COVID-19 Impact on Pain management: Highlighting, Explaining, and Realigning services (CIPHER)
COVID-19 对疼痛管理的影响:突出显示、解释和重新调整服务 (CIPHER)
基本信息
- 批准号:10673419
- 负责人:
- 金额:--
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2022
- 资助国家:美国
- 起止时间:2022-10-01 至 2024-09-30
- 项目状态:已结题
- 来源:
- 关键词:AreaAttitudeBeliefCOVID-19COVID-19 impactCOVID-19 pandemicCaringChronic low back painCodeCognitiveCognitive ScienceCollaborationsCommunitiesDataDevelopmentEnvironmentEquityEvaluationEventFeedbackFilmFundingFutureGender identity disorderGoalsHealthcareHealthcare SystemsHigh PrevalenceHourIndianaInternational Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10)InterruptionInterventionInterviewKnowledgeLearningLesbian Gay Bisexual Transgender QueerLife ExperienceLiteratureLow Back PainMeasuresMedicalMental HealthMethodologyMethodsNeurologicOpioidPainPain managementPatientsPerceptionPerformancePersonal SatisfactionPersonsPlayPopulationPrevalenceProviderQuestionnairesRecommendationReportingResearch PersonnelResistanceRespondentRiskSamplingServicesSubstance Use DisorderSurveysTestingTranscriptTranslatingTranslationsUniversitiesVeteransViolenceWorkacceptability and feasibilitycatalystchronic painchronic painful conditioncisgendercohortcomorbiditydisorder riskexperiencegender diversityhealth care disparityimprovedinnovationmeetingsmembernovelopioid overdoseopioid useoverdose riskpandemic diseasephysical conditioningpost-COVID-19prescription opioidpreventprimary care providerprogramsresponsesocial stigmatransgender
项目摘要
Background: Transgender and gender diverse (TGD) Veterans are a priority population at greater risk of harm
following disruptions in chronic pain care, with higher rates of chronic pain conditions and of physical and
mental health comorbidities associated with prescription opioid use and overdose risk. Moreover, TGD
Veterans avoid medical care due to negative experiences rooted in stigma, reporting “insensitivity, harassment,
and violence” and “a general lack of knowledge about transgender patients and care among providers.”
Significance: Both the higher rates of chronic pain conditions and the increased prevalence of SUD and
overdose risk underscore that consistent chronic pain care and close oversight of care plans are essential for
TGD Veterans, and interruptions may have dire consequences. The need to better understand and develop
strategies to improve chronic pain care for TGD Veterans is critical and urgent to support wellbeing, manage
pain, ameliorate discriminatory treatment rooted in provider biases, and prevent opioid-related crises.
Innovation and Impact: Identity Development Evaluation and Sharing (IDEAS) is an innovative, evidence-
supported methodology in which qualitative data are presented via theatricalized, filmed monologues. Studies
have shown that viewing an IDEAS performance significantly reduces stigma beliefs, and literature suggests
IDEAS may facilitate translation of qualitative findings into actionable recommendations for optimizing future
care because data are presented in deeply contextualized ways – embedded in Veterans’ life experiences.
Specific Aims: The proposed work will supplement an existing VA-funded study, CIPHER, which focuses on
1) understanding changes in Veterans’ chronic low-back pain care after COVID-19 and their associated
impacts; and 2) using these data to develop strategies to optimize future delivery of VA pain services. Aim 1 of
the proposed work will enhance CIPHER by elucidating chronic pain care experiences of a high priority
population, TGD Veterans. In aim 2 of the proposed work we will apply findings from Aim 1 to develop a novel,
interactive intervention to support equitable TGD Veteran care, advancing CIPHER’s aim of developing short
and long-term strategies to optimize equitable delivery of pain management services post-COVID-19.
Methodology: In aim 1 we will purposefully sample TGD Veterans from CIPHER’s cohort of Veterans with
chronic low back pain use ICD-10 Gender Identity Disorder codes. We will conduct narrative interviews to learn
about TGD Veterans’ chronic pain care experiences prior to and following the onset of the pandemic. We will
identify key messages via thematic analysis of interview transcripts, focusing especially on areas for future
care optimization. In aim 2 we will apply IDEAS to produce a 25-minute film with professional actors portraying
key messages from aim 1 findings. We will share the film with CIPHER stakeholders and primary care
providers during a 1-hour meeting in which TGD Veteran panelists join for a 15-minute PI-moderated post-film
panel conversation. Stakeholders and providers will complete a pre/post Acceptance and Action Questionnaire
– Stigma, which provides a composite score with lower scores indicating reduced enacted stigma. An
unadjusted two sample paired t-test will be used to assess the difference in matched pre-post AAQ-S survey
scores. To assess whether IDEAS feasibly and acceptably shares qualitative data to facilitate actionable
change, we will distribute the Acceptability of Intervention Measure (AIM) and the Feasibility of Intervention
Measure (FIM) anonymously via an online survey that will include space for open-ended responses with each
item, asking respondents to describe if/how IDEAS facilitates actionable change. We will use explanatory
sequential mixed methods to expand quantitative AIM/FIM findings with qualitative feedback.
Next steps/Implementation: The proposed work will result in an IDEAS film depicting chronic pain care
experiences of TGD Veterans that can be disseminated by CIPHER stakeholders, as well as data on pre/post
change in provider stigma and stakeholders’ perceptions of IDEAS feasibility and acceptability.
背景:跨性别和性别多样化 (TGD) 退伍军人是受到更大伤害风险的优先人群
慢性疼痛护理中断后,慢性疼痛状况以及身体和精神疾病的发生率更高
与处方阿片类药物使用和过量风险相关的心理健康合并症。此外,TGD
退伍军人由于源于耻辱的负面经历而避免接受医疗护理,他们报告说“麻木不仁、骚扰、
和暴力”以及“普遍缺乏对跨性别患者和提供者护理的了解”。
意义:慢性疼痛的发病率较高,SUD 和 SUD 的患病率也较高。
过量风险强调持续的慢性疼痛护理和对护理计划的密切监督对于
TGD 退伍军人,中断可能会产生可怕的后果。需要更好地理解和发展
改善 TGD 退伍军人慢性疼痛护理的策略对于支持福祉、管理
疼痛,改善源于医疗服务提供者偏见的歧视性待遇,并预防与阿片类药物相关的危机。
创新和影响:身份发展评估和共享(IDEAS)是一项创新的、循证的
支持的方法论通过戏剧化的电影独白来呈现定性数据。研究
研究表明,观看 IDEAS 表演可以显着减少耻辱感,文献表明
IDEAS 可以促进将定性发现转化为优化未来的可行建议
之所以关心,是因为数据以深度情境化的方式呈现——嵌入退伍军人的生活经历中。
具体目标:拟议的工作将补充现有的 VA 资助的研究 CIPHER,该研究的重点是
1) 了解 COVID-19 后退伍军人慢性腰痛护理的变化及其相关
影响; 2) 使用这些数据制定策略以优化未来 VA 疼痛服务的提供。目标 1 的
拟议的工作将通过阐明高度优先的慢性疼痛护理经验来增强 CIPHER
人口,TGD 退伍军人。在拟议工作的目标 2 中,我们将应用目标 1 的发现来开发一部小说,
互动干预支持公平的 TGD 退伍军人护理,推进 CIPHER 发展短期目标的目标
以及优化 Covid-19 后公平提供疼痛管理服务的长期战略。
方法:在目标 1 中,我们将有目的地从 CIPHER 退伍军人队列中抽取 TGD 退伍军人
慢性腰痛使用 ICD-10 性别认同障碍代码。我们将进行叙述性访谈来学习
关于 TGD 退伍军人在大流行病爆发之前和之后的慢性疼痛护理经历。我们将
通过对采访记录进行主题分析来确定关键信息,特别关注未来的领域
护理优化。在目标 2 中,我们将应用 IDEAS 制作一部由专业演员扮演的 25 分钟电影
目标 1 调查结果的关键信息。我们将与 CIPHER 利益相关者和初级保健人员分享该影片
在 1 小时的会议期间,TGD 资深小组成员参加了由 PI 主持的 15 分钟的片后会议
小组对话。利益相关者和提供商将完成接受前/后接受和行动调查问卷
– 耻辱,提供综合分数,较低的分数表明所制定的耻辱减少。一个
未调整的两个样本配对 t 检验将用于评估匹配前后 AAQ-S 调查的差异
分数。评估 IDEAS 是否可行且可接受地共享定性数据以促进可操作
变更时,我们将分发干预措施的可接受性(AIM)和干预的可行性
通过在线调查匿名测量(FIM),其中包括每个问题的开放式答复空间
项目,要求受访者描述 IDEAS 是否/如何促进可行的变革。我们将使用解释性的
顺序混合方法通过定性反馈扩展定量 AIM/FIM 结果。
后续步骤/实施:拟议的工作将产生一部描述慢性疼痛护理的 IDEAS 电影
TGD 退伍军人的经验可以由 CIPHER 利益相关者传播,以及前/后数据
提供商耻辱感和利益相关者对 IDEAS 可行性和可接受性的看法发生变化。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Marianne Matthias其他文献
Marianne Matthias的其他文献
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{{ truncateString('Marianne Matthias', 18)}}的其他基金
COVID-19 Impact on Pain management: Highlighting, Explaining, and Realigning services (CIPHER)
COVID-19 对疼痛管理的影响:突出显示、解释和重新调整服务 (CIPHER)
- 批准号:
10412749 - 财政年份:2022
- 资助金额:
-- - 项目类别:
COVID-19 Impact on Pain management: Highlighting, Explaining, and Realigning services (CIPHER)
COVID-19 对疼痛管理的影响:突出显示、解释和重新调整服务 (CIPHER)
- 批准号:
10595645 - 财政年份:2022
- 资助金额:
-- - 项目类别:
Options for Pain Management using Nonpharmacological Strategies (OPTIONS)
使用非药物策略的疼痛管理选项(选项)
- 批准号:
10534972 - 财政年份:2022
- 资助金额:
-- - 项目类别:
Equity Using Interventions for Pain and Depression (EQUIPD)
公平使用疼痛和抑郁干预措施 (EQUIPD)
- 批准号:
10595133 - 财政年份:2022
- 资助金额:
-- - 项目类别:
Communication and Activation in Pain to Enhance Relationships and Treat Pain with Equity (COOPERATE)
疼痛中的沟通和激活,以增强关系并公平地治疗疼痛(合作)
- 批准号:
9502687 - 财政年份:2018
- 资助金额:
-- - 项目类别:
Communication and Activation in Pain to Enhance Relationships and Treat Pain with Equity (COOPERATE)
疼痛中的沟通和激活,以加强关系并公平地治疗疼痛(合作)
- 批准号:
10159110 - 财政年份:2018
- 资助金额:
-- - 项目类别:
Communication and Activation in Pain to Enhance Relationships and Treat Pain with Equity (COOPERATE)
疼痛中的沟通和激活,以加强关系并公平地治疗疼痛(合作)
- 批准号:
10213832 - 财政年份:2018
- 资助金额:
-- - 项目类别:
Communication and Activation in Pain to Enhance Relationships and Treat Pain with Equity (COOPERATE)
疼痛中的沟通和激活,以加强关系并公平地治疗疼痛(合作)
- 批准号:
9927912 - 财政年份:2018
- 资助金额:
-- - 项目类别:
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- 批准号:
9145524 - 财政年份:2015
- 资助金额:
-- - 项目类别:
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