Research Project-Pain: Culturally Adapted Cognitive Behavioral Based Physical Therapy for Latinos with Chronic Spine Pain

研究项目-疼痛-项目摘要 脊柱疼痛是工作场所最常见的肌肉骨骼疾病之一，患病率很高 在少数种族/族裔中，估计每年生产力下降的成本高达1000亿美元， 失去的工资。脊柱疼痛也降低了受影响的个人及其家庭的生活质量。西班牙裔/拉丁美洲 报告与工作相关的肌肉骨骼疼痛比白种人更频繁和严重，但大多数 现有的慢性脊柱疼痛的干预措施已经在主要是高加索人中开发和测试， 人口。与人类健康部国家疼痛战略相一致，我们的长期目标是 为慢性脊柱炎患者制定可获得的、有效的和文化上知情的管理策略 疼痛，以减少疼痛预防和管理的差异。本申请提出了一种多站点 随机对照临床试验（RCT），以评估6周的可行性，可接受性和有效性 认知行为为基础的物理治疗（CBPT）远程康复干预西班牙裔/拉丁美洲人， 来自医疗服务不足的城市和农村社区的慢性脊柱疼痛。在第一阶段，我们将 形成性研究与焦点小组，以适应CBPT干预，已被证明有效的优化 腰椎手术后的康复结果与慢性脊柱疼痛的保守治疗 西班牙裔/拉丁裔。在II期，我们将进行多中心随机对照试验，以评估适应性CBPT的疗效 远程康复计划相比，在西班牙裔/拉丁美洲人从城市和农村社区的常规护理。我们 还将使用生态瞬时评估和可穿戴传感器技术来探索心理， 行为和环境预测因子以及治疗反应的介导因子。总之，这些目标将 为今后研究的设计提供信息，以确定传播和执行《联合国千年发展目标》的最佳做法， CBPT远程康复干预西班牙裔/拉丁裔慢性脊柱疼痛的最终目标 减少疼痛管理中的健康差异。

RESEARCH PROJECT-PAIN – Project Summary Spine pain is among the most common musculoskeletal complaints in the workplace, with a high prevalence among racial/ethnic minorities and an estimated annual cost of up to $100 billion in reduced productivity and lost wages. Spine pain also reduces quality of life for affected individuals and their families. Hispanics/Latinos report more frequent and severe episodes of work-related musculoskeletal pain than Caucasians, yet most existing interventions for chronic spine pain have been developed and tested in predominantly Caucasian populations. Consistent with the Department of Human Health National Pain Strategy, our long-term goal is to develop accessible, effective, and culturally informed management strategies for individuals with chronic spine pain to reduce disparities in pain prevention and management. The current application proposes a multi-site randomized controlled clinical trial (RCT) to assess the feasibility, acceptability, and efficacy of a 6-week cognitive-behavioral-based physical therapy (CBPT) tele-rehabilitation intervention for Hispanics/Latinos with chronic spine pain from medically underserved urban and rural communities. In Phase I, we will conduct formative research with focus groups to adapt a CBPT intervention that has proven effective for optimizing rehabilitation outcomes after lumbar spine surgery to the conservative management of chronic spine pain in Hispanics/Latinos. In Phase II, we will conduct a multi-site RCT to assess the efficacy of the adapted CBPT tele-rehabilitation program compared to usual care in Hispanics/Latinos from urban and rural communities. We also will use ecological momentary assessment and wearable sensor technologies to explore psychological, behavioral, and environmental predictors and mediators of treatment response. Together, these aims will inform the design of future studies to determine best practices for dissemination and implementation of the CBPT tele-rehabilitation intervention among Hispanics/Latinos with chronic spine pain with the ultimate goal of reducing health disparities in pain management.