scholarly journals CAN HEART DISEASE SELF-MANAGEMENT EDUCATION ALSO REDUCE PAIN INTERFERENCE IN AFRICAN AMERICAN OLDER ADULTS?

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S718-S718
Author(s):  
Mary R Janevic ◽  
Kristi Allgood ◽  
Jessica Ramsay ◽  
Cainnear Hogan ◽  
Rebecca Courser ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
African American ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Management Education ◽  
High Impact ◽  
Pain Interference ◽  
Self Management ◽  
African American Adults

Abstract Many older adults with heart disease, especially those from vulnerable populations, live with chronic pain. Self-management strategies for reducing cardiovascular risk (e.g., physical activity, stress reduction) are also recommended for management of chronic pain. It is not known, however, whether self-management education focused on heart health has a beneficial “side effect” on pain-related outcomes. We explored this possibility using data from a randomized controlled trial (n=405) of Take Heart, a group intervention adapted for low-income, African American adults 50 and over with heart disease or significant risk factors. We first assessed the sample prevalence of high-impact chronic pain; i.e., substantial pain-related disability in one or more life domains (National Pain Strategy, 2016). Next, we assessed whether participation in Take Heart resulted in decreased pain interference (PROMIS-29). One-third of participants (n=131) met criteria for high impact chronic pain. Mean pain interference T-score in the entire sample at baseline was 58.1 (SD=9.9), indicating a score one standard deviation greater than population average. Compared to controls, intervention participants had a greater, but non-significant, improvement in pain interference (0.7 vs. -0.8; p=.11). Overall, findings demonstrate that African American adults with cardiovascular conditions have a high burden of comorbid pain. This pain was not greatly improved by an intervention that taught key chronic disease self-management skills but did not address pain specifically. Future research can test whether incorporating pain-management content into heart disease education has a stronger impact on improving pain outcomes -- which may, in turn, promote adherence to behaviors to reduce cardiovascular risk.

scholarly journals Acceptability and Effects of Commercially Available Activity Trackers for Chronic Pain Management Among Older African American Adults

Pain Medicine ◽  
2019 ◽  
Vol 21 (2) ◽  
pp. e68-e78 ◽  
Author(s):  
Mary R Janevic ◽  
Varick Shute ◽  
Susan L Murphy ◽  
John D Piette
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
African American ◽  
Pain Management ◽  
Feasibility Trial ◽  
Chronic Pain Management ◽  
Step Counts ◽  
African American Adults ◽  
Activity Trackers ◽  
Wearable Activity Trackers

Abstract Background Wearable activity trackers may facilitate walking for chronic pain management. Objective We assessed the acceptability of a commercially available tracker and three alternative modes of reporting daily steps among older adults in a low-income, urban community. We examined whether using the tracker (Fitbit ZipTM) was associated with improvements in functioning and activity. Design Randomized controlled pilot and feasibility trial. Subjects Fifty-one African American adults in Detroit, Michigan, aged 60 to 85 years, with chronic musculoskeletal pain (28 in the intervention group, 23 controls). Methods Participants completed telephone surveys at baseline and eight weeks. Intervention participants wore trackers for six weeks, alternately reporting daily step counts via text messages, automated telephone calls, and syncing (two weeks each). We used multimethods to assess satisfaction with trackers and reporting modalities. Adherence was indicated by the proportion of expected days on which valid step counts were reported. We assessed changes in pain interference, physical function, social participation, walking frequency, and walking duration. Results More than 90% of participants rated trackers as easy to use, but some had technical or dexterity-related difficulties. Text reporting yielded 79% reporting adherence vs 69% each for automated calls and syncing. Intervention participants did not show greater improvement in functioning or walking than controls. Conclusions With appropriate support, wearable activity trackers and mHealth reporting for chronic pain self-care are feasible for use by vulnerable older adults. Future research should test whether the effects of trackers on pain-related outcomes can be enhanced by incorporating behavior change strategies and training in evidence-based cognitive-behavioral techniques.

Impact of Self-Management Education on the Functional Health Status of Older Adults with Heart Disease

1992 ◽  
Vol 32 (4) ◽  
pp. 438-443 ◽  
Author(s):  
N. M. Clark ◽  
N. K. Janz ◽  
M. H. Becker ◽  
M. A. Schork ◽  
J. Wheeler ◽  
...  
Keyword(s):  
Older Adults ◽  
Heart Disease ◽  
Health Status ◽  
Management Education ◽  
Functional Health ◽  
Self Management ◽  
Functional Health Status

scholarly journals CHRONIC PAIN SELF-MANAGEMENT PRACTICES AND PREFERENCES AMONG URBAN AFRICAN AMERICAN OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S70-S70
Author(s):  
Mary R Janevic ◽  
Mary Janevic ◽  
Sheria Robinson-Lane ◽  
Susan Murphy ◽  
John Piette
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
African American ◽  
Pain Management ◽  
Focus Group ◽  
Management Practices ◽  
Pilot Trial ◽  
Self Management ◽  
Management Interventions ◽  
African American Older Adults

Abstract African American older adults experience disproportionate burden from disabling chronic pain. Pain self-management interventions for this group are most effective when they integrate culturally-relevant preferences into intervention design. In the STEPS pilot trial, we collected focus group (n=23) and survey (n=57) data from African Americans age 60+ years about pain-management practices. Participants were recruited from the community and reported pain for 3+ months, with intensity >4 (0 to 10 scale). The most frequently-used pain-management strategies were exercise (75%) and prayer/Bible reading (74%). Also commonly used were healthy eating (61%), OTC medications (65%), and herbal supplements (51%). Focus group themes provided more nuanced information, including reasons for avoiding prescription pain medications, positive experiences with topical treatments, the value of movement, and the role of social support. Findings reveal strong engagement in pain self-care in this population. Interventions can build on existing practices by incorporating spirituality and appealing options for physical activity.

Toward Identifying Mild Cognitive Impairment in Hispanic and African American Adults

2017 ◽  
Vol 2 (2) ◽  
pp. 110-116
Author(s):  
Valarie B. Fleming ◽  
Joyce L. Harris
Keyword(s):  
Older Adults ◽  
African American ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Healthcare Access ◽  
Communication Disorders ◽  
Healthcare Systems ◽  
Prevention Education ◽  
Education Management ◽  
African American Adults

Across the breadth of acquired neurogenic communication disorders, mild cognitive impairment (MCI) may go undetected, underreported, and untreated. In addition to stigma and distrust of healthcare systems, other barriers contribute to decreased identification, healthcare access, and service utilization for Hispanic and African American adults with MCI. Speech-language pathologists (SLPs) have significant roles in prevention, education, management, and support of older adults, the population must susceptible to MCI.

Heuristic Model Linking Contextual Processes to Self-Management in African American Adults With Type 2 Diabetes

2001 ◽  
Vol 27 (5) ◽  
pp. 685-693 ◽  
Author(s):  
Gene H. Brody ◽  
Leonard Jack ◽  
Velma McBride Murry ◽  
Melissa Landers-Potts ◽  
Leandris Liburd
Keyword(s):  
Type 2 Diabetes ◽  
African American ◽  
Self Management ◽  
Heuristic Model ◽  
African American Adults

scholarly journals The Situated Influence of Chronic Pain Perception on Chinese Older Adults’ Self-Management in Home Care

Geriatrics ◽  
2018 ◽  
Vol 3 (4) ◽  
pp. 64
Author(s):  
Fang Liu ◽  
Min Tong
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
Chronic Disease ◽  
Pain Perception ◽  
Community Dwelling ◽  
Self Management ◽  
Chinese Older Adults ◽  
Care Experience ◽  
Management Capacity ◽  
Important Others

Background and objective: Worldwide, 26 million older adults die from chronic disease, and chronic pain is typically a part of the experience of chronic disease. This study explores the perception of chronic pain for home-dwelling Chinese older adults and its influence on (1) self-management ability and (2) management and reduction of chronic pain. Methods: Adopting a qualitative study design, we conducted in-depth interviews with 10 Chinese community-dwelling older adults who experience chronic pain. Half of our informants perceive chronic pain, whereas the other half, diagnosed with Alzheimer’s disease, do not report that they perceive chronic pain. Data were analyzed with inductive thematic analysis. Results: Chronic pain perception plays important roles in (1) defining the challenge of self-management, (2) connecting previous caretaking experience, (3) adjusting the identity of self-management, (4) acquiring support from important others and (5) re-planning self-management arrangements. Conclusion: Pain perception helps to motivate Chinese older adults to face health challenges and regain self-management capacity through adjustments in self-identity and care experience with the support of important others. Pain perception can consolidate the situation of independent living of older adults. It helps to motivate Chinese older adults to face health challenges and regain self-management capacity.

scholarly journals Chronic Kidney Disease and Older African American Adults: How Embodiment Influences Self-Management

Geriatrics ◽  
2018 ◽  
Vol 3 (3) ◽  
pp. 52 ◽  
Author(s):  
Tyrone Hamler ◽  
Vivian Miller ◽  
Sonya Petrakovitz
Keyword(s):  
Chronic Kidney Disease ◽  
African American ◽  
Kidney Disease ◽  
Adult Population ◽  
Self Management ◽  
Individual Choice ◽  
Daily Lives ◽  
African American Adults ◽  
Embodiment Theory ◽  
Management Behaviors

Patients living with chronic kidney disease (CKD) must balance the medical management of their kidney disease and other chronic conditions with their daily lives, including managing the emotional and psychosocial consequences of living with a chronic disease. Self-management is critical to managing chronic kidney disease, as treatment consists of a complex regimen of medications, dosages, and treatments. This is a particularly important issue for older African American adults who will comprise a significant portion of the older adult population in the coming years. Yet current conceptualizations of self-management behaviors cannot adequately address the needs of this population. Embodiment theory provides a novel perspective that considers how social factors and experiences are embodied within decision-making processes regarding self-management care among older African Americans. This paper will explore how embodiment theory can aid in shifting the conceptualization of self-management from a model of individual choice, to a framework that cannot separate lived experiences of social, political, and racial factors from clinical understandings of self-management behaviors. This shift in the conceptualization of self-management is particularly important to consider for CKD management because the profound illness burdens require significant self-management and care coordination skills.

scholarly journals MECHANISM OF ACTION: AGE DIFFERENCES IN RESPONSE TO ACCEPTANCE AND COMMITMENT THERAPY FOR CHRONIC PAIN

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S809-S809
Author(s):  
Julie L Wetherell ◽  
Matthew Herbert ◽  
Niloofar Afari
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
Acceptance And Commitment Therapy ◽  
Behavioral Therapy ◽  
Pain Interference ◽  
Younger Adults ◽  
Pain Acceptance ◽  
Commitment Therapy ◽  
Acceptance And Commitment

Abstract A recent randomized comparison of Acceptance and Commitment Therapy (ACT) vs. Cognitive-Behavioral Therapy for chronic pain found a clear age interaction effect, such that older adults benefitted more from ACT. In a subsequent study comparing ACT delivered in person to ACT delivered via telehealth to a sample of veterans (N=128, mean age 51.9, SD 13.3, range 25-89), we found no significant age by modality interactions, suggesting that older veterans responded as well as younger people did to telehealth delivery. Consistent with our previous findings, we found a trend for older adults to experience greater reduction in pain interference (p = .051) and significantly greater reduction in pain severity (p = .001) than younger adults following ACT. In younger veterans, change in pain acceptance from baseline to posttreatment was related to change in pain interference from baseline to 6-month follow-up (r = -.38), but change in pain interference from baseline to posttreatment was not related to change in pain acceptance from baseline to follow-up (r = .14), suggesting that, consistent with the ACT model, increased pain acceptance at posttreatment was related to reduced pain interference at follow-up. By contrast, in older veterans, both correlations were significant and of comparable magnitude (rs = -.43 and -.46, respectively), providing no support for the idea that change in pain acceptance drove change in pain interference. Overall, our findings suggest that ACT may work better in older adults with chronic pain than in younger adults, but via a different mechanism.

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