ASSIST - Address Self-Management Strategies to Improve and Sustain T2D outcomes for adults with comorbid chronic pain and type 2 diabetes in the South

项目总结 农村社区多发性疾病的发生率很高，这导致了过度的 疾病的负担。这在阿巴拉契亚和密西西比三角洲的南部地区尤为突出 服务不足群体(例如，农村居民)比例较高的地区，以及潜在的社会群体(例如， 收入、教育、住房)和环境(例如，食物沙漠、绿地/安全空间、初级教育机会 保健服务)风险因素，这可能增加患慢性病的可能性，例如 糖尿病和其他健康状况。 慢性疼痛是一种持续或反复发作的疼痛，持续三个月以上，是 这对生活质量和福祉产生了负面影响，并造成了相当大的经济负担。这 疾病有复杂的病因，影响身体和情感功能，并有不同的治疗方法。 治疗和管理。大约3400万美国人患有糖尿病，大约50%-70%的人 患有糖尿病的美国成年人也患有慢性疼痛。糖尿病，一种代谢性疾病 以高血糖为特征，可能会对心脏、血管、眼睛造成严重损害， 肾脏和神经。慢性疼痛和2型糖尿病并存的特点是体力下降。 功能、生活质量下降和抑郁，这可能会增加心脏病、中风以及 加重其他危险因素，如高血压或高胆固醇。 充足的证据表明治疗和自我管理策略(例如，血糖监测、饮食、锻炼) 如果适当遵守推荐的指南，治疗糖尿病的药物是有效的。然而，管理慢性疼痛 糖尿病会削弱一个人从事推荐的糖尿病自我管理活动的能力 因为它通常会导致血糖水平升高。技术具有支持自我管理的潜力 战略和减少农村居民的健康差距，但仅限于为特定和独特的需求而设计 社区中的一员。因此，拟议的项目将检查心理因素、心理社会风险和 复原力因素与糖尿病和慢性疼痛共病的过早发病率和死亡率相关 南方农村，目标是改善2型糖尿病的结果(例如，血糖控制、生活质量和 预防或减少糖尿病并发症)。此外，我们还将研究它的效用和潜力 利用技术的力量(即可穿戴式活动监控器)进一步检查障碍和促进者 南方农村居民的自我管理策略和一般健康促进行为。

PROJECT SUMMARY Rural communities are laden with high rates of multiple syndemic health conditions, contributing to an excess burden of disease. This is particularly salient in the Southern regions of the Appalachia and Mississippi Delta regions, where there is a high proportion of underserved groups (e.g., rural dwellers), and underlying social (e.g., income, education, housing), and environmental (e.g., food deserts, green space/safe spaces, access to primary health care services) risk factors, which may increase the likelihood of developing chronic diseases, such as diabetes and other health conditions. Chronic pain, a persistent or recurring pain that lasts more than three months, is a common condition among U.S. adults that negatively impacts quality of life, wellbeing, and causes considerable economic burdens. This condition has a complex etiology, impacts physical and emotional function, and has a varied approach to treatment and management. Approximately 34 million Americans have diabetes, and approximately 50-70% of the U.S. adult population with diabetes also suffer from chronic pain. Diabetes, a metabolic disorder characterized by high levels of blood glucose, may cause serious damage to the heart, blood vessels, eyes, kidneys, and nerves. The co-occurrence of chronic pain and type 2 diabetes is marked by decreased physical function, lower quality of life, and depression, which may increase the onset of heart disease, stroke, as well as exacerbate other risk factors such as high blood pressure or high cholesterol. Ample evidence suggests treatment and self-management strategies (e.g., glucose monitoring, diet, exercise) for diabetes are effective with proper adherence to recommended guidelines. However, managing chronic pain and diabetes can undermine a person's ability to engage in recommended diabetes self-management activities as it often leads to elevated blood glucose levels. Technology has the potential to support self-management strategies and reduce health disparities for rural dwellers, but only if designed for the specific and unique needs of the community. Therefore, the proposed project will examine the psychological factors, psychosocial risk, and resilience factors associated with premature morbidity and mortality of comorbid diabetes and chronic pain in the rural South, with the goal of improving type 2 diabetes outcomes (e.g., glycemic control, quality of life, and preventing or reducing diabetes complications). Additionally, we will examine the utility and the potential leveraging power of technology (i.e., wearable activity monitors) to further examine barriers and facilitators to self-management strategies and general health promoting behaviors among rural dwellers in the South.