Taking Community Action Against Pain

描述（由申请人提供）：拟议的项目，题为采取社区行动对抗疼痛，解决了老年人的慢性疼痛（CP）问题，这是一种非常普遍，病态和昂贵的疾病，与这个年龄组的痛苦负担有关。以自我管理计划为形式的CP循证治疗已被开发用于社区，并已证明有效，但尚未广泛传播。许多障碍可能存在于个人，程序和文化层面，对程序翻译工作产生负面影响，需要进行表征。制定克服障碍的战略对于提高方案覆盖面和方案效益都是必要的。使用基于社区的参与性研究（CBPR），本申请旨在回答以下科学问题：1）CP老年人采用和遵守疼痛减轻协议的主要障碍是什么？2)如何使用CBPR调整循证疼痛协议，以更好地满足三个不同种族/民族群体（包括非洲裔美国人、西班牙裔美国人和非西班牙裔白色美国人）的老年人的需求？和3）使用基于CBPR的程序与传统CP程序对疼痛协议的有效性有什么影响？为解决上述问题，提出了以下目标：1）扩大和维持现有的社区-研究者伙伴关系，2）获取当地知识和资源，以设计最佳的方案实施和可能的适应方法，3）综合这些活动的结果，为我们的高级中心合作伙伴产生疼痛方案，4）试点测试新的方案，和5）将CBPR程序结果与通过常规疼痛程序产生的结果进行比较，即，“日常护理”，以及6）传播项目调查结果和相关产品。该项目的预期产品包括：1）用于后续R 01应用的试点数据; 2）由于访问我们社区合作伙伴的集体资源和知识，预计将出现新的计划; 3）关于使用CBPR与“常规护理”对疼痛干预计划有效性的影响的知识; 4）出版适合广泛从业者的学术文章和报告。该项目将在位于整个纽约市的文化多样的老年中心进行，这是适当的，因为目前有1000万老年人（其中高达50%患有CP）使用美国15，000多个老年中心提供的服务。 该项目旨在改善因关节炎和/或关节炎相关疾病而患有慢性疼痛的老年人的健康和福祉。该项目将开发和测试具有文化敏感性的疼痛管理方案，供属于以下3个种族/民族群体之一的65岁及以上成年人在社区使用：非洲裔美国人、西班牙裔美国人和非西班牙裔白色美国人。为了确保这些项目的文化相关性，研究人员建议与不同的社区团体合作，包括患有慢性疼痛的老年人以及最终将举办这些项目的中心的工作人员（例如，高级中心）。

DESCRIPTION (provided by applicant): The proposed project, entitled Taking Community Action Against Pain, addresses the problem of chronic pain (CP) in older persons, which is a highly prevalent, morbid, and costly disorder that is associated with a substantial burden of suffering in this age group. Evidence-based treatments for CP in the form of self- management programs have been developed for use in the community and have demonstrated efficacy, but have not been widely disseminated. Numerous barriers likely exist at the individual, program, and cultural level that have a negative impact on program translation efforts and are in need of characterization. The development of strategies to overcome the barriers is necessary to improve both program reach and program benefits. Using community based participatory research (CBPR), this application seeks to answer the following scientific questions: 1) What are the major barriers to adoption of and adherence to a pain-reduction protocol by seniors with CP?; 2) How can an evidence-based pain protocol be adapted using CBPR to better meet the needs of seniors from three distinct race/ethnicity groups including African American, Hispanic American, and non-Hispanic White Americans?; and 3) What is the effect of using a CBPR-based program versus a conventional CP program on the effectiveness of the pain protocol? The following aims are proposed to address the above questions: 1) Expand and maintain existing community-researcher partnerships, 2) Access local knowledge and resources to design optimal methods for program implementation and possible adaptation; 3) Synthesize findings from these activities to generate pain programs for our senior center partners; 4) Pilot test the new programs; and 5) Compare CBPR program outcomes to those generated via the conventional pain program, i.e., `usual care', and 6) Disseminate project findings and related products. Anticipated products of this project include: 1) Pilot data for use in a subsequent R01 application; 2) New programs are anticipated to emerge as a result of accessing the collective resources and knowledge of our community partners; 3) Knowledge regarding the effects of using CBPR versus `usual care' on the effectiveness of a pain intervention program; and 4) Publication of scholarly articles and reports tailored to a wide range of practitioners. The project will take place in culturally diverse senior centers located throughout New York City, which is appropriate given that 10 million older adults (up to 50% of whom have CP) currently use services provided by over 15,000 senior centers in the U.S. The planned work has significant potential to reduce the substantial morbidity and suffering associated with CP among seniors. This project seeks to improve the health and well being of older adults with chronic pain due to arthritis and/or arthritis-related diseases. The project will develop and test culturally sensitive pain-management programs for use in the community by adults aged 65 and above who belong to one of 3 race/ethnicity groups: African Americans, Hispanic Americans, and non-Hispanic White Americans. To ensure cultural relevance of the programs, the investigators have proposed to partner with diverse community groups to include older adults with chronic pain as well as staff from centers that will ultimately host the programs (e.g., senior centers).