BACKGROUND AND OBJECTIVES: Chronic pain (CP) and cognitive decline (CD) often co-occur in older adults, which can reinforce a "disability spiral." Early interventions teaching pain coping skills and gradual increases in activity (walking) are needed to promote overall well-being and potentially delay further decline of cognition and daily functioning. The goal of this mixed-methods study was to guide the development of two mind-body activity programs for CP and CD which focus on increasing walking using time goals (Active Brains) or step count reinforced by a Fitbit (Active Brains-Fitbit). RESEARCH DESIGN AND METHODS: Older adults with CP and CD (N = 23) participated in a one-time focus group (four total) and completed measures of physical, emotional, and cognitive functioning. Qualitative analyses identified population-specific needs, preferences, and perceptions of proposed program skills. Quantitative analysis compared clinical characteristics to population norms and explored intercorrelations among treatment targets. RESULTS: Thematic analyses revealed six main themes: (1) challenges living with CP and (2) CD, (3) current walking, (4) technology (Fitbit) to increase walking, (5) perceptions of proposed program skills (e.g., mind-body, pain, and increased walking), and (6) program barriers and facilitators. Quantitative analyses showed that (a) participants had physical function below reference values and (b) higher self-efficacy correlated with higher cognitive, emotional, and physical functioning. DISCUSSION AND IMPLICATIONS: Focus group participants were enthusiastic about the proposed program skills. Current work includes open pilot testing, qualitative interviews, and a small randomized controlled trial to optimize the programs and methodology in preparation for efficacy testing against an educational control.
BACKGROUND AND OBJECTIVES: Chronic pain (CP) and cognitive decline (CD) often co-occur in older adults, which can reinforce a "disability spiral." Early interventions teaching pain coping skills and gradual increases in activity (walking) are needed to promote overall well-being and potentially delay further decline of cognition and daily functioning. The goal of this mixed-methods study was to guide the development of two mind-body activity programs for CP and CD which focus on increasing walking using time goals (Active Brains) or step count reinforced by a Fitbit (Active Brains-Fitbit). RESEARCH DESIGN AND METHODS: Older adults with CP and CD (N = 23) participated in a one-time focus group (four total) and completed measures of physical, emotional, and cognitive functioning. Qualitative analyses identified population-specific needs, preferences, and perceptions of proposed program skills. Quantitative analysis compared clinical characteristics to population norms and explored intercorrelations among treatment targets. RESULTS: Thematic analyses revealed six main themes: (1) challenges living with CP and (2) CD, (3) current walking, (4) technology (Fitbit) to increase walking, (5) perceptions of proposed program skills (e.g., mind-body, pain, and increased walking), and (6) program barriers and facilitators. Quantitative analyses showed that (a) participants had physical function below reference values and (b) higher self-efficacy correlated with higher cognitive, emotional, and physical functioning. DISCUSSION AND IMPLICATIONS: Focus group participants were enthusiastic about the proposed program skills. Current work includes open pilot testing, qualitative interviews, and a small randomized controlled trial to optimize the programs and methodology in preparation for efficacy testing against an educational control.
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Authors: Jonathan Greenberg; Ann Lin; Emily L Zale; Ronald J Kulich; Peter James; Rachel A Millstein; Hannah Shapiro; Michael E Schatman; Robert R Edwards; Ana-Maria Vranceanu Journal: J Pain Res Date: 2019-12-11 Impact factor: 3.133
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Authors: Ryan A Mace; Jonathan Greenberg; Nicole Lemaster; Brooke Duarte; Terence Penn; Millan Kanaya; James D Doorley; Jessica L Burris; Cale A Jacobs; Ana-Maria Vranceanu Journal: JMIR Form Res Date: 2022-04-27