Brooks Amber K, Athawale Abha, Rush Virginia, Yearout Abigail, Ford Sherri, Rejeski W Jack, Strahley Ashley, Fanning Jason
Department of Anesthesiology, Wake Forest University School of Medicine, Winston-Salem, NC, United States.
Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, United States.
Front Pain Res (Lausanne). 2024 Apr 25;5:1340400. doi: 10.3389/fpain.2024.1340400. eCollection 2024.
Chronic pain is a prevalent issue among older adults in the United States that impairs quality of life. Physical activity has emerged as a cost-effective and non-pharmacological treatment for chronic pain, offering benefits such as improved physical functioning, weight loss, and enhanced mood. However, promoting physical activity in older individuals with chronic pain is challenging, given the cyclical relationship between pain and sedentary behavior. The Mobile Intervention to Reduce Pain and Improve Health (MORPH) trial was designed as an innovative, mobile health (mHealth) supported intervention to address this issue by targeting daylong movement, weight loss, and mindfulness to manage pain in older adults with chronic multisite pain. The objective of this paper is to provide the result of a qualitative analysis conducted on post-intervention interviews with MORPH participants.
At the conclusion of the MORPH study, 14 participants were interviewed regarding their experience with the program. All interviews were conducted by phone before being transcribed and verified. A codebook of significant takeaways was created based on these accounts. Summaries were further synthesized into themes using the principles of thematic analysis.
Three key themes of the MORPH intervention emerged from the qualitative interviews: MORPH technology (smart scales, Fitbit, MORPH Companion App) facilitated program adherence and accountability; MORPH intervention components (food tracking and mindfulness activities) facilitated program adherence and awareness, respectively; and, group meetings provided motivational support and accountability. Mobile health technologies, including a dedicated MORPH app, facilitated self-monitoring strategies, helped to break the cycle of old habits, and provided participants with immediate feedback on successes; however, technical issues required timely support to maintain engagement. Food tracking contributed to adherence and accountability for weight loss. Mindfulness activities increased participants' awareness of anxiety provoking thoughts and pain triggers. Finally, social support via group meetings and connection, played a crucial role in behavior change, but participants noted consistency in the delivery medium was essential to fostering genuine connections.
Overall, the study results highlight the key considerations related to program technology, intervention components, and the value of social support that can help to guide the development of future interventions similar to MORPH.
慢性疼痛是美国老年人中普遍存在的问题，会损害生活质量。体育活动已成为一种经济有效的慢性疼痛非药物治疗方法，具有改善身体机能、减轻体重和改善情绪等益处。然而，鉴于疼痛与久坐行为之间的循环关系，促进患有慢性疼痛的老年人进行体育活动具有挑战性。减少疼痛和改善健康的移动干预（MORPH）试验旨在设计一种创新的、移动健康（mHealth）支持的干预措施，通过针对全天活动、体重减轻和正念来管理患有慢性多部位疼痛的老年人的疼痛，以解决这一问题。本文的目的是提供对MORPH参与者干预后访谈进行定性分析的结果。
在MORPH研究结束时，对14名参与者进行了关于他们参与该项目经历的访谈。所有访谈均通过电话进行，然后进行转录和核实。根据这些记录创建了一个重要收获的编码手册。使用主题分析原则将总结进一步综合成主题。
定性访谈中出现了MORPH干预的三个关键主题：MORPH技术（智能秤、Fitbit、MORPH伴侣应用程序）促进了项目依从性和责任感；MORPH干预组件（食物追踪和正念活动）分别促进了项目依从性和意识；小组会议提供了激励支持和责任感。移动健康技术，包括专门的MORPH应用程序，促进了自我监测策略，有助于打破旧习惯的循环，并为参与者提供了关于成功的即时反馈；然而，技术问题需要及时支持以保持参与度。食物追踪有助于减肥的依从性和责任感。正念活动提高了参与者对引发焦虑的想法和疼痛触发因素的意识。最后，通过小组会议和联系提供的社会支持在行为改变中发挥了关键作用，但参与者指出，传递媒介的一致性对于建立真正的联系至关重要。
总体而言，研究结果突出了与项目技术、干预组件以及社会支持价值相关的关键考虑因素，这些因素有助于指导未来类似于MORPH的干预措施的开发。
