Using Technology to Deliver Evidence-Based Interventions for Pain to Patients with Sickle Cell Disease

利用技术为镰状细胞病患者提供循证疼痛干预措施

• 批准号: 9224339
• 负责人: Charles Richard Jonassaint
• 金额: $ 16.52万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-02-01 至 2020-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9224339
• 关键词: Acute Pain; Address; Adolescent; Adult; Adverse effects; Affect; African; African American; Anxiety; Applications Grants; Award; Behavior; Behavior Therapy; Car Phone; Caring; Cellular Phone; Cessation of life; Child; Chronic; Clinical; Clinical Oncology Supplement (K12); Clinical Trials; Cognitive Therapy; Conduct Clinical Trials; Coping Skills; Custom; Data; Development; Distress; Drug Addiction; E-learning; Education; Effectiveness; Effectiveness of Interventions; Evidence based intervention; Exercise; Family member; Feedback; Foundations; Future; Generic Drugs; Goals; Gold; Health; Individual; Institution; Intervention; Intervention Trial; Leadership; Learning; Learning Module; Low income; Medical; Mental Depression; Mental Health; Mentored Patient-Oriented Research Career Development Award; Mentors; Methodology; Minority; Moods; Multimedia; Opioid; Outcome; Pain; Pain management; Patient Recruitments; Patients; Pharmaceutical Preparations; Population; Pragmatic clinical trial; Provider; Psychologist; Qualitative Methods; Qualitative Research; Quality of life; Randomized; Recruitment Activity; Recurrence; Research; Research Methodology; Research Personnel; SECTM1 gene; Sickle Cell; Sickle Cell Anemia; Technology; Testing; Time; Training; Training Support; Translating; Underserved Population; Work; base; behavioral health; career; career development; chronic pain; cognitive testing; community organizations; computerized; coping; cost; design; disability; effective therapy; efficacy testing; ethnic minority population; evidence base; experience; follow-up; health care service utilization; health disparity; implementation science; improved; literacy; medical attention; mobile application; negative affect; pain symptom; patient advocacy group; patient oriented; patient population; payment; physical conditioning; premature; primary outcome; programs; psychologic; racial minority; skills; success; therapy design; user centered design

PROJECT ABSTRACT The overarching goal of this candidate's program of research is to improve behavioral and physical health and reduce health disparities by using multimedia technology to deliver evidence-based interventions to underserved populations. The focus is sickle cell disease (SCD), a condition that disproportionately affects those of African descent. Many people living with SCD suffer from daily chronic pain as well as recurrent acute pain episodes that require medical attention. Opioid medication is the primary treatment for pain in SCD, despite its limited effectiveness and negative side-effects. The proposed K23 attempts to address the need for an alternative, non-pharmacological pain treatment in SCD. Computerized cognitive behavioral therapy (cCBT) has been found effective for reducing chronic pain and may be a low cost, easily accessible and scalable pain treatment in SCD. The candidate's K12 project tested a cCBT program for anxiety and depression; preliminary results suggest that patients liked using the program, but found that much of its content did not relate to their lives. To address this limitation, the proposed K23 project will adapt an existing cCBT program for pain management to create ReThink Pain SCD, a culturally-tailored, mobile-phone delivered behavioral intervention designed specifically to help African American patients self-manage chronic sickle cell pain. Aim 1: Modify and tailor the generic cCBT pain program, using qualitative research methods to understand the needs and barriers to pain management in patients with SCD, as well as the opportunities to engage this population using multimedia. These data will inform the development of the features and content of ReThink Pain SCD. Aim 2: Conduct a pilot pragmatic clinical trial to test the feasibility and acceptability of implementing this pain intervention into routine SCD care. Forty patients with SCD will be randomized to either receive 8 sessions of the cCBT program or 8 online education modules on a smartphone. Primary outcomes of the trial include feasibility (recruitment, retention, provider and patient feedback) and acceptability (sessions completed) of the ReThink Pain SCD program. In order to achieve the goals of this research plan and transition to independence, the candidate requires further training in user-centered design, implementation science, design and conduct of pragmatic clinical trials, and team management and leadership. This proposal includes an exceptional team of mentors and consultants. Primary mentor Dr. Bruce Rollman is founding Director of the Center for Behavioral Health and Smart Technology. Co-mentor Dr. Robert Noll is a clinical psychologist with expertise in behavioral intervention trials. Co-mentor Dr. Laura De Castro is a nationally recognized trialist and expert in sickle cell disease. This training and research plan will form the basis for a future multicenter clinical trial testing the efficacy of ReThink Pain SCD for improving pain outcomes among adults with SCD, to be proposed in an R01 grant application before the end of the K23 award.

项目摘要 这位候选人的研究计划的首要目标是改善行为和身体健康，并 通过使用多媒体技术提供基于证据的干预措施来减少健康差距 服务不足的人群。焦点是镰状细胞病(SCD)，这种疾病对 那些非洲人后裔。许多患有SCD的人每天都遭受慢性疼痛和反复发作的急性疼痛。 需要医疗护理的疼痛发作。阿片类药物是SCD疼痛的主要治疗方法， 尽管它的效果有限，而且有负面副作用。拟议的K23试图满足以下需求 SCD的一种非药物治疗疼痛的替代疗法。计算机认知行为疗法(CCBT) 已被发现对减轻慢性疼痛有效，而且可能是一种低成本、容易获得和可扩展的疼痛 在SCD中的治疗。候选人的K12项目测试了一项针对焦虑和抑郁的cCBT计划；初步 结果表明，患者喜欢使用该程序，但发现其大部分内容与他们的 活着。为了解决这一限制，拟议的K23项目将对现有的cCBT计划进行调整，以适应疼痛 管理层将创建重新思考疼痛SCD，这是一种为文化量身定做的手机提供的行为干预 专为帮助非裔美国患者自我管理慢性镰状细胞疼痛而设计。目标1：修改和 定制通用的CCBT Pain计划，使用定性研究方法了解需求和障碍 SCD患者的疼痛管理，以及接触这一人群的机会 多媒体。这些数据将为重新思考疼痛SCD的特征和内容的发展提供信息。目标2： 进行试点务实临床试验，以测试实施这一痛苦的可行性和可接受性 对SCD常规护理的干预。40名SCD患者将被随机分为8个疗程 CCBT项目或智能手机上的8个在线教育模块。试验的主要结果包括 可行性(招聘、保留、提供者和患者反馈)和可接受性(已完成的课程) 重新思考疼痛SCD计划。 为了实现本研究计划的目标并过渡到独立，应聘者需要 在以用户为中心的设计、实施科学、实用临床设计和实施方面的进一步培训 试验，以及团队管理和领导力。这项建议包括一支杰出的导师团队和 顾问。主要导师布鲁斯·罗尔曼博士是行为健康中心的创始主任 智能科技。共同导师罗伯特·诺尔博士是一位在行为干预方面具有专业知识的临床心理学家。 审判。共同导师劳拉·德·卡斯特罗博士是全国公认的镰状细胞疾病三项研究专家。这 培训和研究计划将构成未来多中心临床试验的基础，以测试Reink的有效性 Pain SCD用于改善成年SCD患者的疼痛结局，将在R01拨款申请中提出 在K23大奖结束之前。