SBIR-STTR Award

Pain is the primary reason that people seek medical care. Unfortunately, under-treatment of pain is well- documented in cancer (Cohen et al, 2003; Deandrea et al., 2008) and other medical conditions (Boulanger et al., 2007; Hadjistavropoulos et al., 2006). While medication continues to be the first line of defense against pain, empirical support for the effectiveness of cognitive-behavioral pain management (CBPM) techniques continues to grow. Used alone or in conjunction with pharmacological treatment, CBPM techniques such as diaphragmatic breathing, progressive muscle relaxation, and guided imagery have been shown to significantly reduce both cancer- and non-cancer-related pain. Currently, however, a lack of cultural adaptation and provider training are barriers to the more wide-spread use of these treatments, especially in rural and tribal clinics that treat American Indians (AIs) and Alaska Natives (ANs). Research indicates that cultural appropriateness is important to the acceptability of cognitive behavioral interventions vis-a-vis minority patients. Therefore, this Fast-Track application proposes to create an internet-delivered, culturally- tailored multimedia training to teach empirically-supported CBPM techniques to providers serving rural communities and AI/ANs, so that these providers, in turn, can teach these techniques to their patients. The proposed product, PATINA (Pain Management Training in Native American Communities), is innovative in its web- and internet-based approach to training CBPM techniques, in its cultural specificity, and in its use of telehealth to conduct formative and evaluative research in rural hospital and tribal clinic settings. Primary customers will be rural healthcare providers and those treating AI/AN patients. Continuing education units will be awarded for completing the training. Combining the best features of books and classes, web-based training is low cost, convenient, and offers interactivity, feedback and practice opportunities.

Public Health Relevance:
Cognitive-behavioral pain management (CBPM) techniques are strongly endorsed by several national organizations as an important component of a comprehensive pain management approach. However, lack of access to provider training is a major barrier to their more wide-spread use, especially in rural areas and clinics that serve American Indians and Alaska Natives. This proposal seeks to improve public health by creating an internet-delivered, culturally-tailored multimedia training to teach CBPM techniques to providers serving rural areas and American Indians and Alaska Natives, so that these providers can teach these techniques to their patients.

Thesaurus Terms:
21+ Years Old; Active Follow-Up; Acute Pain; Address; Adult; Aged 65 And Over; Alaska; Alaska Indian; Alaska Native; Alaskan; Alaskan American; Alaskan Indian; Alaskan Native; American; American Indian; American Indian And Alaska Native; American Indians; Area; Articulation; Aspiration, Respiratory; Award; Behavior Therapy, Cognitive; Behavioral; Behavioral Therapy; Books; Breathing; Cancers; Caring; Chronic; Clinic; Cognitive; Cognitive Therapy; Communities; Community Hospitals; Competence; Continuance Of Education; Continuing Education; Data; Development And Research; Discipline Of Nursing; Drugs; Education, Continuing; Educational Process Of Instructing; Effectiveness; Elderly; Elderly, Over 65; Equipment; Evaluation; Exercise; Exercise, Physical; Feedback; Focus Groups; Frequencies (Time Pattern); Frequency; Guided Imagery; Health Care Providers; Health Personnel; Healthcare Providers; Healthcare Worker; Human, Adult; Imagery (Psychotherapy); Indians, American; Informatics; Inhalation; Inhaling; Inspiration, Respiratory; Internet; Joints; Learning; Malignant Neoplasms; Malignant Tumor; Medical; Medication; Medicine; Methods And Techniques; Methods, Other; Minority; Multimedia; Multimedium; Muscle Relaxation; Muscle Relaxation Phase; Native Alaskan; Native Americans; Nursing; Nursing Field; Nursing Profession; On-Line Systems; Online Systems; Outcome Measure; Prov; Pain; Pain Control; Pain Therapy; Pain Management; Painful; Patients; Pharmaceutic Preparations; Pharmaceutical Preparations; Pharmacological Treatment; Pharmacology; Phase; Provider; Psychology; Psychotherapeutic Imagery; Psychotherapy, Cognitive; Public Health; Questionnaires; R & D; R&D; Randomized Controlled Trials; Research; Rural; Rural Community; Rural Health; Rural Hospitals; Science Of Medicine; Societies; Solutions; Specificity; Teaching; Techniques; Testing; Therapy, Cognition; Training; Www; Washington; Addiction; Adult Human (21+); Advanced Age; Base; Cognitive Behavior Intervention; Cognitive Behavior Modification; Cognitive Behavioral Intervention; Cognitive Behavioral Modification; Cognitive Behavioral Therapy; Cognitive Training; Conference; Cost; Design; Designing; Drug/Agent; Elders; Follow-Up; Geriatric; Health Care Personnel; Health Care Worker; Health Provider; Healthcare Personnel; Improved; Innovate; Innovation; Innovative; Inspiration; Interest; Late Life; Later Life; Malignancy; Medical Personnel; Neoplasm/Cancer; Non-Cancer Pain; Older Adult; Older Person; Online Computer; Preference; Primary Outcome; Prototype; Public Health Medicine (Field); Public Health Relevance; Randomized Controlled Study; Research And Development; Rural Area; Senior Citizen; Skills; Symposium; Telehealth; Treatment Provider; Tribal Health; Usability; Web; Web Based; World Wide Web

Pain is the primary reason that people seek medical care. Unfortunately, under-treatment of pain is well- documented in cancer (Cohen et al, 2003; Deandrea et al., 2008) and other medical conditions (Boulanger et al., 2007; Hadjistavropoulos et al., 2006). While medication continues to be the first line of defense against pain, empirical support for the effectiveness of cognitive-behavioral pain management (CBPM) techniques continues to grow. Used alone or in conjunction with pharmacological treatment, CBPM techniques such as diaphragmatic breathing, progressive muscle relaxation, and guided imagery have been shown to significantly reduce both cancer- and non-cancer-related pain. Currently, however, a lack of cultural adaptation and provider training are barriers to the more wide-spread use of these treatments, especially in rural and tribal clinics that treat American Indians (AIs) and Alaska Natives (ANs). Research indicates that cultural appropriateness is important to the acceptability of cognitive behavioral interventions vis-a-vis minority patients. Therefore, this Fast-Track application proposes to create an internet-delivered, culturally- tailored multimedia training to teach empirically-supported CBPM techniques to providers serving rural communities and AI/ANs, so that these providers, in turn, can teach these techniques to their patients. The proposed product, PATINA (Pain Management Training in Native American Communities), is innovative in its web- and internet-based approach to training CBPM techniques, in its cultural specificity, and in its use of telehealth to conduct formative and evaluative research in rural hospital and tribal clinic settings. Primary customers will be rural healthcare providers and those treating AI/AN patients. Continuing education units will be awarded for completing the training. Combining the best features of books and classes, web-based training is low cost, convenient, and offers interactivity, feedback and practice opportunities.

Public Health Relevance:
Cognitive-behavioral pain management (CBPM) techniques are strongly endorsed by several national organizations as an important component of a comprehensive pain management approach. However, lack of access to provider training is a major barrier to their more wide-spread use, especially in rural areas and clinics that serve American Indians and Alaska Natives. This proposal seeks to improve public health by creating an internet-delivered, culturally-tailored multimedia training to teach CBPM techniques to providers serving rural areas and American Indians and Alaska Natives, so that these providers can teach these techniques to their patients.

Public Health Relevance Statement:
7. Project Narrative/Relevance Cognitive-behavioral pain management (CBPM) techniques are strongly endorsed by several national organizations as an important component of a comprehensive pain management approach. However, lack of access to provider training is a major barrier to their more wide-spread use, especially in rural areas and clinics that serve American Indians and Alaska Natives. This proposal seeks to improve public health by creating an internet-delivered, culturally-tailored multimedia training to teach CBPM techniques to providers serving rural areas and American Indians and Alaska Natives, so that these providers can teach these techniques to their patients.

NIH Spending Category:
American Indians / Alaska Natives; Arctic; Behavioral and Social Science; Cancer; Clinical Research; Mind and Body; Neurosciences; Pain Conditions - Chronic; Rural Health

Project Terms:
Acute Pain; addiction; Address; Adult; Alaska; Alaska Native; American; American Indian and Alaska Native; American Indians; Area; Award; base; Behavioral; Books; Breathing; Caring; Chronic; Clinic; Cognitive; Cognitive Therapy; cognitive training; Communities; Community Hospitals; Competence; Continuing Education; cost; Data; design; Discipline of Nursing; Educational process of instructing; Effectiveness; Elderly; Equipment; Evaluation; Exercise; Feedback; Focus Groups; follow-up; Frequencies (time pattern); Guided imagery; Health Personnel; improved; Informatics; innovation; interest; Internet; Joints; Learning; Malignant Neoplasms; Medical; Medicine; Minority; Multimedia; Muscle relaxation phase; Native Americans; non-cancer pain; Online Systems; Outcome Measure; Pain; Pain management; Patients; Pharmaceutical Preparations; Pharmacological Treatment; Pharmacology; Phase; preference; primary outcome; prototype; Provider; Psychology; public health medicine (field); public health relevance; Questionnaires; Randomized Controlled Trials; Research; research and development; Rural; rural area; Rural Community; Rural Health; Rural Hospitals; skills; Societies; Solutions; Specificity; symposium; Techniques; telehealth; Testing; Training; tribal health; usability; Washington