Feasibility of a dual English/Spanish mobile augmented reality pain assessment app to reduce postoperative prescription opioid use in Hispanic/Latino pediatric and adolescent cancer patients

项目摘要/母公司赠款摘要 西班牙裔/拉丁裔青年滥用处方阿片类药物治疗疼痛症状的风险最高 美国的少数民族人口。几乎没有合法的临床适应症来开阿片类药物到 儿童和青少年，因为早期使用阿片类药物是成年期依赖和物质的已知“门户” 虐待障碍。癌症和大手术是两种关键的医疗条件，当放在一起时，会导致 儿童和青少年从被诊断为幸存者到成年后经历巨大的痛苦 并使他们面临持续和慢性处方阿片类药物使用和依赖的更高风险。围手术期 环境，阿片类药物处方的临床决定依赖于疼痛强度的快速、口头沟通 临床工作人员、儿科患者和家庭成员之间的水平和不良事件 急诊护理环境。说西班牙语的西班牙裔/拉丁裔患者和/或英语水平有限的成年照顾者 熟练程度被迫依赖于机构翻译服务的可用性或双语的存在 临床工作人员，他们可能不容易找到或不容易使用。这些基础设施障碍在 低收入或中等收入医院，使这些患者面临更高的疼痛评估不准确的风险，两者都在 以及过度治疗他们的疼痛，以及接触不适当数量的处方阿片类药物。 我们的目标是减少西班牙裔/拉丁裔对疼痛和阿片类药物处方的不准确评估和治疗 接受大手术的癌症儿童和青少年使用快速、双语的英语/西班牙语， 适合年龄的、引人入胜的移动增强现实(AR)工具，可帮助他们及其家人 即时交流有关他们的急性疼痛和疼痛相关不良事件的信息 术后住院环境。为了实现这一目标，我们与母语为双语的西班牙语合作- 与MD Anderson癌症中心的儿科麻醉师和疼痛专家交谈，以开发 APP具有与西班牙裔和非西班牙裔儿科人口相关和吸引人的内容，并将 论证在第一阶段的术后麻醉护理病房实施APP的可行性 临床试验。据我们所知，目前还没有关于移动AR增强疼痛管理的研究 把重点放在这群人身上。由于大多数癌症儿童预计都能长期存活，因此 在这一高风险疼痛人群中预防不适当的处方阿片类药物使用将持续一生 孩子。

PROJECT SUMMARY/ABSTRACT OF PARENT GRANT Hispanic/Latino youth are at the highest risk for prescription opioid misuse for pain indications amongst all minority populations in the United States. There are few legitimate clinical indications for prescribing opioids to children and adolescents, as early opioid use is a known “gateway” to adulthood dependence and substance abuse disorders. Cancer and major surgery are two critical medical conditions that when put together, cause children and adolescents to experience significant pain from the time of diagnosis into adulthood as survivors and put them at higher risk for persistent and chronic prescription opioid use and dependency. In perioperative settings, clinical decisions on opioid prescribing are dependent on rapid, verbal communication of pain intensity levels and adverse events between the clinical staff, the pediatric patient, and most often, family members in the acute care setting. Spanish-speaking Hispanic/Latino patients and/or adult caregivers with limited English proficiency are forced to rely on the availability of institutional translation services or the presence of bilingual clinical staff, which may not be readily available or easy to use. These infrastructural barriers, exacerbated in low or middle-income hospitals, put these patients at higher risk of inaccurate pain assessments, both under and over-treatment of their pain, and exposure to inappropriate amounts of prescription opioids. Our goal is to reduce inaccurate assessment and treatment of pain and opioid prescribing in Hispanic/Latino children and adolescents with cancer undergoing major surgery with a rapid, dual English/Spanish-language, age-appropriate, engaging mobile augmented reality (AR) tool that can help them and their families to communicate information about their acute pain and pain-related adverse events in the immediate postoperative inpatient setting. To achieve this goal, we have collaborated with bilingual native Spanish- speaking pediatric anesthesiologists and pain specialists at the MD Anderson Cancer Center to develop the app with content relevant and engaging to Hispanic and non-Hispanic pediatric populations and will demonstrate the feasibility of implementing the app in the postoperative anesthesia care unit in a Phase I clinical trial. To our knowledge, there are no studies to investigate mobile AR for enhancing pain management focused on this population. As most children with cancer are expected to survive long-term, the benefits of preventing inappropriate prescription opioid use in this high-risk pain population will last over the lifetime of a child.