"Pushed to Their Limits": Health Care Provider Perspectives on Barriers and Facilitators to Implementing a Mind-Body and Activity Program for Older Adults With Chronic Pain in a Community Clinic for the Underserved.

Autor:	Rush CL; Author Affiliations: Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts (Dr Rush, and Mss Brewer and Levey, and Drs Presciutti, McDermott, and Vranceanu); Harvard Medical School, Boston, Massachusetts (Drs Rush, Presciutti, McDermott, Greenberg, Ritchie, and Vranceanu); Revere HealthCare Center, Massachusetts General Hospital, Boston, Massachusetts (Drs Pasinski, Yousif, Gholston, and Raju) Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts (Dr Ritchie)., Brewer JR, Levey N, Presciutti AM, McDermott K, Pasinski R, Yousif N, Gholston M, Raju V, Greenberg J, Ritchie CS, Vranceanu AM
Jazyk:	angličtina
Zdroj:	Family & community health [Fam Community Health] 2024 Nov 06. Date of Electronic Publication: 2024 Nov 06.
DOI:	10.1097/FCH.0000000000000416
Abstrakt:	Older adults from underserved backgrounds experience chronic pain at a rate of 60% to 75%. Pharmacological treatments have limited efficacy and involve considerable risks. Mind-body interventions hold promise to improve pain outcomes but are typically not implemented in community clinics in which they are needed most, thus contributing to health disparities in chronic pain treatment. We conducted qualitative focus groups and interviews with 20 providers (eg, primary care doctors, nurses, administrators). We sought their perspectives on barriers and facilitators to implementing an evidence based mind-body activity program for older adults with chronic pain at an underserved community health clinic in Massachusetts. Subthemes were identified within 2 superordinate domains (barriers and facilitators) using a hybrid inductive-deductive thematic analysis approach following the Framework Method. Providers discussed facilitators (partner with clinic staff to facilitate referrals and buy-in, integrate referrals through the electronic medical record, offer groups in different languages, post and tailor advertisements) and barriers (limited staff bandwidth, scheduling challenges, inconsistent patient participation). These results will directly inform tailoring and subsequent effectiveness testing and implementation of the pain management program for older underserved adults with chronic pain in this community health care setting. Competing Interests: The authors declare no conflicts of interest/competing interests. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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