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.
Public Health Relevance Statement: PROJECT NARRATIVE In this SBIR, ALTality, Inc. ("SpellBound") will assess the feasibility of a dual English/Spanish language augmented reality(AR)-enabled tool for assessing inpatient postoperative pain/nausea/vomiting in Hispanic/Latino children and adolescents with cancer in collaboration with bilingual Spanish-speaking anesthesiologists at the MD Anderson Cancer Center. If successful, the AR app will be an immediately implementable and commercially viable method of providing Hispanic/Latino pediatric cancer patients with limited English proficiency an adjunctive tool to overcome infrastructural barriers to receiving translation services in acute care settings that put them at higher risk of under and/or overtreatment of pain by prescription opioids and future prescription opioid dependency and misuse, at no cost to them or their families.
Project Terms: Adult; 21+ years old; Adult Human; adulthood; Age; ages; Pain management; Pain Control; Pain Therapy; pain treatment; Analgesics; Analgesic Agents; Analgesic Drugs; Analgesic Preparation; Anodynes; Antinociceptive Agents; Antinociceptive Drugs; pain killer; pain medication; pain reliever; painkiller; Anesthesia procedures; Anesthesia; Malignant Neoplasms; Cancers; Malignant Tumor; malignancy; neoplasm/cancer; Child; 0-11 years old; Child Youth; Children (0-21); youngster; Clinical Trials; Communication; Cessation of life; Death; Diagnosis; Disease; Disorder; Environment; Family; Future; Goals; Health Personnel; Health Care Providers; Healthcare Providers; Healthcare worker; health care personnel; health care worker; health provider; health workforce; healthcare personnel; medical personnel; treatment provider; Hospitalization; Hospital Admission; Hospitals; Pediatric Hospitals; Children's Hospital; Income; Economic Income; Economical Income; Inpatients; Language; Methods; Minority Groups; Minority People; Minority Population; Minority individual; Nausea and Vomiting; opiate abuse; opiate drug abuse; opioid drug abuse; opioid abuse; Painful; Pain; Analgesia Tests; Nociception Tests; Pain Assessment; pain assay; Pain Measurement; Post-operative Pain; pain after surgery; post-surgical pain; postsurgical pain; Postoperative Pain; Patients; Post-Operative; Postoperative; Postoperative Period; Racial Group; Racial Stocks; Race; Risk; Software; Computer software; Testing; Texas; Time; Translations; United States; United States Substance Abuse and Mental Health Services Administration; SAMHSA; Substance Abuse and Mental Health Services Administration; Work; Caregivers; Care Givers; Family member; Healthcare; health care; Hispanic; Latino; Specialist; Youth; Youth 10-21; Caring; base; improved; Acute Pain; Chronic; Clinical; Phase; Medical; Adolescent; Adolescent Youth; juvenile; juvenile human; Survivors; Ensure; pediatric; Childhood; Opiates; Opioid; Ethnicity; Ethnic Origin; Childhood Cancers; Malignant Childhood Tumor; Malignant Pediatric Neoplasm; Malignant Pediatric Tumor; Malignant childhood cancer; cancer in a child; cancer in children; child with cancer; childhood malignancy; children with cancer; pediatric cancer; pediatric malignancy; Malignant Childhood Neoplasm; Collaborations; bilingual; bilingualism; Exposure to; tool; Severities; Dependence; Protocol; Protocols documentation; Source; Opiate Dependence; opioid addiction; opioid dependence; opioid dependent; Opiate Addiction; Operative Procedures; Surgical; Surgical Interventions; Surgical Procedure; surgery; Operative Surgical Procedures; Services; Prescription medication misuse; non-medical prescription drug use; nonmedical prescription drug use; prescription drug misuse; prescription misuse; misuse of prescription only drugs; experience; cohort; neural; relating to nervous system; Reporting; abuse of substances; substance abuse; Substance abuse problem; response; Adverse Experience; Adverse event; Phase I Clinical Trials; Early-Stage Clinical Trials; Phase 1 Clinical Trials; phase I protocol; Narration; preventing; prevent; Symptoms; NIDA; National Institute on Drug Abuse; National Institute of Drug Abuse; Cancer Center; Cancer Patient; Enrollment; enroll; Not Hispanic or Latino; Non-Hispanic; Nonhispanic; Perioperative; Small Business Innovation Research Grant; SBIR; Small Business Innovation Research; Text; cost; Minority; Outcome; Population; 17 year old; 17 years of age; age 17 years; seventeen year old; seventeen years of age; commercial application; high risk; standard care; standard treatment; prescription opioid; licit opioid; opiate medication; opioid medication; prescribed opiate; prescribed opioid; prescription opiate; Pain intensity; mobile application; mobile app; mobile device application; pediatric patients; child patients; phase II trial; phase 2 trial; Limited English Proficiency; Augmented Reality; opioid use; opiate consumption; opiate drug use; opiate intake; opiate use; opioid consumption; opioid drug use; opioid intake; high risk population; high risk group; opioid mortality; opiate deaths; opiate mortality; opioid deaths; opioid overdose death; opioid related death; overtreatment; over-treatment; prescription opioid misuse; non-medical use of prescription opiates; non-medical use of prescription opioids; nonmedical use of prescription opiates; nonmedical use of prescription opioids; opioid analgesic misuse; opioid medication misuse; opioid prescription medication misuse; prescription opiate misuse; prescription opioid addiction; addiction to prescription opioids; dependence on prescription opioids; prescription opiate addiction; prescription opioid dependence; opioid misuse; non-medical opioid use; nonmedical opioid use; opiate misuse; Infrastructure; machine translation; postoperative recovery; post-operative recovery; recovery after surgery; recovery following surgery; opioid sparing; acute care; Phase I/II Clinical Trial; Phase 1/2 Clinical Trial; minority patient; patients from minority; patients of minority; Latino Population; Latino group; Latino individual; Latino people; Latinos; Hispanic Populations; Hispanic group; Hispanic individual; Hispanic people; Hispanics
