Feasibility of Remote-Delivery Interventions: Tai Chi and Wellness for PTSD and Pain in Veterans

远程干预的可行性：太极拳和针对退伍军人创伤后应激障碍和疼痛的健康

• 批准号: 10620214
• 负责人: Deanna L. Mori
• 金额: $ 19.94万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-10 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10620214
• 关键词: Address; Adherence; Aerobic; Affect; Aftercare; Boston; COVID-19; COVID-19 pandemic; Cardiovascular system; Caring; Chinese; Chronic; Clinical Trials; Data; Development; Diagnosis; Disease; Ensure; Exercise; Feasibility Studies; Feedback; Future; Goals; Health; Health Services Accessibility; Health care facility; Healthcare Systems; Home; Integrative Therapy; Intervention; Interview; Life; Measures; Memory; Mental Health; Mental disorders; Military Personnel; Mind-Body Intervention; Minority Participation; Muscle; Outcome; Outcome Measure; Pain; Participant; Patients; Perception; Phase; Physical Function; Population; Post-Traumatic Stress Disorders; Procedures; Protocols documentation; Public Health; Quality of life; Randomized; Reporting; Research; Severities; Social Distance; Standardization; Symptoms; Tai Ji; Trauma; Travel; Treatment Protocols; United States Department of Veterans Affairs; Veterans; Veterans Health Administration; Videoconferencing; Well in self; Woman; acceptability and feasibility; barrier to care; care seeking; chronic musculoskeletal pain; chronic pain; cohort; conditioning; cost; design; disability; effective therapy; efficacy evaluation; eligible participant; feasibility trial; flexibility; follow up assessment; follow-up; global health; improved; improved outcome; intervention delivery; military veteran; mind/body; novel; participant retention; physical conditioning; post intervention; psychosocial; randomized trial; randomized, controlled study; recruit; remote delivery; satisfaction; standardize measure; study population; success; symptom management; videoconference

Project Summary Posttraumatic stress disorder (PTSD) affects almost one quarter of military Veterans seeking care from Veterans Administration healthcare facilities. PTSD is associated with many health-related issues, especially chronic musculoskeletal pain, and is increasingly considered a systemic disorder, affecting both mind and body. Accessible treatments that address PTSD and chronic pain are urgently needed. Tai Chi is an ancient Chinese exercise that uses an integrated mind-body approach to enhance quality of life. Tai Chi delivered in groups has been shown to improve both mental health and physical health in patients with a variety of chronic conditions. However, no studies to date have examined Tai Chi for PTSD and pain in Veterans. Since the onset of COVID-19, interventions that can be delivered without the need for face-to-face contact are greatly needed. Remote mind-body interventions delivered via videoconferencing platforms can reduce barriers to treatment for Veterans isolated by PTSD-related avoidance, travel related challenges, or public health social distancing restrictions. The proposed study will evaluate the feasibility of remotely delivered Tai Chi for PTSD and pain in Veterans. This trial represents first steps toward a long-term goal of establishing this mind-body treatment to address these maladies for Veterans via a remote videoconferencing platform. In Phase One, the research team will adapt and do a ‘dry run’ of two existing 12-week, twice per week interventions (Tai Chi and a Wellness control) for delivery via videoconferencing for the study population. In Phase One, the team will recruit 12 participants (6 in each group) and utilize quantitative and qualitative feedback to refine and standardize the interventions. In Phase Two, 36 participants will be randomly assigned over 3 cohorts (n = 12 for each cohort, n = 6 for each group) to either a Tai Chi or a Wellness group for 12 weeks with a three-month post-treatment follow up assessment. The feasibility and acceptability of a remotely delivered randomized trial of these two interventions and the assessment protocols will be determined. Feasibility will be quantified using rates of participant eligibility, recruitment, attrition, and adherence to the treatment and assessment protocols. Feasibility will be indicated (1) by the ability to meet recruitment goals, including women and minority participation, and (2) by having at least 75% of participants regularly attend sessions and engage in home practice and 70% complete post-intervention and follow-up assessments. Acceptability will be assessed via participants’ ratings on a standardized measure of treatment satisfaction, supplemented by qualitative exit interviews. Acceptability will be indicated by 70% of the participants reporting treatment satisfaction and credibility. Information from this trial will be utilized to design a large randomized control study evaluating the efficacy of Tai Chi for improving outcomes for Veterans with PTSD and chronic musculoskeletal pain. The proposed study will be pivotal to establish procedures to fully evaluate a novel, accessible, nonpharmacologic approach for symptom management of PTSD and chronic pain in a future large-scale trial of Tai Chi.

项目摘要 创伤后应激障碍(PTSD)影响着近四分之一寻求治疗的退伍军人 退伍军人管理局医疗设施。创伤后应激障碍与许多与健康有关的问题有关，尤其是 慢性肌肉骨骼疼痛，越来越多地被认为是一种系统性疾病，影响精神和 尸体。迫切需要针对创伤后应激障碍和慢性疼痛的可获得的治疗。太极是一项古老的运动 中国人的运动，使用身心一体化的方法来提高生活质量。太极拳送到 已有研究表明，小组治疗可以改善各种慢性精神疾病患者的心理健康和身体健康 条件。然而，到目前为止，还没有研究过太极对退伍军人的创伤后应激障碍和疼痛的影响。自.以来 新冠肺炎的发病，不需要面对面接触就能提供的干预措施大大 需要的。通过视频会议平台提供的远程心身干预可以减少 对因创伤后应激障碍相关回避、旅行相关挑战或公共卫生社会隔离的退伍军人的治疗 距离限制。拟议的研究将评估远程太极治疗创伤后应激障碍的可行性 以及退伍军人的痛苦。这项试验是朝着建立这种心身的长期目标迈出的第一步。 通过远程视频会议平台为退伍军人解决这些疾病的治疗。在第一阶段， 研究团队将对现有的两项为期12周、每周两次的干预措施(太极拳和 健康控制)，通过视频会议为研究人群提供。在第一阶段，团队将 招募12名参与者(每组6名)，并利用定量和定性反馈来细化和 规范干预措施。在第二阶段，36名参与者将被随机分配到3个队列中(n=12 对于每个队列，每组n=6)到太极拳或健康组，为期12周，为期3个月 治疗后随访评估。远程随机试验的可行性和可接受性 将确定这两种干预措施中的哪一种以及评估方案。可行性将被量化，使用 参与者资格、招募、自然减员以及遵守治疗和评估方案的比率。 可行性将通过(1)实现包括妇女和少数族裔在内的招聘目标的能力来确定 参与，以及(2)至少75%的参与者定期参加会议并参与家庭活动 70%的人完成了干预后和后续评估。可接受性将通过以下方式评估 参与者对治疗满意度的标准化衡量标准的评分，并辅之以定性退出 采访。70%的参与者报告治疗满意并表示可接受 可信度。这项试验的信息将被用来设计一项大型随机对照研究，评估 太极对改善患有创伤后应激障碍和慢性肌肉骨骼疼痛的退伍军人的疗效。这个 拟议的研究将是建立完全评估一种新的、可获得的、非药理学的程序的关键 未来大规模太极试验中创伤后应激障碍和慢性疼痛的症状处理方法。