Group acupuncture for painful diabetic neuropathy among underserved patients

描述(由申请人提供)：K01指导研究科学家发展奖的目的是促进候选人作为补充和替代医学(CAM)的独立研究人员的发展，重点是在服务不足的人群中进行慢性病管理。赵博士的长期职业目标是在公共卫生和CAM之间架起桥梁，以改善患有糖尿病等慢性病、服务不足的人群的生活质量。为此，该K01奖的拟议指导研究旨在设计、实施和评估一种基于针刺组的干预措施，以改善服务不足的痛性糖尿病神经病变患者的生活质量。为了支持这项研究和赵博士的独立CAM研究目标，这项K01应用程序包括通过课程作业和量身定做的教程进行正式的指导培训，内容涉及临床研究方法、基于实践的针灸研究、糖尿病管理和服务不足人群的生活质量，以及负责任的研究行为。这项培训将用于有两个具体目标的研究：(1)通过正式的治疗手册，为疼痛的糖尿病神经病变制定标准化的针灸方案；(2)评估团体针灸在服务不足的患者中治疗疼痛的糖尿病神经病变的可接受性、可行性和初步疗效。加州大学旧金山分校是拟议培训的理想环境，因为它提供了在服务不足的人群中接触到CAM和糖尿病管理专家的机会，并与旧金山综合医院建立了密切的联系，旧金山综合医院是一家服务于低收入、种族多元化人口的城市安全网医院。拟议的研究和职业发展活动的完成将为R01应用的开发提供信息，并确保赵博士有能力对CAM疗法进行独立研究，以改善服务不足人群的生活质量。 公共卫生相关性：慢性疼痛在糖尿病患者中非常普遍，并对生活质量、日常功能和自我管理疾病的能力产生负面影响。鉴于治疗疼痛的标准药物治疗的局限性，迫切需要其他有效的疼痛管理方法来提高生活质量，特别是在患糖尿病风险最高且疼痛治疗不足的脆弱人群中。如果建议的目标得以实现，团体针灸可能为改善服务不足的糖尿病人群的生活质量提供一种可行的模式，可以在安全网医院和其他环境中实施。

DESCRIPTION (provided by applicant): The purpose of this K01 Mentored Research Scientist Development Award is to promote the candidate's development as an independent researcher in complementary and alternative medicine (CAM) with a focus on chronic disease management among underserved populations. Dr. Chao's long-term career goal is to bridge public health and CAM to improve quality of life among underserved populations living with chronic conditions, such as diabetes. Towards this end, the proposed mentored research for this K01 award is to design, implement, and evaluate an acupuncture group-based intervention to improve quality of life among underserved patients with painful diabetic neuropathy. To support this research and Dr. Chao's goal of independent CAM research, this K01 application includes formal, mentored training through coursework and tailored tutorials in clinical research methodologies, practice-based acupuncture research, diabetes management and quality of life among underserved populations, and responsible conduct of research. This training will be applied to research with two Specific Aims: (1) to develop a standardized acupuncture protocol for painful diabetic neuropathy through formal treatment manualization; and (2) to evaluate acceptability, feasibility, and preliminary efficacy of group acupuncture for painful diabetic neuropathy among underserved patients. The University of California, San Francisco is an ideal environment for the proposed training because it provides access to experts in both CAM and diabetes management among underserved populations and close affiliation with San Francisco General Hospital, an urban safety net hospital serving a low-income, ethnically diverse population. Completion of the proposed research and career development activities will inform the development of an R01 application and ensure Dr. Chao's ability to conduct independent research on CAM therapies to improve quality of life among underserved populations. PUBLIC HEALTH RELEVANCE: Chronic pain is highly prevalent among people with diabetes and negatively impacts on quality of life, daily functioning, and ability to engage in self-management of disease. Given the limitations of standard pharmaceutical treatments for pain, alternative approaches to effective pain management are critically needed to improve quality of life, especially among vulnerable populations who are most at risk of suffering from diabetes and undertreated for pain. If the proposed aims are achieved, group acupuncture may provide a viable model for improving quality of life among underserved diabetes populations that can be implemented in safety net hospitals and other settings.