Transition from Acute to Chronic Pain After Thoracic Surgery

胸外科手术后从急性疼痛转变为慢性疼痛

• 批准号: 10614222
• 负责人: Chad M Brummett
• 金额: $ 58.04万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-01 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10614222
• 关键词: Acute; Acute Pain; Address; Administrative Supplement; Anesthesiology; Area; Behavioral; Biological Markers; Black race; Blood; Brain imaging; Caring; Characteristics; Chronic; Chronic low back pain; Cities; Clinic; Clinical; Clinical Research; Clinical Trials; Cohort Studies; Collaborations; Color; Communication; Communities; Community Health Aides; Counseling; Data; Development; Education; Education and Outreach; Employee; Enrollment; Ensure; Ethnic Origin; Ethnic group; Failure; Fatigue; Feedback; Foundations; Funding; Future; Gender; Genetic; Goals; Grouping; Health Care Research; Health Services Accessibility; Health system; Hispanic; Hospitals; Human Resources; Individual; Infrastructure; Intervention; Knowledge; Lead; Medical; Michigan; Modeling; Moods; Operative Surgical Procedures; Outcome Measure; Pain; Pain Research; Parents; Participant; Patient Outcomes Assessments; Patient Recruitments; Patients; Persons; Phase; Physicians; Population Heterogeneity; Postoperative Pain; Practice based research; Precision medicine trial; Prevention; Preventive therapy; Process; Provider; Questionnaires; Race; Recruitment Activity; Research; Research Personnel; Research Training; Resources; Risk; Role; Rural; Sampling Studies; Sensory; Sequential Multiple Assignment Randomized Trial; Site; Structure; Techniques; Testing; Thoracic Surgical Procedures; Time; Training; Trust; Underrepresented Minority; Underrepresented Populations; United States National Institutes of Health; Universities; Visit; Work; base; biosignature; chronic pain; clinical center; clinical pain; cohort; community based participatory research; community based research; community engagement; design; diversity and equity; ethnic diversity; ethnic minority; experience; explicit bias; health equity; health inequalities; high throughput screening; hispanic community; implicit bias; improved; knee replacement arthroplasty; meetings; minority patient; neuroimaging; outreach; pain chronification; patient population; people of color; predictive marker; prevent; process evaluation; programs; prospective; racial and ethnic; racial diversity; racial minority; recruit; resilience; study population; transmission process; unconscious bias; urban area

Project Summary/Abstract Increasing the racial/ethnic diversity of participants in clinical pain research and including diverse partners in the design and conduct of research are intertwined goals that are essential to increasing the acceptability, feasibility, rigor, and relevance of pain research. This proposed administrative supplement to the parent Multisite Clinical Center (MCC) for the Acute to Chronic Pain Signatures Program (A2CPS) at the University of Michigan will support a robust effort to enhance patient and other community engagement, particularly that of underrepresented minorities, and to implement a sustained outreach effort to under-resourced Black and Hispanic communities in and around Detroit, Michigan. The goal of the A2CPS consortium is to develop biological markers and groupings of patient characteristics that predict the development of chronic pain after surgery, as well as well as resilience to chronic pain development. The biological markers to be studied include patient questionnaires (e.g., pain, mood, function), brain imaging, experimental pain testing, and blood markers (e.g., genetics). The study assesses patients before surgery and through one year after total knee replacement or thoracic surgery. Supplement Aim 1 is to hire a full-time Community Research Facilitator (CRF) who will conduct outreach in the Detroit areas and affiliated groups within the Henry Ford Health System and Wayne State University. The CRF will have experience as a community health worker or similar role; that is, they will possess deep knowledge of local resources and support a sustainable partnership between researchers and diverse communities. The CRF will lead outreach efforts in predominantly Black and Hispanic communities in the Detroit area to boost study recruitment efforts and increase cohort diversity; facilitate bidirectional communication and knowledge transmission between the study team and community partners; and help enrolled participants navigate the challenges of participating in clinical research, thereby enhancing retention. Supplement Aim 2 is to partner with an existing Community Advisory Board, which includes people living with pain who are diverse in terms of race/ethnicity, age, gender, and rural/urban location; as well as other advisors including providers, clinicians, and pain researchers. This group will review study materials and processes and give feedback on changes needed to enhance recruitment and retention of underrepresented populations. Supplement Aim 3 will increase the research staff within the Henry Ford Detroit research and Wayne State University teams to better staff the surgery clinics with more diverse patients and facilitate navigation of and comfort with the in-person study visits. Finally, Supplement Aim 4 will support all research staff with direct patient contact at our MCC to do the Faster Together training from Coursera focused on unconscious bias and training in recruitment of underrepresented minority cohorts. The additional infrastructure afforded by this supplement will facilitate getting input from diverse patients for new studies as they are being planned, recruiting more diverse populations into ongoing studies, and disseminating findings to communities.

项目总结/摘要 增加临床疼痛研究参与者的种族/民族多样性， 研究的设计和实施是相互交织的目标，对提高可接受性至关重要， 疼痛研究的可行性、严谨性和相关性。这一建议的行政补充，以家长 多中心临床中心（MCC）的急性到慢性疼痛签名程序（A2 CPS）在大学 密歇根州将支持一项强有力的努力，以加强病人和其他社区的参与，特别是 代表性不足的少数民族，并对资源不足的黑人和 密歇根州底特律及其周边地区的西班牙裔社区。A2 CPS联盟的目标是开发 生物学标记物和患者特征分组，其预测术后慢性疼痛的发展。 手术，以及对慢性疼痛发展的适应力。待研究的生物标志物包括 患者问卷（例如，疼痛、情绪、功能）、脑成像、实验性疼痛测试和血液标记物 (e.g.,遗传学）。这项研究评估了手术前和全膝关节置换术后一年的患者 或者胸外科手术补充目标1是聘请一名全职社区研究促进者（CRF）， 在底特律地区和亨利福特卫生系统和韦恩的附属团体开展外联活动 州立大学。CRF将具有社区卫生工作者或类似角色的经验;即，他们将 拥有对当地资源的深入了解，并支持研究人员之间的可持续伙伴关系， 多样化的社区。CRF将在2010年在主要是黑人和西班牙裔社区领导外联工作。 底特律地区，以促进研究招聘工作和增加队列的多样性;促进双向 研究团队与社区合作伙伴之间的沟通和知识传递;以及帮助 登记的参与者应对参与临床研究的挑战，从而提高保留率。 补充目标2是与现有的社区咨询委员会合作，该委员会包括患有艾滋病的人。 在种族/民族、年龄、性别和农村/城市位置方面存在差异的疼痛患者;以及其他顾问 包括提供者、临床医生和疼痛研究人员。该小组将审查学习材料和过程， 就加强征聘和留住任职人数不足的人员所需的变革提供反馈意见。 补充目标3将增加研究人员在亨利福特底特律研究和韦恩国家 大学团队，以更好地工作人员的外科诊所与更多样化的病人，并促进导航和 对亲自研究访视感到舒适。最后，补充目标4将支持所有研究人员， 我们MCC的患者联系人参加了Coursera的Faster Together培训，重点是无意识偏见， 为征聘代表性不足的少数群体提供培训。由此提供的额外基础设施 补充将有助于从不同的患者那里获得新研究的投入， 招募更多不同的人群参与正在进行的研究，并向社区传播研究结果。