Browsing by Author "Pekmezi, Dorothy"

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    Intervention Mapping to develop a Social Cognitive Theory-based intervention for chronic pain tailored to individuals with HIV
    (Elsevier, 2018-02-19) Merlin, Jessica S.; Young, Sarah R.; Johnson, Mallory O.; Saag, Michael; Demonte, William; Kerns, Robert; Bair, Matthew J.; Kertesz, Stefan; Turan, Janet M.; Kilgore, Meredith; Clay, Olivio J.; Pekmezi, Dorothy; Davies, Susan; Medicine, School of Medicine
    Chronic pain is an important comorbidity among individuals with HIV. Behavioral interventions are widely regarded as evidence-based, efficacious non-pharmacologic interventions for chronic pain in the general population. An accepted principle in behavioral science is that theory-based, systematically-developed behavioral interventions tailored to the unique needs of a target population are most likely to be efficacious. Our aim was to use Intervention Mapping to systematically develop a Social Cognitive Theory (SCT)-based intervention for chronic pain tailored to individuals with HIV that will improve pain intensity and pain-related functional impairment. Our Intervention Mapping process was informed by qualitative inquiry of 24 patients and seven providers in an HIV primary care clinic. The resulting intervention includes group and one-on-one sessions and peer and staff interventionists. We also developed a conceptual framework that integrates our qualitative findings with SCT-based theoretical constructs. Using this conceptual framework as a guide, our future work will investigate the intervention's impact on chronic pain outcomes, as well as our hypothesized proximal mediators of the intervention's effect.
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    A Randomized Pilot Trial of a Novel Behavioral Intervention for Chronic Pain Tailored to Individuals with HIV
    (Springer Nature, 2018-08) Merlin, Jessica S.; Westfall, Andrew O.; Long, Dustin; Davies, Susan; Saag, Michael; Demonte, William; Young, Sarah; Kerns, Robert D.; Bair, Matthew J.; Kertesz, Stefan; Turan, Janet M.; Kilgore, Meredith; Clay, Olivio J.; Starrels, Joanna; Pekmezi, Dorothy; Johnson, Mallory O.; Medicine, School of Medicine
    Chronic pain is an important and understudied comorbidity in people living with HIV (PLWH). We conducted a pilot trial of Skills TO Manage Pain (STOMP), an innovative social cognitive theory-based pain self-management intervention tailored to PLWH, to assess feasibility, acceptability, and preliminary efficacy. Eligibility criteria included being HIV+, ≥ moderate pain for ≥ 3 months and a score of ≥ 4 on the three-item PEG pain severity and interference scale. Participants were randomized in a 1:1 fashion to STOMP or a usual care comparison. Among 22 participants randomized to STOMP, median session attendance was 9/12 (75%). Of 19 STOMP participants surveyed, 13 reported being "much better" overall since beginning treatment. Brief pain inventory-total scores decreased by 2 points in the intervention group and 0.9 in the control group (p = 0.11). STOMP is feasible, acceptable, and shows preliminary evidence of efficacy and promise for a full-scale trial.