Candidate. I am excited to submit this application to NCCIH for a K23 Award. To date, I have received quality training as a scientist-practitioner in clinical health psychology, emphasizing research with HIV populations. To become an independent investigator with a research program focused on the use of mind-body interventions to manage chronic conditions, I require additional training in intervention design, implementation, and evaluation. Training Plan. My training goals for this K23 award include: 1) extend my knowledge of mind-body interventions for chronic pain management; 2) develop expertise regarding treatment for adults living with HIV and chronic pain; 3) cultivate advanced skills in clinical trial methods; 4) develop, implement, and evaluate a pilot trial of Tai Chi for chronic pain management among persons living with HIV; and 5) continue my professional development toward a successful career as an independently-funded investigator. Environment. During the award period, I will be an Assistant Professor in the Department of Psychiatry and Human Behavior (DPHB) at Brown University and Research Scientist at the Centers for Behavioral and Preventive Medicine (CBPM) of The Miriam Hospital. DPHB is among the top academic departments of psychiatry in the United States, with approximately 200 ongoing studies and $50 million in externally sponsored research. DPHB has an impressive track record of providing a suitable environment for the successful completion of K awards. CBPM provides an outstanding research environment that supports faculty in developing state-of-the-science, programmatic research by fostering a stimulating intellectual environment that encourages collaboration. Miriam Hospital is home to the Immunology Center, an urban HIV-clinic that provides comprehensive primary and specialty care for 1,700 HIV-infected patients, and is a major component of the Centers for AIDS Research (CFAR), a joint research effort between Brown and Boston Universities. Mentors. I have constructed an expert mentorship team, with leading scientists in the fields of mind-body research, behavioral interventions, HIV medicine, chronic pain management, and qualitative methods. Proposed Research. Consistent with the strategic priorities of NCCIH, the Office of AIDS Research, and NIH?s Federal Pain Research Strategy (FPRS), the proposed research addresses gaps in non-pharmacological chronic pain management in a neglected chronic pain group [i.e., people living with HIV (PLWH)]. I propose three research aims: 1) to understand perceived access, barriers, facilitators, and benefits related to Tai Chi for chronic pain among patients with HIV, in-depth qualitative interviews will be conducted with PLWH (N?12-18) and providers (N?6-10) at the Immunology Center; 2) optimize recruitment material for Tai Chi intervention and determine best format to deliver intervention based on information learned in qualitative study; and 3) to examine the feasibility and acceptability of Tai Chi for chronic pain management for PLWH, we will conduct a randomized pilot study (N = 40) of Qigong/Tai Chi Easy compared to a health education control group.
Chronic pain is highly comorbid among the 1.2 million persons living with HIV, with recent prevalence estimates ranging from 55-67%. Needed are evidenced-based non-pharmacological interventions to improve chronic pain management and reduce the demand for opioids in the United States. The proposed research will address this need by examining the feasibility and acceptability of Tai Chi as a mind-body intervention for chronic pain management in an HIV population.
