UH3NR020929

REACHING RURAL VETERANS: APPLYING MIND-BODY SKILLS FOR PAIN USING A WHOLE HEALTH TELEHEALTH INTERVENTION (RAMP-WH) - 1 THIS PROJECT ADDRESSES THE SIGNIFICANT CHALLENGE OF IMPLEMENTING EFFECTIVE, NON-OPIOID INTERVENTIONS FOR CHRONIC PAIN 2 MANAGEMENT IN RURAL AND REMOTE DWELLING VETERAN POPULATIONS. PAIN IS A COMPLEX BIOPHYSICAL, PSYCHOLOGICAL, AND SOCIAL 3 (BPS) CONDITION AND THERE IS A GROWING EVIDENCE BASE TO SUPPORT SEVERAL COMPLEMENTARY AND INTEGRATIVE HEALTH (CIH) 4 APPROACHES, WHICH CAN ADDRESS PAIN IN A MORE HOLISTIC WAY. WHILE THE VA HAS BECOME A LEADER IN ADVANCING CIH THROUGH 5 ITS WHOLE HEALTH INITIATIVE, THERE REMAIN MANY BARRIERS, ESPECIALLY FOR RURAL PATIENTS. OUR TEAM HAS CO-DEVELOPED, WITH 6 MULTIPLE-LEVELS OF VA STAKEHOLDERS (INCLUDING RURAL PATIENTS), AN INNOVATIVE TELEHEALTH EVIDENCE-BASED INTERVENTION THAT 7 BUILDS UPON OUR TEAM'S PREVIOUS RESEARCH. THE REACHING RURAL VETERANS: APPLYING MIND-BODY SKILLS FOR PAIN USING A 8 WHOLE HEALTH TELEHEALTH INTERVENTION (RAMP-WH) PROJECT STRATEGICALLY COALESCES MULTIPLE EVIDENCE BASED CIH SELF- 9 MANAGEMENT STRATEGIES TO ADDRESS VETERANS' BPS NEEDS AND OVERCOME EXISTING BARRIERS. COMPRISED OF PAIN EDUCATION, 10 MINDFULNESS, PAIN SPECIFIC EXERCISES, AND COGNITIVE BEHAVIORAL STRATEGIES, THE PROGRAM IS COHESIVE AND SCALABLE. DESIGNED 11 TO BE IMPLEMENTED WITHIN THE VA THROUGH ITS NATIONWIDE WHOLE HEALTH SYSTEM INITIATIVE, IT USES VA WHOLE HEALTH (WH) 12 COACHES AS PROGRAM FACILITATORS. RAMP-WH IS A 12-WEEK PROGRAM INCLUDING A 1-TO-1 SESSION WITH A WH COACH, FOLLOWED 13 BY 11 GROUP SESSIONS INCLUDING PRE-RECORDED EXPERT LED EDUCATION VIDEOS, MIND-BODY SKILL TRAINING AND PRACTICE, AND 14 FACILITATED DISCUSSIONS. FOR THE PREPARATORY PHASE (UG3) WE WILL CONDUCT 1) STAKEHOLDER ENGAGEMENT ACTIVITIES INCLUDING 15 IDENTIFYING AND DEVELOPING NEW COMMUNITY PARTNERSHIPS AND USING MIXED METHODS DATA COLLECTION FROM MULTIPLE LEVELS OF 16 STAKEHOLDERS (N=35-50 PATIENTS, COMMUNITY PARTNERS, VA HEALTHCARE SYSTEM LEADERS AND STAFF), GUIDED BY THE ESTABLISHED 17 RE-AIM/PRISM FRAMEWORK, TO LEARN ABOUT KEY FACTORS THAT CAN AFFECT LONG-TERM ADOPTION; AND 2) CONDUCT A PILOT STUDY OF 18 40 RURAL VA PATIENTS WITH CHRONIC PAIN TO ASSESS THE FEASIBILITY OF DELIVERING RAMP-WH (EXPERIMENTAL INTERVENTION FOR 19 THE UH3 TRIAL) IN TERMS OF RECRUITMENT AND ENGAGEMENT, INTERVENTION FIDELITY AND ADHERENCE, DATA COLLECTION, AND OTHER KEY 20 METRICS. FOR THE UH3 PHASE, WE WILL CONDUCT A RANDOMIZED HYBRID TYPE 2 EFFECTIVENESS-IMPLEMENTATION MULTI-SITE 21 PRAGMATIC CLINICAL TRIAL OF RAMP-WH COMPARED TO USUAL CARE, AMONG RURAL PATIENTS (N=500) IN THE VA HEALTHCARE 22 SYSTEM. UH3 AIM 1 WILL ASSESS THE RELATIVE EFFECTIVENESS OF RAMP-WH IN TERMS OF THE PRIMARY EFFECTIVENESS OUTCOME 23 OF PAIN INTERFERENCE AT 13 AND 26 WEEKS AND SECONDARY OUTCOMES INCLUDING OPIOID USE AND OTHER HEAL RECOMMENDED 24 OUTCOMES. IN UH3 AIM 2 WE WILL WORK ITERATIVELY WITH MULTIPLE LEVELS OF STAKEHOLDERS (FROM UG3) TO EVALUATE 25 INTERVENTION IMPLEMENTATION STRATEGIES USED IN THE TRIAL AND ADAPT THESE STRATEGIES TO SCALE UP RAMP-WH WITHIN THE 26 NATIONAL VA HEALTHCARE SYSTEM. THIS WILL INCLUDE: A) CONDUCTING MIXED-METHODS ASSESSMENTS OF STAKEHOLDER AND 27 RANDOMIZED TRIAL PARTICIPANT VIEWS OF IMPLEMENTATION-RELATED BARRIERS AND FACILITATORS, RESOURCE NEEDS, AND OTHER RE- 28 AIM/PRISM DOMAINS; B) WORKING WITH STAKEHOLDERS TO CO-CREATE ADDITIONAL PLAUSIBLE STRATEGIES FOR OVERCOMING BARRIERS TO 29 IMPLEMENTATION OF RAMP-WH; AND C) CONDUCTING BUDGET IMPACT ANALYSES USING MODELS INFORMED BY STAKEHOLDER VIEWS TO 30 INFORM FUTURE DECISION MAKING. 31

Center For Veterans Research & Education

NURSES UNDERSTAND THAT IMPROVING HEALTH AND WELL-BEING MEANS ADDRESSING PEOPLE'S NEEDS IN MULTIPLE SETTINGS, CONTEXTS, AND OVER THE WHOLE LIFE COURSE. SCIENCE SUPPORTED BY THE NATIONAL INSTITUTE OF NURSING RESEARCH (NINR) USES THIS HOLISTIC PERSPECTIVE TO IMPROVE INDIVIDUAL AND POPULATION HEALTH AND ADVANCE HEALTH EQUITY. NINR-SUPPORTED RESEARCH PROMOTES HEALTH AND WELL-BEING BY ADDRESSING NEEDS AT MULTIPLE LEVELS INDIVIDUAL, FAMILY, COMMUNITY, AND SOCIETAL LEVELS AND DEVELOPING TREATMENT AND PREVENTION STRATEGIES THAT ARE RESPONSIVE TO THE REALITY OF PEOPLE'S LIVES. NURSES KNOW PEOPLE, AND PEOPLE TRUST NURSES. PATIENT AND FAMILIES INTERACT WITH NURSES MORE THAN ANY OTHER CLINICIANS. NURSING SCIENCE USES THIS SPECIAL RELATIONSHIP TO BETTER UNDERSTAND PATIENTS, FAMILIES, AND COMMUNITIES AND THE MANY FACTORS THAT INFLUENCE THEIR HEALTH. NURSING SCIENCE SUPPORTED BY NINR USES THIS KNOWLEDGE TO DEVELOP STRATEGIES FOR IMPROVING HEALTH AND WELLNESS ACROSS POPULATIONS, HEALTH CARE SETTINGS, AND THE LIFESPAN, WITH AN EMPHASIS ON ACHIEVING HEALTH EQUITY. NINR-SUPPORTED SCIENTISTS HAVE DEVELOPED INTERVENTIONS FOR: SUPPORTING PARENTS OF PREMATURE INFANTS, PROMOTING HIV PREVENTION IN UNDERSERVED POPULATIONS, IMPROVING TRANSITIONAL CARE LEADING TO BETTER OUTCOMES AND COST-SAVINGS, AND HELPING INNER-CITY CHILDREN MANAGE ASTHMA. NURSING SCIENCE TRANSCENDS THE BOUNDARIES OF DISEASE AND RESEARCH DISCIPLINES TO BETTER UNDERSTAND THE EXPERIENCES OF INDIVIDUALS AND FAMILIES LIVING WITH ILLNESS AND TO DEVELOP PERSONALIZED APPROACHES THAT MAXIMIZE HEALTH AND WELL-BEING FOR INDIVIDUALS AT ALL STAGES OF LIFE, ACROSS DIVERSE POPULATIONS AND SETTINGS. NINR-SUPPORTED SCIENCE USES NURSING SCIENCE'S UNIQUE, PATIENT AND COMMUNITY-FOCUSED PERSPECTIVE AND WIDE REACH ACROSS CLINICAL AND COMMUNITY SETTINGS TO ADVANCE OUR UNDERSTANDING OF THE SOCIAL DETERMINANTS OF HEALTH: THOSE FACTORS THAT ARE AT THE ROOT OF THE INEQUITIES THAT WE SEE, SUCH AS FOOD INSECURITY AND ACCESS TO HEALTHCARE. NINR RESEARCH EFFORTS IN WELLNESS INVESTIGATE THE KEY BIOLOGICAL, BEHAVIORAL, AND SOCIAL FACTORS THAT PROMOTE LONG-TERM HEALTH AND HEALTHY BEHAVIORS AND PREVENT THE DEVELOPMENT OF ILLNESS ACROSS HEALTH CONDITIONS, SETTINGS, AND THE LIFESPAN. RESEARCH IN WELLNESS IS ALSO FOCUSED ON DEVELOPING AND TESTING CULTURALLY APPROPRIATE INTERVENTIONS TO PROMOTE HEALTH AND PREVENT ILLNESS IN MINORITY AND UNDERSERVED GROUPS. NINR ALSO SUPPORTS SCIENCE TO ASSIST INDIVIDUALS, FAMILIES, AND HEALTH CARE PROFESSIONALS IN MANAGING ADVANCED, SERIOUS ILLNESS, AND PLANNING FOR END-OF-LIFE DECISIONS. IN ADDITION, NINR PROMOTES TECHNOLOGICAL ADVANCEMENTS THAT ADDRESS A RANGE OF HEALTH CARE CHALLENGES AND FACILITATE THE DELIVERY OF REAL-TIME PERSONALIZED INFORMATION TO INDIVIDUALS AND FAMILIES, HEALTH CARE PROVIDERS, AND COMMUNITIES. FINALLY, NINR HAS A LONGSTANDING AND CONTINUING COMMITMENT TO DEVELOPING THE NEXT GENERATION OF NURSE SCIENTISTS: THOSE INDIVIDUALS AND TEAM MEMBERS WHO WILL CARRY THE FIELD OF NURSING SCIENCE INTO THE FUTURE. IN ORDER TO PREPARE AN INNOVATIVE, DIVERSE, AND TALENTED NEXT GENERATION OF NURSE SCIENTISTS, NINR SUPPORTS A VARIETY OF TRAINING OPPORTUNITIES FOR SCIENTISTS AND TRAINEES AT ALL CAREER LEVELS, PARTICULARLY THOSE AT AN EARLY CAREER STAGE WHO ARE SO CRITICAL TO SUSTAINING THE FUTURE OF INNOVATIVE RESEARCH AND HIGH QUALITY HEALTH CARE.

93.279 - Drug Abuse and Addiction Research Programs

National Institute of Nursing Research (NINR) [HHS - NIH]

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

Minneapolis, Minnesota 554172309 United States

Single Zip Code

HEAL Initiative: Prevention and Management of Chronic Pain in Rural Populations (UG3/UH3, Clinical Trials Required) (RFA-NR-23-001)