Evidence-Based Pain Intervention for Veterans: Leveraging Mobile & Social Media

针对退伍军人的循证疼痛干预：利用移动设备

• 批准号: 9766874
• 负责人: SARA S JOHNSON
• 金额: $ 14.92万
• 依托单位: PRO-CHANGE BEHAVIOR SYSTEMS, INC.
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-08-01 至 2022-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9766874
• 关键词: Address; Adopted; Adult; Advocate; Affect; American; Americas; Car Phone; Caring; Chronic; Cognitive Therapy; Communities; Computers; Coping Skills; Data; Death Rate; Decision Making; Development; Diabetes Mellitus; Disease; Economics; Educational Curriculum; Effectiveness; Elements; Feedback; Freedom; Frequencies; Funding; Goals; Health; Health behavior change; Healthcare; Healthcare Systems; Heart Diseases; Individual; Individual Differences; Institutes; Internet; Intervention; Life; Malignant Neoplasms; Maps; Mental Health; Modeling; Motivation; Musculoskeletal Diseases; Notification; Online Systems; Outcome; Pain; Pain intensity; Pain interference; Pain management; Participant; Patients; Personal Satisfaction; Phase; Play; Population; Post-Traumatic Stress Disorders; Prevalence; Primary Health Care; Problem Solving; Public Health; Randomized; Readiness; Recommendation; Reporting; Research; Resources; Role; Science; Self Management; Severities; Sleep Disorders; Small Business Innovation Research Grant; Social Network; Societies; Soldier; Subgroup; Subway; Suggestion; Symptoms; Syndrome; Tablet Computer; Testing; Text Messaging; Therapeutic Intervention; Traumatic Brain Injury; Underserved Population; Veterans; Vulnerable Populations; base; behavior change; chronic musculoskeletal pain; chronic pain; common treatment; community setting; coping; cost; cost effective; disparity reduction; evidence base; experience; follow-up; handheld mobile device; health administration; healthcare community; impression; improved; improved functioning; innovation; neglect; non-drug; operation; opioid epidemic; opioid overdose; pain reduction; pain relief; pain self-management; patient oriented; post intervention; preference; programs; prototype; randomized trial; recruit; secondary analysis; secondary outcome; self-management program; skills; sleep behavior; sleep health; social media; social networking website; stress management; usability

Chronic musculoskeletal pain creates a significant public health burden, and Veterans are disproportionately affected. The frequency and extent of co-occurrence of pain and PTSD, pain and Traumatic Brain Injury (TBI), all three conditions (Post-deployment Multi-symptom Disorder (PMD), and other multi-symptom syndromes can complicate and reduce the effectiveness of pain treatment. Furthermore, the majority of Veterans do not seek care in VA settings, requiring an approach that will be available to all Veterans. The Blueprint for Relieving Pain in America and National Pain Strategy call for the promotion of self-management; reducing disparities among vulnerable subgroups (e.g., Veterans); and the tailoring of pain care. Proponents of integrated treatment for common co-morbid conditions are advocating for interventions that address multiple conditions. This Phase II proposal builds on a successful NACTS-funded Phase I SBIR that developed and pilot tested a theoretically-grounded, mobile- optimized, interactive pain self-management intervention for Veterans with chronic musculoskeletal pain. Health eRide: Your Journey to Managing Pain 1) was tailored specifically to Veterans' readiness and preferred strategies for pain self-management; 2) leveraged SMS messaging, social networking, and gaming principles to increase engagement and retention; and 3) helped to address the co-occurrence of PTSD and TBI by including health behavior change messages for sleep hygiene and stress management. At 30-day follow-up, participants (n=44) reported significant reductions in pain and pain impact, as well as increased readiness to employ self-management strategies. Over 68% of participants reported favorable global impression of change. Phase II will involve 1) completing the development of Health eRide by transforming it into an app and enhancing its functionality for mobile browsers, enhancing the social networking and gaming features, and adding e-coaching capabilities; and 2) conducting a year- long randomized trial in which 540 Veterans with chronic pain recruited from both VA facilities and the community are randomly assigned to Health eRide or an online educational cognitive- behavioral therapy intervention. Differences in pain intensity and interference will be examined at 6 months (immediately post-intervention) and 12-months. A number of secondary analyses will be conducted to examine the impact Health eRide has on other outcomes (e.g., PTSD symptoms). A successful trial will set the stage for widespread dissemination of an efficacious, easily accessible tailored pain self-management intervention to address an urgent need among our nation's Veterans as well as an adaptation for general adult populations.

慢性肌肉骨骼疼痛造成了重大的公共健康负担，退伍军人 受到不成比例的影响。疼痛与 PTSD、疼痛同时发生的频率和程度 和创伤性脑损伤 (TBI)，所有三种情况（部署后多症状 障碍 (PMD) 和其他多症状综合征可能会使病情复杂化并减少病情 疼痛治疗的有效性。 此外，大多数退伍军人不会在退伍军人管理局寻求护理 设置，需要一种可供所有退伍军人使用的方法。缓解蓝图 美国疼痛和国家疼痛战略呼吁促进自我管理；减少 弱势群体（例如退伍军人）之间的差异；以及疼痛护理的定制。 常见共病综合治疗的支持者正在提倡 针对多种情况的干预措施。该第二阶段提案建立在成功的基础上 NACTS 资助的第一阶段 SBIR 开发并试点测试了一个理论上基于移动的 为患有慢性病的退伍军人提供优化的交互式疼痛自我管理干预 肌肉骨骼疼痛。 Health eRide：您的疼痛管理之旅 1) 是专门定制的 退伍军人的疼痛自我管理准备情况和首选策略； 2）利用短信 消息传递、社交网络和游戏原则，以提高参与度和保留率；和 3) 通过改变健康行为来帮助解决 PTSD 和 TBI 的共存问题 有关睡眠卫生和压力管理的信息。在 30 天的随访中，参与者 (n=44) 据报道，疼痛和疼痛影响显着减少，就业准备度也提高 自我管理策略。超过 68% 的参与者对全球印象良好 改变。第二阶段将涉及 1) 通过改造来完成 Health eRide 的开发 进入应用程序并增强其移动浏览器的功能，增强社交 网络和游戏功能，并添加电子教练功能； 2) 进行一年- 长期随机试验，从 VA 两个机构招募了 540 名患有慢性疼痛的退伍军人 社区被随机分配到 Health eRide 或在线教育认知- 行为治疗干预。将检查疼痛强度和干扰的差异 6 个月（干预后立即）和 12 个月。一些二次分析 将进行检查 Health eRide 对其他结果（例如 PTSD 症状）。一次成功的试验将为广泛传播有效的、 易于获得的定制疼痛自我管理干预措施，以满足患者的迫切需求 我们国家的退伍军人以及一般成年人口的适应。