Adherence in African Americans Being Treated for Cancer Pain

非裔美国人接受癌症疼痛治疗的依从性

• 批准号: 8743309
• 负责人: Katherine Aylward Yeager
• 金额: $ 9.18万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-27 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8743309
• 关键词: AIDS clinical trial group; Acquaintances; Address; Adherence; Affect; African American; Analgesics; Area; Behavior; Belief; Cancer Burden; Cancer Pain Management; Caregiver Burden; Censuses; Church; Communities; Crime; Education; Event; Friends; Gender; Geographic Locations; Goals; Grant; Health; Health behavior; Household; Household Heads; Individual; Knowledge; Link; Location; Malignant Neoplasms; Measures; Mental Depression; Mentors; Mentorship; Methods; Minority; Modeling; Monitor; Neighborhoods; Opiates; Outcome; Pain; Pain management; Patients; Persons; Pharmaceutical Preparations; Positioning Attribute; Poverty; Qualitative Methods; Quality of life; Questionnaires; Recommendation; Religion and Spirituality; Reporting; Research; Research Methodology; Research Personnel; Risk Factors; Sampling; Sickle Cell; Social Environment; Social Network; Social support; Socioeconomic Factors; Source; Spirituality; Symptoms; System; Time; Training; Treatment outcome; Unemployment; Universities; Vacuum; advanced disease; base; cancer pain; career; community intervention; compliance behavior; contextual factors; density; design; economic cost; experience; family influence; improved; indexing; medication compliance; novel; public health relevance; research study; segregation; skills; social; statistics; treatment adherence

DESCRIPTION (provided by applicant): African Americans experience a disproportionate burden of cancer pain, suffer worse treatment outcomes, and have overall poor adherence to pain medication. Unfortunately, past research on pain has not fully explored factors important to cancer pain relief and treatment adherence in an economically diverse group of African Americans. Knowledge of the reasons why individuals do not adhere to pain treatment is essential if we are to better understand why they receive inadequate pain relief when adequate treatments are available. The proposed application moves beyond previous understanding of adherence by exploring the context of individuals - the social network and neighborhood that surround them and influence their behavior. This examination of social contextual factors requires a mixed method multilevel approach to explore the "what" and "how" of opiate adherence. Framed in a social ecological model, the aims of this study are to examine the influence of individual (symptom profile including pain and depression, pain beliefs, education, and gender) interpersonal (religious and social support), and neighborhood factors (socioeconomic measures, segregation, and drug related crime) on "around the clock" opiate adherence in African Americans being treated for cancer pain. A parallel mixed method design approach will be used that includes a quantitative and qualitative strand. The quantitative strand will provide information on what factors influence opiate adherence and the qualitative strand will provide a rich description of how these factors affect adherence. Along with the execution of this research, a comprehensive training and career mentoring plan will be carried out at Emory University under the mentorship of experts in symptom outcomes, pain disparities, medication adherence, and community factors of sociodemographic outcomes of health. The candidate's training goals include: 1) develop expertise in mixed- method research focusing on a minority sample being treated for cancer pain; 2) acquire methodological skills in geospatial analysis and statistics in order to better understand sources of disparities in non-adherence to opiates; and 3) build skills to position for next steps in the research trajectory. The goal of this project is to enhance understanding of pain medication adherence in African Americans. The long-range goal is to identify effective mechanisms to improve cancer pain relief, especially for those suffering the highest burden of cancer, African Americans. This training grant will prepare the candidate to be a successful independent researcher with preliminary information to improve pain management through treatment/assessment recommendations and/or patient and community interventions to ultimately improve pain management in African Americans with cancer pain.

描述（由申请人提供）：非裔美国人经历了不成比例的癌症疼痛负担，遭受更差的治疗结果，并且总体上对止痛药的依从性较差。不幸的是，过去关于疼痛的研究并没有充分探索在经济多样化的非裔美国人群体中癌症疼痛缓解和治疗依从性的重要因素。如果我们要更好地理解为什么当有足够的治疗方法时，他们却没有得到足够的疼痛缓解，那么了解个人不坚持疼痛治疗的原因是必不可少的。拟议的应用程序超越了先前对依从性的理解，通过探索个人的背景-围绕他们并影响他们行为的社会网络和邻居。这种社会背景因素的检查需要一种混合方法，多层次的方法来探索“什么”和“如何”阿片类药物的依从性。在社会生态模型的框架下，本研究的目的是检查个人（症状特征，包括疼痛和抑郁，疼痛信念，教育和性别）人际（宗教和社会支持）和社区因素（社会经济措施，隔离和毒品相关犯罪）对非裔美国人治疗癌症疼痛的“全天候”阿片类药物依从性的影响。一个平行的混合方法设计方法将被使用，包括定量和定性链。定量链将提供影响阿片类药物粘附性的因素的信息，定性链将提供这些因素如何影响粘附性的丰富描述。在进行本研究的同时，Emory大学将在症状结果、疼痛差异、药物依从性和社会人口健康结果的社区因素方面的专家的指导下，开展全面的培训和职业指导计划。候选人的培训目标包括：1)发展混合方法研究的专业知识，专注于治疗癌症疼痛的少数样本；2)掌握地理空间分析和统计方面的方法学技能，以便更好地了解阿片类药物不依从性差异的来源；和3)