Dee publishes randomized control trial of physical therapy strategies for chronic pain after trauma

Congratulations to Justine Dee, MS, Clinical Associate Professor of Rehabilitation and Movement Science on the publication of a major article from her doctoral research!

Justine McCuen Dee & Benjamin Littenberg (2022) Regional vs global physical therapy interventions to treat chronic pain in survivors of trauma: a randomized controlled trial, Journal of Manual & Manipulative Therapy, DOI: 10.1080/10669817.2022.2159615

ABSTRACT

Background

A history of traumatic life events is associated with chronic pain in later life. Physical therapists utilize a variety of methods to treat pain, however, they have struggled to find effective interventions to improve patient outcomes.

Objective

To compare impairment-based, regional (REGION-PT) physical therapy (PT) to a global (GLOBAL-PT) model consisting of pain neuroscience education, graded motor imagery, and exercise for adults with chronic pain and history of trauma.

Design

Randomized Controlled Trial.

Methods

Adults ≥ 18 years of age with chronic pain and a history of ≥1 trauma identified through the Life Events Checklist received the allocated intervention once a week for six weeks. Treatment effects were assessed using linear mixed models.

Results

Ninety-eight participants completed the trial. There were no difference in outcomes between groups. There were significant interactions between race and intervention. Both interventions were associated with improvements in pain interference for white participants, but non-white participants experienced improvement only with GLOBAL-PT. Regardless of allocation, participants improved in physical function, six of the PROMIS-29 domains, and in pain interference measures.

Conclusion

Both interventions are reasonable strategies for individuals with chronic pain and a history of trauma.

 

FW: Free Crash Course in NIH Funding: 2023 NIH Grants Conference on Feb. 1-2

A great opportunity:

 

Free Crash Course in NIH Funding: 2023 NIH Grants Conference on Feb. 1-2.

New to NIH grants and looking to better understand the processes and policies behind NIH funding or are you Experienced and want to brush up on the latest policies and information?

Consider this your personal invitation from the NIH to attend this virtual event on February 1-2, 2023, where NIH and HHS experts will share policies, resources, guidance, and case studies in informative and engaging sessions.

The jam-packed agenda offers 2 days of sessions designed to clarify the NIH grants process and policies, and opportunities to engage with presenters through Q&A and chat features.

Registration is free and includes your personal “All Access Pass” to the virtual NIH Grants Conference 2022-2023 season.

 

Once registered and logged into the conference site, you are free to explore the 2-day agenda, on-demand library of related resources, and create your personal schedule.

 

Enjoy and see you there.

 

Thank you,

 

Brian

 

Brian Prindle, MBA, CRA | Executive Director | Signing Official

University of Vermont

Research Administration and Integrity

Office of the Vice President for Research

213 Waterman | 85 South Prospect Street

Burlington, VT 05405-0160

 

 

FW: Call for proposals: Sustainable Campus Fund Innovation Research Project

Please note that the Graduate College is now accepting Sustainable Campus Fund Innovation Research Project proposals.

 

Please share widely with your graduate students.

 

àThe deadline is Tuesday, February 20, 2023.

 

Instructions for may be found here on the Graduate College website.

 

Thank you,

New publication from Bonnell, et al.

Urban–Rural Differences in Mental and Physical Health among Primary Care Patients with Multiple Chronic Conditions: A Secondary Analysis from a Randomized Clinical Trial

by

Levi N. Bonnell

^1,*,

Jessica Clifton

¹,

Gail L. Rose

²,

Elizabeth N. Waddell

³ and

Benjamin Littenberg

¹

¹Department of Medicine, University of Vermont, Burlington, VT 05405, USA

²Department of Psychiatry, University of Vermont, Burlington, VT 05405, USA

³Division of General Internal Medicine and Geriatrics, Oregon Health and Science University, Portland, OR 97201, USA

^*Author to whom correspondence should be addressed.

Int. J. Environ. Res. Public Health 2022, 19(23), 15580; https://doi.org/10.3390/ijerph192315580

Purpose: Rural health disparities are largely attributable to access to healthcare, socioeconomic status, and health behaviors. Little is known about the persistence of these disparities when differences in access to care are eliminated. We sought to investigate urban–rural differences in physical and mental health in primary care patients with demonstrated access to primary care. Methods: We obtained cross-sectional survey responses from a multicenter randomized controlled trial on 2726 adult primary care patients with multiple chronic medical or behavioral conditions from 42 primary care practices in 13 states. Study outcomes include measures of mental health including: The Patient-Reported Outcomes Measurement Information System (PROMIS-29^®), General Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9), as well as physical health including: the PROMIS-29^® and the Duke Activity Status Index (DASI). Urban–rural residence was indicated by census-tract Rural Urban Commuting Areas of the participant’s home address. Differences in mental and physical health outcomes attributable to rurality were assessed using multilevel models with a random intercept for census-tract. Results: After adjustment for demographic and neighborhood characteristics, urban residents had significantly worse generalized anxiety disorder (GAD-7) (ß = 0.7; 95% CI = 0.1, 1.3; p = 0.027), depression (PHQ-9) (ß = 0.7; 95% CI = 0.1, 1.4; p = 0.024), and functional capacity (DASI) (ß = −0.4; 95% CI = −0.5, −0.2; p < 0.001) compared to rural residents. Urban residents also had significantly worse anxiety and depression as measured by the PROMIS-29^® compared to their rural counterparts. There were no urban–rural differences in the other PROMIS-29^® subdomains. Conclusions: Among adults with demonstrated access to care and multiple diagnosed chronic conditions, rural residents had better mental health and functional capacity than their urban counterparts. This finding is not consistent with prior research documenting rural health disparities and should be confirmed.

FW: NHATS and NSOC Final Data Released

From: NHATS Data <nhatsdata@westat.com>
Sent: Tuesday, November 22, 2022 12:44 PM
To: NHATS Data <nhatsdata@westat.com>
Subject: NHATS and NSOC Final Data Released

 

Dear NHATS and NSOC Data Users,

 

Final versions of the National Health and Aging Trends Study (NHATS) Round 11 and National Study of Caregiving (NSOC) IV files are now available at https://nhats.org/researcher/data-access. Data files are available in both SAS and Stata formats.

 

Updated documentation (with SAS, Stata, and new R code), including revised User Guides, FAQ, crosswalks between the instruments and the codebook, crosswalks of changes from the beta to final versions, and new technical papers on weighting and income imputation can be found at https://www.nhats.org/researcher.

 

Also, make sure to save the date! The National Health and Aging Trends Study (NHATS) and the National Study of Caregiving (NSOC) will host two virtual workshops in the summer of 2023. The NHATS workshop will occur online June 26 -28, 2023, and the NSOC workshop will occur online July 31- August 2, 2023. Applications will open in early April. The workshop is designed for those with experience using NHATS or NSOC data who are working towards a completed manuscript or proposal. All users are encouraged to complete the NHATS online course for beginners beforehand. The data training portion assumes familiarity with statistical programming (e.g. SAS, STATA, R). Graduate students interested in applying are encouraged to have successfully defended their proposal before the workshop begins.

 

Thank you,

The NHATS and NSOC Team

 

Fwd: Post doctoral associate search

From: CVRI-VT <CVRI-VT@med.uvm.edu>

Sent: Monday, November 7, 2022, 4:38 PM
Subject: Post doctoral associate search

Hi all,

I'm looking for a new post doc. I hope you can help spread the word – post this information wherever you are able… if you know of someone, please send me their name so I can reach out.

Thank you!

Mary

 

 

 

Mary Cushman, MD, MSc

Professor and Vice Chair for Emerging Researchers, Department of Medicine

Co-Director, Vermont Center for Cardiovascular and Brain Health

Larner College of Medicine, University of Vermont

Director, Thrombosis and Hemostasis Program, University of Vermont Medical Center

Editor-in-Chief, Research and Practice in Thrombosis and Haemostasis

Twitter: @MaryCushmanMD

 

Laboratory for Clinical Biochemistry Research

Cardiovascular Research Institute of Vermont

 

 

This message and any attachments may contain information that is confidential, privileged and/or protected from disclosure under state and federal laws. If you received this message in error or through inappropriate means, please reply to this message to notify the Sender that the message was received by you in error, and then permanently delete this message from all storage media, without forwarding or retaining a copy.

Sevard and Autism Coolaborative get funding from PCORI

 

CTS doctoral candidate Lilliane Sevard is featured in this article about a big new award from PCORI for $350K. Congrats!

https://www.uvm.edu/news/cess/cdci/uvm-autism-collaborative-receives-350000-funding-rural-autism-outreach

FW: Attention, Researchers: 2021 BRFSS Public Data Set Now Available!

Attention, Researchers: 2020 BRFSS Public Data Set Now Available!

BRFSS Newsletter September 13, 2022

 

Attention, Researchers: 2021 BRFSS Public Data Set Now Available!

 

Click Here to Learn More About the 2021 Data!

Centers for Disease Control and Prevention/Division of Population Health Releases   2021 BRFSS Public Data Set Now Available

 

The 2021 Behavioral Risk Factor Surveillance System (BRFSS) data set is now publicly available. The BRFSS provides flexible, timely, and ongoing data collection that allows for state-to-state and state-to-nation comparisons, as well as the basis for small area estimates such as PLACES. State-specific data—including racial- and ethnic-specific data from the BRFSS—provide a sound basis for developing and maintaining public health programs, including programs designed to reduce racial and ethnic disparities and to address health risks and social determinants of health.   In the 2021 calendar year, BRFSS was active in 50 states (with 49 states reporting), plus the District of Columbia, Puerto Rico, Guam, and the US Virgin Islands. Reaching participants on both landline and cellular telephones, the survey collected information on health risk behaviors, clinical preventive health practices, and health care access (primarily related to chronic disease and injury) from a representative sample of noninstitutionalized adults aged 18 years or older in each state.   The BRFSS is the largest ongoing telephone-based health surveillance system in the world, conducting more than 438,000 interviews in 2021. BRFSS staff are working to make this new data set available soon through its online Prevalence and Trends Tools. Learn more about the 2021 BRFSS data.   Learn more about the BRFSS or send an inquiry to CDCINFO@cdc.gov

 

Learn more about the 2021 BRFSS data. Learn more about the BRFSS Prevalence and Trends Tools.  Learn more about the BRFSS or send an inquiry to CDCINFO@cdc.gov

 

Centers for Disease Control and Prevention 1600 Clifton Rd   Atlanta, GA 30329   1-800-CDC-INFO (800-232-4636)   TTY: 888-232-6348 Questions or Problems  |  Unsubscribe

Bonnell, et al. on health effects of walking during the COVID-19 pandemic.

Congratulations to Levi Bonnell, CTS Doctoral Candidate, and his collaborators for their latest publication based on data from the Integrating Behavioral Health in Primary Care study.

The Relationship Between Mental and Physical Health and Walking During the COVID-19 Pandemic

Levi N. Bonnell, Jessica Clifton, Mariana Wingood, Nancy Gell and Benjamin Littenberg

The Journal of the American Board of Family Medicine September 2022, https://www.jabfm.org/content/early/2022/09/01/jabfm.2022.AP.220090

Introduction: COVID-19 policies such as quarantining, social isolation, and lockdowns are an essential public health measure to reduce the spread of disease but may lead to reduced physical activity. Little is known if these changes are associated with changes in physical or mental health.

Methods: Between September 2017 and December 2018 (baseline) and March 2020 and February 2021 (follow-up), we obtained self-reported demographic, health, and walking (only at follow-up) data on 2042 adults in primary care with multiple chronic health conditions. We examined whether the perceived amount of time engaged in walking was different compared with prepandemic levels and if this was associated with changes in Patient-Reported Outcomes Measurement Information System-29 mental and physical health summary scores. Multivariable linear regression controlling for demographic, health, and neighborhood information were used to assess this association.

Results: Of the 2042 participants, 9% reported more walking, 28% reported less, and 52% reported the same amount compared with prepandemic levels. Nearly 1/3 of participants reported less walking during the pandemic. Multivariable models revealed that walking less or not at all was associated with negative changes in mental (ß = −1.0; 95% CI [−1.6, −0.5]; ß = −2.2; 95% CI [−2.9, −1.4]) and physical (ß = −0.9; 95% CI [−1.5, −0.3]; ß = −3.1; 95% CI [−4.0, −2.3]) health, respectively. Increasing walking was significantly associated with a positive change in physical health (ß = 1.3; 95% CI [0.3, 2.2]).

Conclusions: These findings demonstrate the importance of walking during the COVID-19 pandemic. Promotion of physical activity should be taken into consideration when mandating restrictions to slow the spread of disease. Primary care providers can assess patient’s walking patterns and implement brief interventions to help patients improve their physical and mental health through walking.

 

 

 

Rose publishes new article on the Practice Integration Profile

 

Congratulations to Assistant Professor of Psychiatry Gail L. Rose, for leading the team writing up the latest version of the Practice Integration Profile: PIP 2.0.

Rose GL, Weldon TL, McEntee ML, Hitt JR, Kessler R, Littenberg B, Macchi CR, Martin MP, Mullin DJ, van Eeghen C. Practice integration profile revised: Improving item readability and completion. Families, systems & health: the journal of collaborative family healthcare. 2022. https://do.org/10.1037/fsh0000723

Introduction: The Practice Integration Profile (PIP) is a reliable, valid, and broadly used measure of the integration of behavioral health (BH) into primary care. The PIP assesses operational and procedural elements that are grounded in the AHRQ Lexicon for Behavioral Health and Primary Care Integration. Prior analyses of PIP data and feedback from users suggested the measure was in need of revisions. This article describes the process used to improve readability, clarity, and pragmatic utility of the instrument. Method: Two rounds of structured cognitive interviews were conducted with clinicians in primary care settings. After each round, interview transcripts were coded by an analytic team using an iterative and consensus-driven process. Themes were identified based on codes. Themes and recommendations for revisions were reviewed and modified by committee. Results: Based on feedback and a prior factor analysis of the PIP, revisions were undertaken to: (a) eliminate redundant or overlapping items; (b) clarify the meaning of items; (c) standardize the response categories, and (d) place items in the most appropriate domains. The resulting measure has 28 items in five domains. Discussion: PIP 2.0 will need further examination to confirm its continuing use as a foundational tool for evaluating integrated care.

You can try out the PIP 2.0 at: www.practiceintegrationprofile.com

 

 

Roz King received major SAMHSA grant

Roz King, MSN, RN received notice of award for a Medication Assisted Treatment-Prescription Drug and Opioid Addiction (MAT-PDOA) grant from the Substance Abuse and Mental Health Services Administration (SAMHSA). 

Title: Start Treatment and Recovery (STAR) 

Amount: $3,749,030 over five years 

Working with Dan Wolfson, MD, Miles Lamberson, EMT, Sanchit Maruti, MD, Rick Rawson, PhD, Elly Riser, MD, John Brooklyn MD, Kyle DeWitt, PharmD, Blake Porter, PharmD, and Nick Aunchman, MD, this project will expand and improve our successful program of Emergency Department (ED)-initiated medications for opioid use disorder (MOUD) to include an innovative methadone treatment pathway. We will improve screening to better identify OUD, remove barriers to ED MOUD enrollment and follow-up, improve critical supports for participant success in follow-up recovery, and widen the distribution of harm reduction kits in the prehospital and ED settings. The population of focus includes patients in a large rural and urban catchment area who present to EMS or the EDs of the University of Vermont Medical Center (UVMMC) or Champlain Valley Physicians Hospital (CVPH) with an acute opioid overdose or other signs of opioid use disorder (OUD) who are candidates for starting Medication for Opioid Use Disorder (MOUD).  

With the continued rise in opioid-related overdose fatalities in these areas, our goal is to address the need to increase the number of individuals with OUD that are screened for risk, offered MOUD and harm-reduction kits, and are successfully enrolled and maintained in certified MOUD community addiction recovery programs, thereby decreasing illicit opioid use, prescription opioid misuse, and risk of opioid overdose. 

These collaborative efforts would not have been possible without the support and assistance of a team of collaborators across the University of Vermont Health Network, the Larner College of Medicine, the University of Vermont, and our greater medical community. Deep appreciation is given particularly to Molly Stevens, Ramsey Herrington, Meaghan McKenna, Deb Cannon, Cam Lauf and the Peer Recovery team, the Addiction Treatment Program, and Peter Callas for helping to make this possible. 

Congratulations to everyone involved. 

Ramsey Herrington, MD, FACEP

Healthcare Service Leader, Emergency Medicine

Chair of The Department of Emergency Medicine

Chair, UVMHN Emergency Medicine Specialty Council