; Collaborations; Color; Communication; Communities; Community Health Aides; Counseling; Data; Development; Education; Education and Outreach; Employee; Enrollment; Ensure; Ethnic Origin; Ethnic group; Failure; Fatigue; Feedback; Foundations; Funding; Future; Gender; Genetic; Goals; Grouping; Health Care Research; Health Services Accessibility; Health system; Hispanic; Hospitals; Human Resources; Individual; Infrastructure; Intervention; Knowledge; Lead; Medical; Michigan; Modeling; Moods; Operative Surgical Procedures; Outcome Measure; Pain; Pain Research; Parents; Participant; Patient Outcomes Assessments; Patient Recruitments; Patients; Persons; Phase; Physicians; Population Heterogeneity; Postoperative Pain; Practice based research; Precision medicine trial; Prevention; Preventive therapy; Process; Provider; Questionnaires; Race; Recruitment Activity; Research; Research Personnel; Research Training; Resources; Risk; Role; Rural; Sampling Studies; Sensory; Sequential Multiple Assignment Randomized Trial; Site; Structure; Techniques; Testing; Thoracic Surgical Procedures; Time; Training; Trust; Underrepresented Minority; Underrepresented Populations; United States National Institutes of Health; Universities; Visit; Work; base; biosignature; chronic pain; clinical center; clinical pain; cohort; community based participatory research; community based research; community engagement; design; diversity and equity; ethnic diversity; ethnic minority; experience; explicit bias; health equity; health inequalities; high throughput screening; hispanic community; implicit bias; improved; knee replacement arthroplasty; meetings; minority patient; neuroimaging; outreach; pain chronification; patient population; people of color; predictive marker; prevent; process evaluation; programs; prospective; racial and ethnic; racial diversity; racial minority; recruit; resilience; study population; transmission process; unconscious bias; urban area

Project Summary/Abstract Increasing the racial/ethnic diversity of participants in clinical pain research and including diverse partners in the design and conduct of research are intertwined goals that are essential to increasing the acceptability, feasibility, rigor, and relevance of pain research. This proposed administrative supplement to the parent Multisite Clinical Center (MCC) for the Acute to Chronic Pain Signatures Program (A2CPS) at the University of Michigan will support a robust effort to enhance patient and other community engagement, particularly that of underrepresented minorities, and to implement a sustained outreach effort to under-resourced Black and Hispanic communities in and around Detroit, Michigan. The goal of the A2CPS consortium is to develop biological markers and groupings of patient characteristics that predict the development of chronic pain after surgery, as well as well as resilience to chronic pain development. The biological markers to be studied include patient questionnaires (e.g., pain, mood, function), brain imaging, experimental pain testing, and blood markers (e.g., genetics). The study assesses patients before surgery and through one year after total knee replacement or thoracic surgery. Supplement Aim 1 is to hire a full-time Community Research Facilitator (CRF) who will conduct outreach in the Detroit areas and affiliated groups within the Henry Ford Health System and Wayne State University. The CRF will have experience as a community health worker or similar role; that is, they will possess deep knowledge of local resources and support a sustainable partnership between researchers and diverse communities. The CRF will lead outreach efforts in predominantly Black and Hispanic communities in the Detroit area to boost study recruitment efforts and increase cohort diversity; facilitate bidirectional communication and knowledge transmission between the study team and community partners; and help enrolled participants navigate the challenges of participating in clinical research, thereby enhancing retention. Supplement Aim 2 is to partner with an existing Community Advisory Board, which includes people living with pain who are diverse in terms of race/ethnicity, age, gender, and rural/urban location; as well as other advisors including providers, clinicians, and pain researchers. This group will review study materials and processes and give feedback on changes needed to enhance recruitment and retention of underrepresented populations. Supplement Aim 3 will increase the research staff within the Henry Ford Detroit research and Wayne State University teams to better staff the surgery clinics with more diverse patients and facilitate navigation of and comfort with the in-person study visits. Finally, Supplement Aim 4 will support all research staff with direct patient contact at our MCC to do the Faster Together training from Coursera focused on unconscious bias and training in recruitment of underrepresented minority cohorts. The additional infrastructure afforded by this supplement will facilitate getting input from diverse patients for new studies as they are being planned, recruiting more diverse populations into ongoing studies, and disseminating findings to communities.

项目概要/摘要 增加临床疼痛研究参与者的种族/民族多样性，并纳入不同的合作伙伴 研究的设计和实施是相互交织的目标，对于提高可接受性至关重要， 疼痛研究的可行性、严谨性和相关性。本建议向家长提供行政补充 大学急性至慢性疼痛特征项目 (A2CPS) 多站点临床中心 (MCC) 密歇根州将支持大力加强患者和其他社区的参与，特别是 代表性不足的少数族裔，并对资源不足的黑人和 密歇根州底特律及其周边地区的西班牙裔社区。 A2CPS 联盟的目标是开发 预测慢性疼痛发展的生物标志物和患者特征分组 手术以及对慢性疼痛发展的恢复能力。待研究的生物标志物包括 患者问卷（例如疼痛、情绪、功能）、脑成像、实验性疼痛测试和血液标记物 （例如，遗传学）。该研究评估了手术前和全膝关节置换术后一年的患者 或胸外科手术。补充目标 1 是聘请一名全职社区研究协调员 (CRF)，他将 在底特律地区以及亨利·福特医疗系统和韦恩内的附属团体进行外展活动 州立大学。 CRF 将具有社区卫生工作者或类似角色的经验；也就是说，他们会 对当地资源有深入的了解，并支持研究人员和研究人员之间建立可持续的伙伴关系 多元化的社区。 CRF 将在以黑人和西班牙裔为主的社区中领导外展工作 底特律地区加大研究招募力度并增加队列多样性；促进双向 研究团队与社区合作伙伴之间的沟通和知识传播；并帮助 注册的参与者应对参与临床研究的挑战，从而提高保留率。 补充目标 2 是与现有的社区咨询委员会合作，其中包括患有以下疾病的人 种族/民族、年龄、性别和农村/城市位置不同的人感到痛苦；以及其他顾问 包括提供者、临床医生和疼痛研究人员。该小组将审查研究材料和过程，并 就加强招募和保留代表性不足人群所需的变革提供反馈。 补充目标 3 将增加亨利·福特底特律研究中心和韦恩州立大学的研究人员 大学团队将更好地为外科诊所配备更多多样化的患者，并促进导航和 对亲自考察访问感到满意。最后，补充目标 4 将为所有研究人员提供直接支持 我们 MCC 的患者接触，进行 Coursera 的 Faster Together 培训，重点关注无意识偏见和 招募代表性不足的少数群体的培训。由此提供的额外基础设施 补充品将有助于为正在计划的新研究获取不同患者的意见， 招募更多不同的人群参与正在进行的研究，并向社区传播研究结果。