Research Project-Pain: Culturally Adapted Cognitive Behavioral Based Physical Therapy for Latinos with Chronic Spine Pain

研究项目-Pain-项目摘要 脊椎疼痛是工作场所最常见的肌肉骨骼疾病之一，发病率很高。 并估计每年因生产力下降而造成的损失高达1000亿美元，以及 失去了工资。脊椎疼痛还会降低受影响个人及其家人的生活质量。拉美裔/拉丁裔 报告说，与工作相关的肌肉骨骼疼痛比高加索人更频繁和更严重，但大多数 现有的慢性脊柱疼痛干预措施已经开发出来，并在主要是高加索人中进行了测试 人口。与人类卫生部的国家疼痛战略一致，我们的长期目标是 为慢性脊椎病患者制定可访问、有效且了解文化的管理策略 减少疼痛预防和管理方面的差距。当前的应用程序提出了一个多站点 随机对照临床试验(RCT)评估为期6周的可行性、可接受性和有效性 基于认知-行为的理疗(CBPT)远程康复干预对西班牙裔/拉美裔美国人 来自医疗服务不足的城市和农村社区的慢性脊柱疼痛。在第一阶段，我们会进行 与焦点小组一起进行形成性研究，以适应已被证明对优化有效的CBPT干预 腰椎手术后对慢性脊柱疼痛保守治疗的康复效果 拉美裔/拉丁裔。在第二阶段，我们将进行多点随机对照试验，以评估调整后的CBPT的效果 远程康复计划与城市和农村社区拉美裔/拉丁裔的日常护理相比较。我们 还将利用生态瞬时评估和可穿戴传感器技术来探索心理， 治疗反应的行为、环境预测因子和中介物。这些目标加在一起，将 通报未来研究的设计，以确定传播和实施 对患有慢性脊柱疼痛的拉美裔/拉丁裔进行CBPT远程康复干预，最终目标是 减少疼痛管理方面的健康差距。

RESEARCH PROJECT-PAIN – Project Summary Spine pain is among the most common musculoskeletal complaints in the workplace, with a high prevalence among racial/ethnic minorities and an estimated annual cost of up to $100 billion in reduced productivity and lost wages. Spine pain also reduces quality of life for affected individuals and their families. Hispanics/Latinos report more frequent and severe episodes of work-related musculoskeletal pain than Caucasians, yet most existing interventions for chronic spine pain have been developed and tested in predominantly Caucasian populations. Consistent with the Department of Human Health National Pain Strategy, our long-term goal is to develop accessible, effective, and culturally informed management strategies for individuals with chronic spine pain to reduce disparities in pain prevention and management. The current application proposes a multi-site randomized controlled clinical trial (RCT) to assess the feasibility, acceptability, and efficacy of a 6-week cognitive-behavioral-based physical therapy (CBPT) tele-rehabilitation intervention for Hispanics/Latinos with chronic spine pain from medically underserved urban and rural communities. In Phase I, we will conduct formative research with focus groups to adapt a CBPT intervention that has proven effective for optimizing rehabilitation outcomes after lumbar spine surgery to the conservative management of chronic spine pain in Hispanics/Latinos. In Phase II, we will conduct a multi-site RCT to assess the efficacy of the adapted CBPT tele-rehabilitation program compared to usual care in Hispanics/Latinos from urban and rural communities. We also will use ecological momentary assessment and wearable sensor technologies to explore psychological, behavioral, and environmental predictors and mediators of treatment response. Together, these aims will inform the design of future studies to determine best practices for dissemination and implementation of the CBPT tele-rehabilitation intervention among Hispanics/Latinos with chronic spine pain with the ultimate goal of reducing health disparities in pain management.