Adaptation of Mindfulness Training to Treat Chronic Pain in the Military

正念训练在军队中治疗慢性疼痛的应用

基本信息

批准号：
9097651
负责人：
Susan Gaylord
金额：
$ 24.74万
依托单位：
RESEARCH TRIANGLE INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-08-01 至 2018-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9097651
关键词：
Address Adult Afghanistan Alcohols Analgesics Anxiety Complement Data Empirical Research Evidence based program Fatigue Feasibility Studies Feedback Focus Groups Funding Future Health Health Technology Informal Social Control Iraq Lead Life Link Medical Medical center Mental Depression Military Personnel Modality Modeling Nature North Carolina Online Systems Opioid Analgesics Outcome Pain Pain management Participant Perception Persons Physical Function Population Post-Traumatic Stress Disorders Process Program Accessibility Protocols documentation Public Health Quality of life Randomized Controlled Trials Recruitment Activity Religion and Spirituality Research Research Personnel Role Services Sleep disturbances Sleeplessness Societies Soldier Staging Stress Substance abuse problem Terminology Testing Training Trauma Traumatic Brain Injury Travel Universities Variant Veterans Work addiction alcohol misuse chronic pain coping cost disability drug misuse economic cost efficacy trial evidence base experience improved mHealth member mindfulness mindfulness-based stress reduction mobile application pain symptom programs psychologic public health priorities public health relevance satisfaction secondary outcome skills social stigma usability

项目摘要

DESCRIPTION (provided by applicant): Chronic pain is a significant public health priority for society, including the military. This application will test the acceptability and feasibility of an interactive, web-based mindfulness training with active duty soldiers being treated for chronic pain. We will adapt the evidence-based Mindfulness-based Stress Reduction (MBSR) program for use with this population. The training will be enhanced by mobile applications (apps) for skill practice, using an existing apps platform. Study participants will be recruited from the Interdisciplinary Pain Management Center at Womack Army Medical Center (WAMC) in Fort Bragg, NC, one of eight IPMCs nationally whose work is setting the standard for the DoD through its interdisciplinary, holistic, and multimodal approach to pain management. Rates of chronic pain in the military are exceedingly high, ranging from 28% to 82%. Estimated disability and medical costs for Iraq and Afghanistan veterans range from $350 to $700 billion. Chronic pain in the military often co-occurs with depression, post-traumatic stress disorder, traumatic brain injury, and drug and alcohol misuse. MBSR has a well-established evidence base and is efficacious in reducing depression, anxiety, stress, insomnia, and substance abuse. MBSR is also effective in ameliorating pain symptoms. However, the military's unique context differs dramatically from the civilian setting. These variations impact the feasibility and acceptability o the standard MBSR training, underscoring need for a preliminary study that includes a skillful adaptation process, a pretest, and a pilot test, thus laying the groundwork for a larger efficacy trial. The specific aims of this study are as follows: Aim 1. Adapt the evidence-based MBSR program for the military and add apps to an existing platform to develop a preliminary protocol. Aim 2. Assess the usability of the web-based preliminary protocol and apps at an early, pretest stage (1 group; N=8) in order to manualize and create a test protocol; Aim 3. Test the feasibility and acceptability of the test protocol and apps (4-5 sequential groups; N=32-40). The mindfulness protocol will be delivered via an existing web-based platform that enhances program accessibility and reach. The apps will utilize an existing platform that was developed by a team member with DoD funding, thus saving costs; the DoD is highly supportive of its expanded use. The investigative team includes researchers with in-depth experience in mindfulness, adaptation of evidence-based programs, mobile health technology, and military health research. This acceptability and feasibility study has significant

描述（由申请人提供）：慢性疼痛是社会（包括军队）的重要公共卫生优先事项。该应用程序将测试一个项目的可接受性和可行性对正在接受慢性疼痛治疗的现役士兵进行交互式、基于网络的正念训练。我们将调整基于证据的正念减压 (MBSR) 计划以供该人群使用。培训将通过使用现有应用程序平台的移动应用程序（应用程序）进行技能练习来增强。研究参与者将从北卡罗来纳州布拉格堡沃马克陆军医疗中心 (WAMC) 的跨学科疼痛管理中心招募，该中心是全国八个 IPMC 之一，其工作是通过跨学科、整体和多模式的疼痛方法为国防部制定标准管理。军队中慢性疼痛的发生率非常高，从 28% 到 82% 不等。伊拉克和阿富汗退伍军人的残疾和医疗费用估计在 350 至 7000 亿美元之间。军队中的慢性疼痛常常与抑郁症、创伤后应激障碍、创伤性脑损伤以及滥用药物和酒精同时发生。 MBSR 拥有完善的证据基础，可有效减少抑郁、焦虑、压力、失眠和药物滥用。 MBSR 还可以有效缓解疼痛症状。然而，军队的独特环境与民用环境截然不同。这些变化影响了标准 MBSR 培训的可行性和可接受性，强调需要进行初步研究，包括熟练的适应过程、预测试和试点测试，从而为更大规模的功效试验奠定基础。本研究的具体目标如下：目标 1. 为军队调整基于证据的 MBSR 计划，并将应用程序添加到现有平台以开发初步协议。目标 2. 在早期预测试阶段（1 组；N=8）评估基于网络的初步协议和应用程序的可用性，以便手动化和创建测试协议；目标 3. 测试测试协议和应用程序的可行性和可接受性（4-5 个连续组；N=32-40）。正念协议将通过现有的基于网络的平台提供，该平台增强了计划的可访问性和覆盖范围。这些应用程序将利用由国防部资助的团队成员开发的现有平台，从而节省成本；国防部高度支持其扩大使用。调查团队包括在正念、循证项目改编、移动医疗技术和军事健康研究方面拥有丰富经验的研究人员。这项可接受性和可行性研究具有重要意义