Agile Development of a Digital Exposure Treatment for Youth with Chronic Musculoskeletal Pain

敏捷开发针对患有慢性肌肉骨骼疼痛的青少年的数字暴露治疗

• 批准号: 10454233
• 负责人: Lauren Elisabeth Harrison
• 金额: $ 15.24万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-20 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10454233
• 关键词: Active Learning; Adherence; Adolescence; Adolescent; Adult; Affect; Age; Arthritis; Behavior Therapy; Biomechanics; COVID-19 pandemic; Cellular Phone; Childhood; Clinical; Clinical Research; Clinical Trials; Computers; Country; Data; Data Collection; Development; Development Plans; Devices; Distress; Effectiveness; Evaluation; Evidence based intervention; Evidence based program; Experimental Designs; Feedback; Fright; Funding; Goals; Grant; Health Services Accessibility; Impairment; Individual; Intervention; Interview; Maintenance; Measures; Medicine; Mentors; Mentorship; Methods; Modeling; Monitor; Musculoskeletal Diseases; National Institute of Arthritis and Musculoskeletal and Skin Diseases; Outpatients; Pain; Parents; Participant; Patients; Phase; Physical activity; Prevention; Process; Provider; Randomized; Randomized Controlled Trials; Research; Research Methodology; Research Support; Risk; Scientist; Secure; Services; Structure; Tablets; Teenagers; Time; Training; Treatment Effectiveness; Waiting Lists; Writing; Youth; actigraphy; adherence rate; barrier to care; behavioral health intervention; biomechanical test; career; career development; chronic musculoskeletal pain; chronic pain; clinical care; cohort; cost; design; diaries; digital; digital health; digital intervention; disability; dissemination science; evidence base; experience; flexibility; follow-up; functional disability; high risk; implementation science; innovation; innovative technologies; insight; joint biomechanics; mHealth; multidisciplinary; opioid misuse; pain reduction; patient oriented; pilot trial; prototype; remote assessment; response; retention rate; satisfaction; social; societal costs; statistics; theories; user centered design; user-friendly

Abstract Chronic musculoskeletal (MSK) pain affects the lives of over a quarter of youth, with societal costs exceeding $19.5 billion dollars in the U.S. each year. The impact of chronic MSK pain in adolescence is felt into adulthood and is a documented risk for opioid misuse. There are a number of efficacious behavioral interventions for adolescents with chronic pain, but many access-to-care barriers exist, highlighting the critical need to develop digitally delivered behavioral interventions to drastically increase reach. Graded exposure is a theory- driven, individually-tailored intervention for individuals with chronic pain targeting pain-related impairment by exposing patients to previously feared and avoided activities. This project seeks to develop and evaluate the feasibility and preliminary effectiveness of a digital exposure treatment (iGET Living) for adolescents with chronic musculoskeletal (MSK) pain and their parents, utilizing a sequential replicated and randomized single-case experimental design (SCED) and incorporating innovative technology for remote biomechanical assessment. The central hypothesis is iGET Living will be acceptable and feasible for youth with chronic MSK pain and their parents and will be effective at alleviating functional disability and pain-related distress. Agile research methods will allow for a rapid, iterative development and evaluation of the intervention, yielding a clinically useful solution. This proposal includes a comprehensive training plan under the guidance of mentors with expertise across study aims. Dr. Harrison will obtain specialized training in 1) user-centered design and agile development of digital interventions, 2) clinical research and trial execution, 3) intervention optimization, dissemination, and implementation science, 4) innovative, remote assessment of biomechanical function, 5) advanced qualitative and quantitative statistics, and 6) experiential learning in grant-writing. Research: Aim 1: In an iterative, user- experience design process, Dr. Harrison and her team will develop iGET Living for adolescents with chronic MSK pain and their parents. Data regarding comprehensiveness and acceptability will be collected via interviews with patients and parents. Clinicians specialized in pediatric chronic pain will provide feedback on how providers might integrate into practice, who they would refer, and potential barriers to utilization. Aim 2: Dr. Harrison will evaluate preliminary feasibility and effectiveness of iGET Living to reduce pain-related distress and functional disability utilizing SCED with multiple measures. Successful completion of these aims will provide the opportunity to rapidly evaluate treatment effectiveness and inform iterative development of iGET Living to prepare subsequent RCTs. The strong mentorship team, specialized career development training, and proposed research plan will allow Dr. Harrison to gain the expertise needed to seek R-level funding and achieve her long- term career goal of becoming an independent clinician-scientist with expertise in developing digital interventions for youth with chronic pain and their parents.

摘要