Document text
Principal Investigator: Isabel Roth
Organization: UNIV OF NORTH CAROLINA CHAPEL HILL
Fiscal Year: 2024
Award: $117,118
Funding agency: National Center for Complementary and Integrative Health
PROJECT SUMMARY
Background: Chronic pain impacts a fifth of American adults. Integrative pain management (IPM)
interventions including mindfulness-based stress reduction, yoga, and other methods have demonstrated
improvements in pain and function, and are now included in clinical guidelines for chronic pain conditions.
Despite evidence of efficacy, IPM is not reaching low-income populations at greatest risk for chronic pain and
related opioid overdose. Low-income communities rely on safety-net healthcare facilities to access care, of
which Federally Qualified Health Centers (FQHCs) are the primary providers. The Integrative Medical Group
Visit (IMGV) for chronic pain is one of a few promising IPM interventions developed specifically for safety-net
settings. The challenge now is to examine effectiveness and implementation of IMGV in FQHC settings, to
address chronic pain and risks associated with opioid use. Goals and Objectives: Dr. Roth’s long-term career
goal is to become an independent investigator evaluating effectiveness and implementation of IPM
interventions to reduce the burden of chronic pain, particularly in low-income communities. This K01 career
development award will allow Dr. Roth to gain advanced skills in conducting trials that can identify successful
implementation strategies for IPM interventions. Career Development Activities: The K01 application will
provide structured didactic and hands-on training that will build on Dr. Roth’s training in community-based
participatory research and foundational implementation science skills, through training in cluster-randomized
trial designs, cost measurement and evaluation, and conducting a multi-site pilot study with FQHCs. The plan
will engage Dr. Roth in robust training activities including mentorship, coursework, research projects,
publishing and presenting, workshops and seminars, grant-writing, and responsible conduct of research.
Mentors: Dr. Roth’s mentorship team consists of accomplished scientists from implementation science, clinical
integrative health research, intervention epidemiology, health economics, and FQHCs. Environment: Dr. Roth
will benefit from a comprehensive research training program and infrastructure based at the UNC School of
Medicine’s Program on Integrative Medicine, the top-ranked UNC Gillings School of Public Health, and the
North Carolina Translational and Clinical and Sciences Institute. The North Carolina Community Health Center
Association will provide training in working with FQHCs. Research: Dr. Roth’s proposed K01 research project
will address the limited access to IPM in FQHC settings serving low-income patients. Dr. Roth will first engage
key stakeholders through implementation mapping to identify and refine implementation strategies (Aim 1).
She will then pilot measures of effectiveness and implementation for IMGV in two FQHCs (one rural, one
urban) in North Carolina (Aim 2). This award will prepare Dr. Roth to submit a future competitive grant
application for a hybrid type 2 effectiveness-implementation trial of IMGV for chronic pain in FQHC settings.
Terms: <21+ years old><Academy><Access to Care><Address><Adherence><Administrator><Adoption><Adult><Adult Human><American><American College of Physicians><Analgesic Agents><Analgesic Drugs><Analgesic Preparation><Analgesics><Anodynes><Antinociceptive Agents><Antinociceptive Drugs><Applications Grants><Assess implementation><Award><COVID crisis><COVID epidemic><COVID pandemic><COVID-19 crisis><COVID-19 epidemic><COVID-19 era><COVID-19 global health crisis><COVID-19 global pandemic><COVID-19 health crisis><COVID-19 pandemic><COVID-19 period><COVID-19 public health crisis><COVID-19 years><Career Development Awards><Career Development Awards and Programs><Career Development Programs K-Series><Clinic><Clinical><Cluster randomization trial><Cluster randomized trial><Communities><Community Health Centers><Cost Analyses><Cost Analysis><Cost Measures><Cost metrics><Data><Drugs><ED visit><ER visit><Educational workshop><Effectiveness><Electronic Health Record><Emergency care visit><Emergency department visit><Emergency hospital visit><Emergency room visit><Enrollment><Environment><Epidemic><Epidemiologist><Epidemiology><Feasibility Studies><Federally Qualified Health Center><Feedback><Future><Geography><Gills><Goals><Grant><Grant Proposals><Groups at risk><Guidelines><Health Care Providers><Health Facilities><Health Personnel><Health Policy><Health Services Accessibility><Health care facility><Healthcare Facility><Healthcare Providers><Healthcare worker><Hybrids><Implementation assessment><Improve Access><Integrative Medicine><Intervention><Intervention Strategies><Interview><Investigators><K-Awards><K-Series Research Career Programs><Low Income Population><Low income><Low income group><Maintenance><Maps><Measures><Medical><Medication><Medicine><Mentors><Mentorship><Methods><Neighborhood Health Center><North Carolina><Opiates><Opioid><Overdose><Pain><Pain Control><Pain Therapy><Pain management><Painful><Patient Isolation><Patient Representative><Patients><People at risk><Persons><Persons at risk><Pharmaceutical Preparations><Pilot Projects><Policy Maker><Population><Populations at Risk><Preparation><Provider><Public Health Schools><Publishing><QOL><Quality of life><R-Series Research Projects><R01 Mechanism><R01 Program><Recommendation><Research><Research Career Program><Research Grants><Research Personnel><Research Project Grants><Research Projects><Research Training><Researchers><Risk><Rural><SARS-CoV-2 epidemic><SARS-CoV-2 global health crisis><SARS-CoV-2 global pandemic><SARS-CoV-2 pandemic><SARS-coronavirus-2 epidemic><SARS-coronavirus-2 pandemic><Science><Scientist><Self Efficacy><Self Management><Severe Acute Respiratory Syndrome CoV 2 epidemic><Severe Acute Respiratory Syndrome CoV 2 pandemic><Severe acute respiratory syndrome coronavirus 2 epidemic><Severe acute respiratory syndrome coronavirus 2 pandemic><Site><Structure><Survey Instrument><Surveys><Techniques><Training><Training Activity><Training Programs><Training and Infrastructure><Visit><Workshop><Writing><Yoga><access to health services><access to services><access to treatment><accessibility to health services><adulthood><arm><assess cost><assess effectiveness><availability of services><care access><care as usual><care facilities><career><career development><chronic pain><chronic pain condition><chronic pain control><chronic pain disorder><chronic pain intervention><chronic pain management><chronic pain patient><chronic pain therapy><chronic pain treatment><chronic painful condition><community based participatory research><community led research><community participatory research><community partnered participatory research><coronavirus disease 2019 crisis><coronavirus disease 2019 epidemic><coronavirus disease 2019 global health crisis><coronavirus disease 2019 global pandemic><coronavirus disease 2019 health crisis><coronavirus disease 2019 pandemic><coronavirus disease 2019 public health crisis><coronavirus disease crisis><coronavirus disease epidemic><coronavirus disease pandemic><coronavirus disease-19 global pandemic><coronavirus disease-19 pandemic><cost><cost assessment><cost evaluation><cost measurement><design><designing><determine effectiveness><drug/agent><effectiveness and implementation trial><effectiveness assessment><effectiveness evaluation><effectiveness measure><effectiveness outcome><effectiveness-related outcomes><effectiveness/implementation hybrid trial><effectiveness/implementation trial><electronic health care record><electronic health medical record><electronic health plan record><electronic health registry><electronic medical health record><enroll><epidemiologic><epidemiological><evaluate cost><evaluate effectiveness><evaluate implementation><evaluation of implementation><examine cost><examine effectiveness><experience><health care personnel><health care policy><health care worker><health economics><health provider><health service access><health services availability><health workforce><healthcare personnel><healthcare policy><hybrid type 2 trial><hybrid type II trial><implementation cost><implementation design><implementation evaluation><implementation investment><implementation outcomes><implementation research><implementation research design><implementation science><implementation strategy><implementation/effectiveness><improved><instructor><integrative healing><integrative health><interventional strategy><licit opioid><low income individual><low income people><medical college><medical personnel><medical schools><mindfulness><mindfulness-based stress reduction><opiate consumption><opiate drug use><opiate intake><opiate medication><opiate overdose><opiate related overdose><opiate use><opioid consumption><opioid drug overdose><opioid drug use><opioid induced overdose><opioid intake><opioid intoxication><opioid medication><opioid medication overdose><opioid overdose><opioid poisoning><opioid related overdose><opioid toxicity><opioid use><overdose death><overdose fatalities><pain killer><pain medication><pain reduction><pain reliever><pain treatment><painkiller><participatory action research><patient with chronic pain><pilot study><preparations><prescribed opiate><prescribed opioid><prescription opiate><prescription opioid><primary care health center><primary care provider><primary health center><programs><providers from primary care><providers of primary care><reduce pain><responsible research conduct><retention rate><retention strategy><risk mitigation><safety net><scale up><school of medicine><service availability><severe acute respiratory syndrome coronavirus 2 global health crisis><severe acute respiratory syndrome coronavirus 2 global pandemic><skills><strategies for implementation><teacher><telehealth><theories><training module><treat chronic pain><treatment access><treatment as usual><treatment provider><trial design><usual care>