R33AG081034

Addressing the chronic pain epidemic among older adults in underserved community center; the GETACTIVE+ study.

- Project summary: Chronic musculoskeletal pain (pain > 3 months) is prevalent, costly, challenging to treat and a national priority area.

Older adults have the highest rates of chronic pain, and these are expected to increase given the growth of the older adult population over the next three decades.

Older adults from underserved communities (low SES, racial and ethnic minorities, immigrants) are at the highest risk for negative pain-related health consequences such as lower physical and emotional function and morbidity and mortality.

We lack evidence-based non-pharmacological treatments to address chronic pain within community health clinics that serve this older adult patient population.

GETACTIVE is an evidence-based mind-body activity program that directly targets improvement in pain outcomes by combining cognitive behavioral and mindfulness skills with gradual increase in walking (preferred and safe activity for older adults) linked to valued activities.

In direct response to RFA-NS-22-002, we have partnered with the MGH-Revere Healthcare Center which serves >5,000 disadvantaged older adults, to optimize GETACTIVE to bypass socioecological barriers and effectively engage this population into non-pharmacological pain management strategies.

In the R61 phase, we will: 1) develop GETACTIVE+ (optimized GETACTIVE), 2) evaluate its feasibility and acceptability; and 3) refine and finalize training, program manual, measures, and procedures.

In the R33 phase, we will conduct a randomized, hybrid type 1 effectiveness-implementation trial (N=200) to evaluate effectiveness and implementation of GETACTIVE+ versus treatment as usual on the following outcomes: 1) self-reported physical function (primary), 2) performance based (6MWT) and objective (step count) physical function, emotional function, pain, social support, loneliness (secondary); and 3) feasibility, acceptability, fidelity and adoption at patient, provider and organization levels (implementation).

Through this project we aim to solve the problem of lack of evidence-based non-pharmacological treatments for older adults in underserved communities.

GETACTIVE+ delivered by clinic staff can be routinely incorporated into group visits (already available at MGH-Revere Healthcare Center and other similar community centers) which are billable, thus providing a sustained model of care for older adults with chronic pain from disadvantaged backgrounds.

Because GETACTIVE incorporates mind-body skills with activity (e.g., walking), there is potential for improvement in other outcomes (e.g., decreased risk for morbidity and mortality) over and above pain.

The General Hospital Corporation

TO ENCOURAGE BIOMEDICAL, SOCIAL, AND BEHAVIORAL RESEARCH AND RESEARCH TRAINING DIRECTED TOWARD GREATER UNDERSTANDING OF THE AGING PROCESS AND THE DISEASES, SPECIAL PROBLEMS, AND NEEDS OF PEOPLE AS THEY AGE. THE NATIONAL INSTITUTE ON AGING HAS ESTABLISHED PROGRAMS TO PURSUE THESE GOALS. THE DIVISION OF AGING BIOLOGY EMPHASIZES UNDERSTANDING THE BASIC BIOLOGICAL PROCESSES OF AGING. THE DIVISION OF GERIATRICS AND CLINICAL GERONTOLOGY SUPPORTS RESEARCH TO IMPROVE THE ABILITIES OF HEALTH CARE PRACTITIONERS TO RESPOND TO THE DISEASES AND OTHER CLINICAL PROBLEMS OF OLDER PEOPLE. THE DIVISION OF BEHAVIORAL AND SOCIAL RESEARCH SUPPORTS RESEARCH THAT WILL LEAD TO GREATER UNDERSTANDING OF THE SOCIAL, CULTURAL, ECONOMIC AND PSYCHOLOGICAL FACTORS THAT AFFECT BOTH THE PROCESS OF GROWING OLD AND THE PLACE OF OLDER PEOPLE IN SOCIETY. THE DIVISION OF NEUROSCIENCE FOSTERS RESEARCH CONCERNED WITH THE AGE-RELATED CHANGES IN THE NERVOUS SYSTEM AS WELL AS THE RELATED SENSORY, PERCEPTUAL, AND COGNITIVE PROCESSES ASSOCIATED WITH AGING AND HAS A SPECIAL EMPHASIS ON ALZHEIMER'S DISEASE. SMALL BUSINESS INNOVATION RESEARCH (SBIR) PROGRAM: TO EXPAND AND IMPROVE THE SBIR PROGRAM, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT, TO INCREASE SMALL BUSINESS PARTICIPATION IN FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION. SMALL BUSINESS TECHNOLOGY TRANSFER (STTR) PROGRAM: TO STIMULATE AND FOSTER SCIENTIFIC AND TECHNOLOGICAL INNOVATION THROUGH COOPERATIVE RESEARCH DEVELOPMENT CARRIED OUT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO FOSTER TECHNOLOGY TRANSFER BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION.

93.279 - Drug Abuse and Addiction Research Programs

National Institute on Aging (NIA) [HHS - NIH]

National Institute of Neurological Disorders and Stroke (NNDS) [HHS - NIH]

Boston, Massachusetts 021142927 United States

Single Zip Code

HEAL Initiative: Advancing Health Equity in Pain Management (R61/R33 Clinical Trial Required) (RFA-NS-22-002)

Amendment Since initial award the total obligations have increased 21% from $3,542,451 to $4,293,042.