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.

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.

scholarly journals Chronic Pain Management Among Older Adults: A Scoping Review

2019 ◽  
Vol 5 ◽  
pp. 237796081987425
Author(s):  
Ampicha Nawai
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Chronic Pain ◽  
Pain Management ◽  
Outcome Measures ◽  
Scoping Review ◽  
Roy Adaptation Model ◽  
Chronic Pain Management ◽  
Adaptation Model

Chronic pain is a significant problem for older adults. The effect of chronic pain on older people’s quality of life needs to be described and identified. For a decade, the Roy Adaptation Model has been used extensively to explain nursing phenomena and guide nursing research in several settings with several populations. The objective of this study was to use the Roy Adaptation Model to describe chronic pain and present a systematic scoping review of the literature about the middle-range theory of chronic pain among older adults. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses model guided a scoping review search method. A literature search was undertaken using MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Ovid, and ProQuest. The search terms were “chronic pain,” “pain management,” “older adult,” “Roy Adaptation Model,” and “a scope review.” The search included articles written in English published for the period of 2004–2017. All articles were synthesized using concepts of Roy’s Adaptation Model. Twenty-two studies were considered for the present review. Twenty-one articles were reports of quantitative studies, and one was a report of a qualitative study. Two outcome measures were found in this systematic scoping review. The primary outcomes reported in all articles were the reduction of pain due to interventions and an increase in coping with chronic pain. The secondary outcome measures reported in all studies were the improvement of physical function, quality of life, sleep disturbance, spiritual well-being, and psychological health related to pain management interventions among older adults. Many interventions of all studies reported improvement in chronic pain management among older adults. However, to improve chronic pain management, nurses need to understand about nursing theories, the context which instruments work, and develop empirical instruments based on the conceptual model.

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.

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