一项针对肥胖老年人减轻疼痛和改善健康的移动健康干预措施（MORPH）：MORPH试验方案
A Mobile Health Intervention to Reduce Pain and Improve Health (MORPH) in Older Adults With Obesity: Protocol for the MORPH Trial.
作者信息
Fanning Jason, Brooks Amber K, Ip Edward, Nicklas Barbara J, Rejeski W Jack
机构信息
Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, United States.
Section on Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States.
出版信息
JMIR Res Protoc. 2018 May 14;7(5):e128. doi: 10.2196/resprot.9712.
BACKGROUND
Chronic pain is a complex, age-related health issue that affects both physical functioning and quality of life. Because the impact of chronic pain is worsened by obesity and inactivity, nonpharmacological interventions that promote movement, reduce sitting, and aid in weight loss are needed to help manage pain symptoms among older adults with chronic pain.
OBJECTIVE
The Mobile Intervention to Reduce Pain and Improve Health (MORPH) pilot trial aims to develop and test the feasibility and acceptability of a novel, patient-centered intervention to reduce chronic pain and improve physical functioning in older adults, leveraging the combination of telecoaching and individually adaptive mHealth tools to decrease both body mass and sedentary behavior.
METHODS
MORPH comprises 2 phases, including a 1-year iterative development phase, and a 1-year pilot randomized controlled trial (RCT). During the development phase, representative participants will engage in one-on-one structured interviews and a 1-week field test. The resulting feedback will be used to guide the development of the finalized MORPH intervention package. During the second phase, the finalized intervention will be tested in a pilot RCT (N=30) in which older adult participants with chronic pain and obesity will be assigned to receive the 12-week MORPH intervention or to a waitlist control. Primary outcomes include self-reported pain symptoms and physical function.
RESULTS
Phase 1 recruitment is ongoing as of December 2017.
CONCLUSIONS
The MORPH intervention brings together a strong body of evidence using group-based behavioral intervention designs with contemporary mHealth principles, allowing for intervention when and where it matters the most. Given the ubiquity of smartphone devices and the popularity of consumer activity and weight monitors, the results of this study may serve to inform the development of scalable, socially driven behavioral pain management interventions.
TRIAL REGISTRATION
ClinicalTrials.gov NCT03377634; https://clinicaltrials.gov/ct2/show/NCT03377634 (Archived by WebCite at http://www.webcitation.org/6yj0J5Pan).
REGISTERED REPORT IDENTIFIER
RR1-10.2196/9712.
背景
慢性疼痛是一个复杂的、与年龄相关的健康问题，会影响身体功能和生活质量。由于肥胖和缺乏运动使慢性疼痛的影响更为严重，因此需要采取促进运动、减少久坐并有助于减肥的非药物干预措施，以帮助管理患有慢性疼痛的老年人的疼痛症状。
目的
减少疼痛并改善健康的移动干预（MORPH）试点试验旨在开发并测试一种新型的、以患者为中心的干预措施的可行性和可接受性，该干预措施旨在减轻老年人的慢性疼痛并改善其身体功能，利用远程指导和个性化自适应移动健康工具的组合来降低体重和久坐行为。
方法
MORPH包括两个阶段，即为期1年的迭代开发阶段和为期1年的试点随机对照试验（RCT）。在开发阶段，代表性参与者将参加一对一的结构化访谈和为期1周的实地测试。所得反馈将用于指导最终的MORPH干预方案的开发。在第二阶段，最终干预措施将在一项试点RCT（N = 30）中进行测试，患有慢性疼痛和肥胖症的老年参与者将被分配接受为期12周的MORPH干预或进入等待名单对照组。主要结局包括自我报告的疼痛症状和身体功能。
结果
截至2017年12月，第一阶段的招募工作正在进行中。
结论
MORPH干预将基于群体的行为干预设计的大量证据与当代移动健康原则结合在一起，能够在最重要的时间和地点进行干预。鉴于智能手机设备的普及以及消费者活动和体重监测器的流行，本研究结果可能有助于为可扩展的、社会驱动的行为疼痛管理干预措施的开发提供信息。
试验注册
ClinicalTrials.gov NCT03377634；https://clinicaltrials.gov/ct2/show/NCT03377634（由WebCite存档于http://www.webcitation.org/6yj0J5Pan）。
注册报告标识符
RR1-10.2196/9712。
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