HSR&D Research Career Scientist Award

高铁

• 批准号: 10698477
• 负责人: Marianne Matthias
• 金额: --
• 依托单位: RLR VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-10-01 至 2028-09-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10698477
• 关键词: Academy; Address; Adherence; Affect; American; Anxiety; Area; Award; Black race; COVID-19 impact; Caring; Categories; Chronic low back pain; Clinic Visits; Clinical; Clinical Sciences; Clinical Trials; Communication; Compassion; Complementary therapies; Conceptions; Conflict (Psychology); Counseling; Data; Decision Making; European; Evolution; Follow-Up Studies; Fostering; Funding; Goals; Health; Health Services; Healthcare; Homogeneously Staining Region; Hybrids; Integrative Therapy; Internal Medicine; International; Intervention; Intervention Studies; Interview; Journals; K-Series Research Career Programs; Learning; Light; Medicine; Mental Depression; Methods; New South Wales; New Zealand; Observational Study; Office Management; Opioid; Outcome; Pain; Pain management; Participant; Patient Education; Patient-Centered Care; Patients; Peer Review; Personal Satisfaction; Physicians; Play; Policies; Positioning Attribute; Postdoctoral Fellow; Provider; Public Health; Publications; Publishing; Quality of life; Recommendation; Research; Research Personnel; Role; Safety; Sampling; Scholarship; Scientist; Self Efficacy; Self Management; Services; Shapes; Site; Social support; Societies; System; Testing; Time; Trust; Uncertainty; United States National Institutes of Health; Veterans; Work; career; chronic pain; chronic pain management; college; coping; design; effective intervention; effectiveness/implementation study; evidence base; experience; health care disparity; health communication; health equity; improved; indexing; insight; multi-site trial; multimodality; novel; novel strategies; opioid tapering; pain self-management; patient engagement; patient-clinician communication; patient-level barriers; peer support; prescription monitoring program; programs; racial disparity; randomized trial; self-management program; shared decision making; telehealth; therapy design; tool

My research focuses on understanding and improving chronic pain management for Veterans by leveraging my expertise in health communication, patient engagement, and relationship-centered care. Over the past 14 years, my work has developed from observational to interventional, steadily increasing the impact of my scholarship on Veterans’ care. My research has helped to advance our understanding of how communication shapes healthcare experiences and Veterans’ pain management. Early observational work led to insights into the role of the patient-provider relationship and social support in pain self-management, treatment decision- making, and opioid management, including opioid tapering. I have successfully built upon these findings with each new project, which has led to the design and testing of interventions to improve pain management for Veterans. These interventions have included developing and testing a peer-supported pain self-management program, a coaching program designed to increase patient activation for Black Veterans with chronic pain to help address racialized disparities in pain management, and a shared decision-making intervention to overcome patient-level barriers to use of and adherence to evidence-based nonpharmacologic pain treatments. Beyond developing and testing interventions, I am also moving toward implementation in an effort to broaden my impact and improve care for Veterans. My health equity study, COOPERATE, significantly increased patient activation and communication self-efficacy, while producing other positive outcomes for Black Veterans. In light of these positive results I will be exploring avenues for implementation through our operational partners as well as likely submitting a proposal for a Hybrid Type 2 multi-site effectiveness/implementation study, to further test COOPERATE and prepare for system-wide implementation. COOPERATE represents an important path to achieving health equity for Black Veterans with chronic pain and as such, also represents the increasing impact of my research. My newly-funded study, OPTIONS, also has direct relevance for Veteran care and impact. OPTIONS reflects VA’s priorities of reducing reliance on opioids and increasing use of multimodal care, including evidence-based complementary and integrative therapies and other nonpharmacologic approaches to chronic pain. As such, I have partnered with the VA National Pain Management, Opioid Safety, and Prescription Drug Monitoring Program Office and the Office of Patient- Centered Care and Cultural Transformation, and, assuming positive results, these partnerships will help increase the project’s impact by facilitating VA-wide dissemination and, ultimately, implementation. These examples reflect the evolution of my work from early observational studies to intervention studies, which will ultimately lead to system-wide implementation and greater impact on Veterans’ pain care. The other study I am currently leading as co-PI, CIPHER, is focused on understanding effects of COVID-19-related disruptions in pain care on Veterans with chronic low-back pain, with particular emphasis on disruptions to nonpharmacologic care, which can be more difficult to deliver via telehealth. Using a mixed-methods design with VA administrative data and qualitative interviews with clinicians and Veterans purposefully sampled from the administrative data, we are partnering with the VA National Pain Management Office to understand changes in care and, ultimately, apply these lessons to improving pain care for Veterans.

我的研究重点是通过利用 我在健康沟通、患者参与和以关系为中心的护理方面的专业知识。过去14年 多年来，我的工作已经从观察性发展到干预性，稳步提高了我的影响力 退伍军人护理奖学金。我的研究有助于加深我们对沟通方式的理解 塑造医疗保健体验和退伍军人的疼痛管理。早期的观察工作使人们深入了解 医患关系和社会支持在疼痛自我管理、治疗决策中的作用 制造和阿片类药物管理，包括阿片类药物逐渐减少。我已经成功地建立在这些发现的基础上 每个新项目都导致了干预措施的设计和测试，以改善疼痛管理 退伍军人。这些干预措施包括开发和测试同伴支持的疼痛自我管理 计划，一项旨在提高患有慢性疼痛的黑人退伍军人的患者积极性的辅导计划 帮助解决疼痛管理方面的种族差异，以及共同的决策干预 克服患者使用和坚持基于证据的非药物疼痛的障碍 治疗。除了开发和测试干预措施之外，我还致力于实施 扩大我的影响并改善对退伍军人的护理。我的健康公平研究，合作，显着 提高患者的积极性和沟通自我效能，同时为患者带来其他积极成果 黑人退伍军人。鉴于这些积极成果，我将探索通过我们的实施途径 运营合作伙伴以及可能提交混合 2 类多站点提案 有效性/实施研究，以进一步测试合作并为全系统实施做好准备。 合作是为患有慢性疼痛和慢性疼痛的黑人退伍军人实现健康公平的重要途径 因此，也代表了我的研究的影响力越来越大。我新资助的研究 OPTIONS 也有 与退伍军人护理和影响直接相关。选项反映了 VA 减少对阿片类药物依赖的优先事项 以及更多地使用多模式护理，包括基于证据的补充和综合疗法 其他治疗慢性疼痛的非药物方法。因此，我与 VA National Pain 合作 管理、阿片类药物安全和处方药监测项目办公室和患者办公室 集中护理和文化转型，假设取得积极成果，这些伙伴关系将有助于 通过促进 VA 范围内的传播并最终实施来增加项目的影响力。这些 例子反映了我的工作从早期观察研究到干预研究的演变，这将 最终导致全系统的实施并对退伍军人的疼痛护理产生更大的影响。我是另一个研究 CIPHER 目前作为联合 PI 领导，专注于了解与 COVID-19 相关的干扰的影响 对患有慢性腰痛的退伍军人进行疼痛护理，特别强调非药物干扰 通过远程医疗提供护理可能更困难。使用 VA 混合方法设计 行政数据和对临床医生和退伍军人有目的地抽样的定性访谈 行政数据，我们正在与 VA 国家疼痛管理办公室合作，了解 护理，并最终应用这些经验教训来改善退伍军人的疼痛护理。