Study of Healthy Adaptation and Resilience to Pain in Emerging Adulthood (SHARPE)

成年初期对疼痛的健康适应和恢复力研究（SHARPE）

• 批准号: 10370788
• 负责人: Shreela Palit
• 金额: $ 16.71万
• 依托单位: NEMOURS CHILDREN'S CLINIC
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-07 至 2027-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10370788
• 关键词: Achievement; Address; Adolescence; Adolescent; Adolescent and Young Adult; Adult; Affect; Age; Biological; Biometry; Body mass index; Cardiovascular system; Characteristics; Childhood; Chronic low back pain; Classification; Clinical Investigator; Clinical Research; Clinical Trials Design; Competence; Data; Development; Development Plans; Ecological momentary assessment; Elderly; Equilibrium; Exercise; Exhibits; Familiarity; Family; Fostering; Future; Glean; Goals; Health; Impairment; Individual; Intervention; Investigation; K-Series Research Career Programs; Knowledge; Laboratories; Leadership; Life; Life Cycle Stages; Life Style; Literature; Measurable; Measurement; Measures; Mental Depression; Mentors; Mentorship; Methodology; Modeling; Musculoskeletal Pain; National Institute of Child Health and Human Development; Nature; Outcome; Pain; Pain management; Participant; Patient Self-Report; Patient-Centered Care; Patients; Performance; Persistent pain; Personal Satisfaction; Physical Function; Play; Population; Prevention; Prevention strategy; Procedures; Process; Productivity; Psychology; Quality of life; Recovery; Reporting; Research; Research Personnel; Resolution; Risk; Risk Factors; Role; Sampling; Science; Self Efficacy; Source; Strategic Planning; Stress; Symptoms; Time; Training; Visit; Work; Youth; base; biopsychosocial; career development; chronic musculoskeletal pain; chronic pain; clinical care; clinical pain; clinical predictors; comorbidity; coping; disability; emerging adult; emerging adulthood; experience; follow-up; functional disability; heart rate variability; improved; innovation; knowledge base; multidisciplinary; negative affect; optimism; patient oriented; peer support; precision medicine; prevent; preventive intervention; programs; prospective; protective factors; psychologic; psychosocial; resilience; response; skills; sleep quality; social; stressor; translational scientist; treatment response; young adult

PROJECT SUMMARY/ABSTRACT Chronic musculoskeletal (MSK) pain is the leading source of persistent pain among late adolescents and young adults (AYAs) and contributes to significant functional disability, psychosocial impairment, and reduced quality of life. Moreover, the transitional stage of emerging adulthood presents unique challenges which can further complicate pain-related coping and adjustment in late AYAs. The influence of risk factors on maladaptive pain- related outcomes in youth is well-documented. However, much less is known about protective factors that may mitigate these negative consequences and promote healthy adaptation to pain during the transition to adulthood. It is imperative to identify these protective variables to foster positive outcomes throughout the life course. Resilience, characterized as a dynamic, malleable process leading to positive adaptation in the face of adversity, plays an important role in conferring adaptive responses to pain. However, resilience examined across multiple domains of functioning (i.e., psychological, social, biological, and health/lifestyle) is yet to be explored in late AYAs with and without chronic MSK pain. Thus, the overarching goal of this career development award (K23) is to fill this knowledge gap by: 1) characterizing multi-domain pain resiliency (MDPR) profiles during the transition to adulthood, and 2) investigating the utility of these profiles in predicting pain, functioning, and pain modulatory capacity over time. Information gained from this project will be invaluable for developing patient-centered prevention/intervention efforts. This K23 proposes scientific and training objectives that will be instrumental for launching an independent program of research that advances the science and treatment of pain and disability in late AYAs. The multidisciplinary mentoring team includes experts in biopsychosocial pain mechanisms, resilience/positive psychology, pediatric/adolescent pain, and biostatistics who will provide guidance and training necessary for achievement of professional goals that will facilitate the PI's transition to independence. Primary training objectives for the current proposal are to: 1) expand knowledge of biopsychosocial determinants of chronic pain, specifically factors related to promoting pain resilience across multiple domains of functioning, 2) develop a comprehensive knowledge base for variables influencing pain during the transition to adulthood and enhance training in the assessment and treatment of pain in late adolescents and young adults, 3) augment statistical acumen by increasing familiarity with advanced statistical analytics necessary for clinical research, especially for patient classification to inform patient-centered care, 4) enhance knowledge and skills necessary for clinical trial design and implementation, as well as prevention science methodology, and 5) advance leadership, mentoring, scholarly productivity, and other professional skills integral for fostering competency as an academic and independent clinical and translational investigator. The proposed career development plan extends from the PI's prior work on vulnerability mechanisms in pain, and will forge a path towards investigating strategies that promote resilience and improve pain and disability during the transition to adulthood.

项目总结/摘要 慢性肌肉骨骼（MSK）疼痛是青少年晚期和年轻人持续性疼痛的主要来源 成年人（AYAs），并导致严重的功能障碍，心理障碍和质量下降 生命此外，成年初显阶段的过渡阶段提出了独特的挑战， 在晚期AYA中复杂的疼痛相关应对和调整。危险因素对适应不良疼痛的影响- 在青年方面取得的相关成果已有详细记录。然而，对可能导致癌症的保护性因素知之甚少。 减轻这些负面影响，并促进在向成年过渡期间对疼痛的健康适应。 必须确定这些保护性变量，以促进整个生命过程中的积极成果。 复原力的特点是一个动态的、可延展的过程，导致在面对逆境时积极适应， 在赋予对疼痛的适应性反应中起着重要作用。然而，在多个国家和地区检查的弹性 功能域（即，心理、社会、生物和健康/生活方式）还有待于后期探索 有和没有慢性肌肉骨骼肌疼痛的AYA。因此，这个职业发展奖（K23）的总体目标是 通过以下方式填补这一知识空白：1）表征过渡期间的多领域疼痛弹性（MDPR）概况 2）研究这些特征在预测疼痛、功能和疼痛调节方面的效用 时间的能力。从这个项目中获得的信息将是非常宝贵的发展以病人为中心 预防/干预措施。K23提出了科学和培训目标，这将有助于 启动一项独立的研究计划，推动疼痛和残疾的科学和治疗， 晚的阿雅。多学科指导团队包括生物心理社会疼痛机制专家， 弹性/积极心理学，儿科/青少年疼痛和生物统计学，他们将提供指导和培训 实现专业目标所必需的，这将有助于PI向独立过渡。初级 目前建议的培训目标是：1）扩大对生物心理社会决定因素的了解， 慢性疼痛，特别是与促进多个功能领域的疼痛恢复力相关的因素，2） 发展一个全面的知识库，了解在向成年过渡期间影响疼痛的变量， 加强青少年晚期和年轻人疼痛评估和治疗方面的培训，3）增加 通过提高对临床研究所需的高级统计分析的熟悉程度， 特别是对病人分类，以告知以病人为中心的护理，4）提高必要的知识和技能 用于临床试验设计和实施，以及预防科学方法，以及5）推进 领导力，指导，学术生产力和其他专业技能，作为培养能力的组成部分， 一个学术和独立的临床和翻译研究者。拟议职业发展计划 延伸自PI先前关于疼痛脆弱性机制的工作，并将为研究 在向成年过渡期间促进恢复力并改善疼痛和残疾的战略。