Implementing a Cognitive/Exercise Therapy for Back Pain in The Community Setting

在社区环境中实施背痛认知/运动疗法

• 批准号: 7173221
• 负责人: Manney Carrington Reid
• 金额: $ 8.4万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-01-12 至 2008-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7173221
• 关键词: Acetaminophen; Adherence; Administrator; Adopted; Adoption; Affect; African American; Age; Analgesics; Anti-Inflammatory Agents; Anti-inflammatory; Area; Back; Back Pain; Behavioral; Chronic; Cognitive; Cognitive Therapy; Communities; Community Surveys; Condition; Degenerative polyarthritis; Development; Diagnosis; Disadvantaged; Disease; Drug Prescriptions; Elderly; Epidemiology; Ethnic group; Evaluation; Exercise; Expenditure; Future; Geriatrics; Health; Health Services; Health Services Accessibility; Hispanic Americans; Home environment; Individual; Inpatients; Intervention; Knowledge; Low Back Pain; Lower Extremity; Mental Depression; Methods; Minority; Minority Groups; Morbidity - disease rate; Not Hispanic or Latino; Numbers; Office Visits; Operative Surgical Procedures; Opioid; Outcome; Outpatients; Pain; Pain management; Participant; Persons; Pharmaceutical Preparations; Physical Function; Physical therapy; Physical therapy exercises; Physicians' Offices; Population; Prevalence; Prospective Studies; Protocols documentation; Qualifying; Range; Readiness; Reporting; Research; Research Personnel; Respiratory Tract Infections; Risk; Self Efficacy; Self Management; Social isolation; Sociology; Spinal Fractures; Spinal Stenosis; Sprain; Support System; Surveys; Testing; Time; Treatment Protocols; Woman; Work; base; behavior measurement; caucasian American; chronic pain; community based participatory research; cost; design; disability; functional disability; human old age (65+); improved functioning; instrumental activity of daily living; men; nondrug therapy; older women; osteoporosis with pathological fracture; programs; prospective; psychologic; racial and ethnic; socioeconomics

DESCRIPTION (provided by applicant): Among older persons, chronic back pain (CBP) is a common, morbid, and costly disorder. Non-drug therapies for CBP including cognitive-behavioral and exercise treatments can be feasibly performed by older adults with CBP, have proven efficacy, but are seldom used by affected individuals. This gap between our current pain-management knowledge and limited use of the therapies by older persons with CBP provides strong support for efforts designed to test and implement strategies that facilitate adoption among individuals adversely affected by CBP. Given that prior research has documented significant racial disparities with respect to pain management, targeting at-risk racial/ethnic minorities appears particularly warranted at this time. The investigators have developed an age-appropriate intervention - i.e., an integrated, cognitive- behavioral and exercise therapy (CBET) protocol - for the treatment of CBP among older adults, and now seek to partner with future stakeholders to conduct pre-implementation testing in a community-based setting. The specific aims of this project are to use a community-based participatory research approach to refine our intervention prior to implementation by: (1) surveying community partners (i.e., prospective consumers of the intervention and directors of senior centers where the program will be administered) about their readiness to adopt a self-management program for CBP and perceived barriers to program adoption; and by (2) field testing the intervention in senior centers that serve three specific racial/ethnic groups: Hispanic American, African American, and non-Hispanic White Americans. Products of this research will include a field-tested and modified protocol, as well as stakeholder informed strategies for future program implementation. The long-term aim of this work is to develop an effective and sustainable implementation strategy for the above intervention, targeting community-dwelling older persons. The multi-disciplinary investigative team assembled for this project consists of individuals with complementary expertise in the areas of geriatric medicine and pain management (Dr. M. Carrington Reid), sociology and measurement of behavioral phenomena (Dr. Elaine Wethington), and geriatric physical therapy and instructional development and evaluation (Dr. Katherine Beissner), and are highly qualified to conduct the planned research.

描述（由申请人提供）：在老年人中，慢性背痛（CBP）是一种常见，病态且昂贵的混乱。 CBP的非药物疗法在内，包括认知行为和运动疗法可以由CBP患有CBP的老年人可行地进行，已证明具有疗效，但很少受影响的人使用。我们目前的疼痛管理知识与CBP老年人对疗法的使用有限使用之间的差距为旨在测试和实施策略的努力提供了强有力的支持，这些策略有助于促进受CBP不利影响的个人的采用。鉴于先前的研究已经记录了有关疼痛管理的重大种族差异，因此目前有尤其有必要针对处于危险的种族/族裔少数民族。研究人员已经开发了一种适合年龄的干预措施 - 即，用于在老年人中治疗CBP的综合，认知行为和运动治疗方案（CBET）方案，现在试图与未来的利益相关者合作，以在社区环境中进行实行前实施测试。该项目的具体目的是使用基于社区的参与性研究方法来完善我们的干预措施，并通过以下方式通过：（1）调查社区伙伴（即，干预措施的潜在消费者和高级中心的董事的潜在消费者）就其准备就绪，以便将其准备就绪，以便为CBP和计划采用计划采用计划的障碍；通过（2）现场测试为三个特定种族/族裔群体提供服务的高级中心的干预措施：西班牙裔美国人，非裔美国人和非西班牙裔美国人。这项研究的产品将包括经过现场测试和修改的协议，以及利益相关者知情的策略，以实施未来的计划实施。这项工作的长期目的是为上述干预制定有效且可持续的实施策略，以针对社区居住的老年人。为该项目组成的多学科调查团队由在老年医学和疼痛管理领域（M. Carrington Reid博士），行为现象的社会学和测量（Elaine Wethington博士）（Elaine Wethington博士）以及高度研究（Heariatric Theraption and Thromentitial Dexportion Development and Throment Isalnection（Kather bissine and Spanified）进行行为和行为的人，以及该行为的研究（凯瑟（Katherne Beissner）和凯瑟琳（Katherine Beissner），是对行为现象的行为，并高度进行了行为。