PATINA: Pain Management Training in Native American Communities

描述（由申请人提供）：疼痛是人们寻求医疗护理的主要原因。不幸的是，在癌症中疼痛治疗不足是有据可查的（Cohen等人，2003; Deandrea等人，2008）和其他医学状况（Boulanger等人，2007; Hadjistavropoulos等人，2006年）。虽然药物仍然是对抗疼痛的第一道防线，但认知行为疼痛管理（CBPM）技术的有效性的经验支持继续增长。单独使用或与药物治疗结合使用，CBPM技术，如人工呼吸，渐进式肌肉放松和引导成像，已被证明可以显着减少癌症和非癌症相关的疼痛。然而，目前，缺乏文化适应和提供者培训是更广泛使用这些治疗的障碍，特别是在治疗美洲印第安人（AI）和阿拉斯加原住民（AN）的农村和部落诊所。研究表明，文化的适当性是重要的认知行为干预的可接受性相对于一个维斯于少数民族患者。因此，该快速通道应用程序建议创建一个互联网交付的、文化定制的多媒体培训，向服务于农村社区和人工智能/人工神经网络的提供者教授医学支持的CBPM技术，以便这些提供者反过来可以向他们的患者教授这些技术。拟议的产品，帕蒂纳（疼痛管理培训在美洲土著社区），是创新的，在其网络和基于互联网的方法来培训CBPM技术，在其文化的特殊性，并在其使用远程保健进行形成和评估研究，在农村医院和部落诊所设置。主要客户将是农村医疗服务提供者和治疗AI/AN患者的医疗服务提供者。完成培训后将获得继续教育单位。结合书籍和课程的最佳功能，基于网络的培训成本低，方便，并提供互动，反馈和实践机会。 公共卫生相关性：认知行为疼痛管理（CBPM）技术被一些国家组织强烈认可为综合疼痛管理方法的重要组成部分。然而，缺乏获得提供者培训的机会是其更广泛使用的主要障碍，特别是在农村地区和为美洲印第安人和阿拉斯加土著人服务的诊所。该提案旨在通过创建互联网交付的，文化定制的多媒体培训来改善公共卫生，向服务于农村地区和美洲印第安人和阿拉斯加原住民的提供者教授CBPM技术，以便这些提供者可以向他们的患者教授这些技术。

DESCRIPTION (provided by applicant): Pain is the primary reason that people seek medical care. Unfortunately, under-treatment of pain is well- documented in cancer (Cohen et al, 2003; Deandrea et al., 2008) and other medical conditions (Boulanger et al., 2007; Hadjistavropoulos et al., 2006). While medication continues to be the first line of defense against pain, empirical support for the effectiveness of cognitive-behavioral pain management (CBPM) techniques continues to grow. Used alone or in conjunction with pharmacological treatment, CBPM techniques such as diaphragmatic breathing, progressive muscle relaxation, and guided imagery have been shown to significantly reduce both cancer- and non-cancer-related pain. Currently, however, a lack of cultural adaptation and provider training are barriers to the more wide-spread use of these treatments, especially in rural and tribal clinics that treat American Indians (AIs) and Alaska Natives (ANs). Research indicates that cultural appropriateness is important to the acceptability of cognitive behavioral interventions vis-a-vis minority patients. Therefore, this Fast-Track application proposes to create an internet-delivered, culturally- tailored multimedia training to teach empirically-supported CBPM techniques to providers serving rural communities and AI/ANs, so that these providers, in turn, can teach these techniques to their patients. The proposed product, PATINA (Pain Management Training in Native American Communities), is innovative in its web- and internet-based approach to training CBPM techniques, in its cultural specificity, and in its use of telehealth to conduct formative and evaluative research in rural hospital and tribal clinic settings. Primary customers will be rural healthcare providers and those treating AI/AN patients. Continuing education units will be awarded for completing the training. Combining the best features of books and classes, web-based training is low cost, convenient, and offers interactivity, feedback and practice opportunities. PUBLIC HEALTH RELEVANCE: Cognitive-behavioral pain management (CBPM) techniques are strongly endorsed by several national organizations as an important component of a comprehensive pain management approach. However, lack of access to provider training is a major barrier to their more wide-spread use, especially in rural areas and clinics that serve American Indians and Alaska Natives. This proposal seeks to improve public health by creating an internet-delivered, culturally-tailored multimedia training to teach CBPM techniques to providers serving rural areas and American Indians and Alaska Natives, so that these providers can teach these techniques to their patients.