Mindfulness-Based Cognitive Therapy for the chronic pain-depression co-morbidity among older Blacks in the community; The Quiet Focus study

针对社区老年黑人慢性疼痛抑郁共病的正念认知疗法；

• 批准号: 10644590
• 负责人: Tony V Pham
• 金额: $ 16.96万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-06 至 2028-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10644590
• 关键词: Abbreviations; Address; Adult; Aging; Award; Benchmarking; Biometry; Black Populations; Black race; Boston; Bypass; Capital; Caring; Characteristics; Chronic Disease; Clinical Trials; Communities; Complementary Health; Data; Dose; Educational workshop; Elderly; Elements; Emotional; Environment; Face; First Generation College Students; Focus Groups; Funding; Future; Goals; Health; Hour; Individual; Infrastructure; Institution; Institutional Racism; Integrative Medicine; Intervention; Interview; Link; Manuals; Medicine; Meditation; Mental Depression; Mental Health; Mentors; Mentorship; Methods; Mind-Body Intervention; Modeling; National Center for Complementary and Integrative Health; Outcome; Pain; Pain management; Persons; Physical Function; Prayers; Preparation; Procedures; Protocols documentation; Psychiatrist; Refugees; Research; Research Methodology; Research Personnel; Research Project Grants; Services; Son; Teacher Professional Development; Testing; Time; Training; Training Programs; Travel; Underrepresented Populations; Underserved Population; Vietnamese; Work; acceptability and feasibility; career; chronic depression; chronic musculoskeletal pain; chronic pain; chronic pain management; clinical practice; community engaged research; community engagement; comorbid depression; comorbidity; cost; efficacy evaluation; efficacy trial; emotional functioning; evidence base; experience; improved; instructor; interest; intervention refinement; meetings; mindfulness based cognitive therapy; pain outcome; people of color; preference; primary outcome; programs; public health priorities; recruit; research and development; social determinants; social stigma; therapy development; underserved community; volunteer

Research & Related Other Project Information Project Summary This K23 proposal details a comprehensive 5-year training program that will support the candidate’s transition towards becoming an independent investigator. The candidate (Dr. Tony V Pham), a first generation college student, underrepresented in medicine psychiatrist, will focus his career on developing and rigorously testing mind-body interventions with better access and relevance to underserved populations with chronic illnesses. In this application, the candidate proposes to address the chronic pain-depression co-morbidity in the older Black community by culturally adapting Mindfulness-Based Cognitive Therapy (MBCT). Among older Blacks, chronic pain co-occurs with depression, and this co-morbidity worsens physical and emotional function; however, Blacks face multiple barriers to evidence-based non-pharmacological pain and depression management including systemic racism, stigma, and the lack of culturally tailored care. A culturally tailored MBCT may be an effective and efficient solution to improve physical and emotional outcomes among this underserved population. This K23 will develop Quiet Focus, a cultural adaptation of MBCT for older Blacks with chronic musculoskeletal pain and co-occurring depression. My preliminary conversations with the community revealed strong interest in Quiet Focus, support for MBCT’s relevance to the community, and interest in participation only if the intervention is abbreviated and is delivered by a lay instructor from the Black community. In Aim 1, I will develop Quiet Focus using guidance from the older Black community with chronic pain and co-occurring depression. The starting point for Quiet Focus will be an abbreviated, evidence-based MBCT protocol (8 60-minute sessions) developed by co-mentor Shallcross. I will train lay instructors under the mentorship of co-mentor Joo and develop a fidelity protocol under the mentorship of primary mentor Vranceanu and co-mentor Shallcross. In Aim 2, I will train a Black lay individual to deliver Quiet Focus and assess preliminary feasibility and fidelity. In Aim 3, I will train a new Black lay individual to deliver Quiet Focus and another to deliver a time- and dose-matched control. I will then conduct a feasibility RCT of Quiet Focus and control and assess definitive feasibility benchmarks including fidelity. These proposed efforts will inform an efficacy trial through the R01 mechanism (primary outcome is physical function) as well as future studies aimed at generalizing this work to other underrepresented groups. These study aims are supported by 3 main training goals aimed at developing expertise in: (1) community engaged intervention development, (2) mixed methods research for intervention refinement, and (3) community-engaged clinical trials. These training goals are supported by (1) a team of expert mentors (Vranceanu, Jackson, Joo, and Shallcross), advisors (Mischoulon, Parker, Okereke), and a community advisory board (Jacqueline Hinton, Michael Kincade), (2) a rich institutional environment, and (3) targeted materials and meetings. For the past year, I have built the infrastructure for this proposal through formal and informal meetings with Black community leaders and groups of older Blacks with chronic pain and co-occurring depression. This K23 proposal is in line with NCCIH’s funding priorities to advance how Complementary and Integrative Health can improve pain outcomes, address the whole person, and increase diversity within the research workforce.

研究及相关其他项目信息 项目摘要 此K23提案详细说明了一个全面的5年培训计划，该计划将支持候选人向 成为独立调查员。候选人（Tony V Pham博士）是第一代大学生， 在医学精神病学家中代表性不足，将把他的职业生涯集中在发展和严格测试身心方面 更好地为得不到充分服务的慢性病患者提供相关的干预措施。在本申请中， 候选人建议通过文化方式解决老年黑人社区的慢性疼痛-抑郁共病问题 正念认知疗法（MBCT）在老年黑人中，慢性疼痛与抑郁症并存， 这种共病损害了身体和情感功能;然而，黑人面临着多种障碍，以证据为基础， 非药物性疼痛和抑郁管理，包括系统性种族主义，耻辱，以及缺乏文化 定制护理。文化定制的MBCT可能是一个有效和高效的解决方案，以改善身体和情感 在这一未得到充分服务的人群中取得的成果。这K23将开发安静的焦点，MBCT的文化适应， 患有慢性肌肉骨骼疼痛和抑郁症的老年黑人。我和他们的初步谈话 社区对安静的焦点表现出强烈的兴趣，支持MBCT与社区的相关性，并对 只有当干预是简短的，并由来自黑人社区的外行教练提供时，才能参与。在Aim中 1，我将开发安静的重点使用指导，从老年黑人社区与慢性疼痛和共同发生 萧条安静焦点的起点将是一个简短的，基于证据的MBCT协议（8 60分钟 由共同导师Shallcross开发。我将在共同导师Joo的指导下培训非专业导师， 在主要导师弗兰恰努和共同导师肖尔克罗斯的指导下制定忠诚协议。在目标2中，我将 培训一名黑人平信徒，以提供安静的焦点，并评估初步的可行性和保真度。在目标3中，我将训练一个 一个新的黑色奠定个人提供安静的重点和另一个提供时间和剂量匹配的控制。然后我将 进行安静焦点和控制的可行性RCT，并评估包括保真度在内的明确可行性基准。 这些拟议的努力将通过R 01机制（主要结局是身体功能）为疗效试验提供信息， 以及旨在将这项工作推广到其他代表性不足群体的未来研究。这些研究目标得到支持。 通过3个主要培训目标，旨在发展以下方面的专门知识：（1）社区参与干预发展，（2）混合 方法研究干预措施的完善，和（3）社区参与的临床试验。这些培训目标是 由（1）专家导师（Vranceanu，杰克逊，Joo和Shallcross），顾问（Mischoulon，帕克， Okereke），和一个社区咨询委员会（Jacqueline欣顿，Michael Kincade），（2）丰富的制度环境， （3）有针对性的材料和会议。在过去的一年里，我通过正式的方式为该提案建立了基础设施 与黑人社区领导人和患有慢性疼痛和并发症的老年黑人群体举行非正式会议 萧条这K23建议是符合NCCIH的资金优先事项，以推动如何互补和综合 健康可以改善疼痛结果，解决整个人的问题，并增加研究人员的多样性。