Developing a nonpharmacological pain intervention for community dwelling older adults with dementia

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Candidate: I am an Assistant Research Professor in the Department of Physical Therapy and Rehabilitation Sciences at Drexel University. My long-term career goal is to establish a funded research program as an independent clinician-scientist working to develop evidence-based, pragmatic nonpharmacological programs to manage chronic pain in community-dwelling older adults with Alzheimer’s disease and Alzheimer’s-related dementias (AD/ADRD). To accomplish this goal, I will develop new knowledge and skills in: intervention development; mixed methodologies for intervention development, testing, and refinement; clinical trials using pragmatic and hybrid testing designs; grantsmanship; and research leadership. I will complete the following training objectives: 1) Build expertise in biopsychosocial environmental factors associated with comorbid chronic pain and AD/ADRD; 2) Develop skills in using different qualitative and quantitative methodologies for mapping and developing behavioral interventions that will promote engagement and use of tailored exercise programs by community-dwelling older adults with AD/ADRD; and 3) Gain and apply strategies for developing nonpharmacological pain interventions that have the potential to accelerate the translation of evidence into standard care. Mentoring Team: Joke Bradt, PhD (co-primary), Laura Gitlin, PhD, (co-primary), Peter Gliebus, MD (co-mentor), and Julie Fritz, PT, PhD (co-mentor). Dr. Bradt is a music therapist, Professor and Program Director of the Creative Arts Therapies Program and an expert in chronic pain management and mixed methods research. Dr. Gitlin is Dean and Distinguished University Professor of the College of Nursing and Health Professions and an expert in implementation science and the development of behavioral interventions tailored to the needs of community-dwelling older adults with AD/ADRD and their caregivers. Dr. Gleibus is a neurologist, Associate Professor at Drexel University College of Medicine, Chair of the Department of Neurology, and Director of the Global Neuroscience Institute, with expertise in the interdisciplinary clinical management of AD/ADRD. Dr. Fritz is a physical therapist, Associate Dean for Research and Distinguished Professor at the University of Utah with expertise in developing and implementing exercise-based interventions to manage chronic pain. The mentoring team will guide career development activities, give input, and participate in the K23 research. Research Strategy: The goal of the K23 project is to develop a tailored exercise program prototype to manage knee osteoarthritis pain in community-dwelling older adults with AD/ADRD that is feasible and accepted by key stakeholders. Aim 1: Identify delivery characteristics and design a prototype for a tailored exercise program that is informed in design by the 3-Step Tailored Approach. Aim 2: Assess the feasibility of delivering the tailored exercise program. Aim 3: Evaluate stakeholders’ perceived barriers and facilitators of the tailored exercise program. The proposed study uses an exploratory sequential design and aligns with NIA intervention development Stage I. The study will yield a prototype for a tailored exercise-based intervention program that has been refined for feasibility and acceptability among stakeholders.