Increasing diversity in the nutrition, obesity, and diabetes biomedical workforce: the BRIDGES consortium.

Scientists from diverse backgrounds are underrepresented (UR) in academia. This lack of diversity impedes scientific discovery and innovation. UR scientists tend to conduct research on issues relevant to UR populations, including chronic disease prevention and management, and health disparities.

Special Section on Patient-Reported Outcomes and Informatics: Collection of Patient-Reported Outcome Measures in Rural and Underserved Populations.

The NIH Pragmatic Trials Collaboratory supports the design and conduct of 31 embedded pragmatic clinical trials, and many of these trials use patient-reported outcome measures (PROMs) to provide valuable information about their patients' health and wellness. Often these trials enroll medically underserved patients, including people with incomes below the federal poverty threshold, racial or ethnically minoritized groups, or rural or frontier communities. In this series of trial case reports, we provide lessons learned about collecting PROMs in these populations.

Using PROMIS Methodology to Create Self-Report Measures of Mindfulness and Related Concepts.

Background: Mindfulness meditation is ubiquitous in health care, education, and communities at large. Mindfulness-Based Interventions (MBIs) are the focus of hundreds of NIH-funded trials given the myriad health benefits associated with this practice across multiple populations. Notwithstanding, significant gaps exist in how mindfulness concepts are measured using currently available self-report instruments.

Mentoring as a Buffer for the Impact of Social Unrest due to Systemic Racism and Ambient Discrimination.

Mentoring may act as a buffer for the negative impacts of racial trauma. Building Up (conducted 2020-2024) is a cluster-randomized trial at 25 institutions of postdoctoral fellows and early-career faculty from underrepresented backgrounds. Generalized linear mixed models were used to identify mentoring competencies associated with the impact of social unrest due to systemic racism.

Telehealth mindful exercise for people with knee osteoarthritis: A decentralized feasibility randomized controlled trial.

Objective: Negative psychological beliefs like fear avoidance and catastrophizing can interfere with exercise engagement in people with knee osteoarthritis (OA). Mindfulness, when integrated with exercise, could potentially address both psychological and physical impairments. Our objectives were to optimize and assess the feasibility of a novel telehealth, group-based mindful exercise intervention for people with knee OA.

Primary care barriers and facilitators to nonpharmacologic treatments for low back pain: A qualitative pilot study.

Background: Clinical practice guidelines encourage primary care providers (PCPs) to recommend nonpharmacologic treatment as first-line therapy for low back pain (LBP). However, the determinants of nonpharmacologic treatment use for LBP in primary care remain unclear, particularly in low-income settings.

Objective: To pilot a framework-informed interview guide and codebook to explore determinants of nonpharmacologic treatment use in primary care.

The impact of inclusive mentoring and identity work on self-efficacy in career advancement and career commitment among underrepresented early-career faculty and post-doctoral fellows.

Objective: Researchers from underrepresented groups leave research positions at a disproportionate rate. We aim to identify factors associated with self-efficacy in career advancement and career commitment among underrepresented post-doctoral fellows and early-career faculty.

Methods: Building Up is a cluster-randomized trial with 25 academic health institutions.

Mobile health intervention to address chronic pain among those who engage in hazardous drinking: A pilot study.

Background: Hazardous drinking has been associated with chronic pain in community and medical samples. The purpose of this study was to develop a novel, integrated mobile health intervention that improves pain management and reduces hazardous drinking that may be implemented in primary care settings.

Methods: Forty-eight participants with moderate or greater chronic pain and hazardous drinking were recruited from primary care clinics and through social media sites.

Integrating a Community Advisory Board Into a Pragmatic Trial of Mindfulness for Chronic Low Back Pain.

Background: To improve the implementation of clinical trial interventions, there is a need to facilitate communication between key stakeholders and research teams. Community Advisory Boards (CAB) bring together a range of stakeholders not historically included in the research process to inform and work collaboratively with research teams.

Objective: To describe our procedures and processes for (1) integration of a CAB into a pragmatic clinical trial of a telehealth-delivered group mindfulness program for persons with chronic low back pain (cLBP) within primary care, and (2) for the rapid uptake and implementation of CAB recommendations.

A Cluster Analysis of Initial Primary Care Orders for Patients with Acute Low Back Pain.

Purpose: Primary care physicians (PCPs) often face a complex intersection of patient expectations, evidence, and policy that influences their care recommendations for acute low back pain (aLBP). The purpose of this study was to elucidate patterns of PCP orders for patients with aLBP, identify the most common patterns, and describe patient clinical and demographic characteristics associated with patterns of aLBP care.

Methods: This prospective cohort study included 9574 aLBP patients presenting to 1 of 77 primary care practices in 4 geographic locations in the United States.

A Brief Measure of Fidelity for Mindfulness Programs: Development and Evaluation of the Concise Fidelity for Mindfulness-Based Interventions Tool.

Background: Mindfulness research and clinical programs are widespread, and it is important that mindfulness-based interventions are delivered with fidelity, or as intended, across settings. The MBI:TAC is a comprehensive system for assessing teacher competence, yet it can be complex to implement. A standardized, simple fidelity/engagement tool to address treatment delivery is needed.

Perseverance and consistency of interest in underrepresented post-doctoral fellows and early-career faculty.

Introduction: Underrepresented researchers face more challenges than their well-represented counterparts. Perseverance and consistency of interest are associated with career success in well-represented physicians. Therefore, we examined associations of perseverance and consistency of interest with Clinical Research Appraisal Inventory (CRAI), science identity, and other factors related to career success among underrepresented post-doctoral fellows and early-career faculty.

Racial and Ethnic Disparities in the Incidence of High-Impact Chronic Pain Among Primary Care Patients with Acute Low Back Pain: A Cohort Study.

Objective: We assessed whether race or ethnicity was associated with the incidence of high-impact chronic low back pain (cLBP) among adults consulting a primary care provider for acute low back pain (aLBP).

Methods: In this secondary analysis of a prospective cohort study, patients with aLBP were identified through screening at seventy-seven primary care practices from four geographic regions. Incidence of high-impact cLBP was defined as the subset of patients with cLBP and at least moderate disability on Oswestry Disability Index [ODI >30]) at 6 months.

A Mixed-Methods Analysis of Gender and Career Status Differences in the Impact of the COVID-19 Pandemic on Underrepresented Postdoctoral Fellows and Early-Career Faculty.

Purpose: The lack of racial and ethnic diversity in the biomedical workforce is pronounced and those from underrepresented backgrounds encounter more challenges than their majority counterparts. The extent of the impact of the COVID-19 pandemic on early-career investigators from underrepresented backgrounds is not yet fully understood. To examine the impact of the pandemic on underrepresented early-career biomedical researchers, this study evaluated differences in productivity, research, and psychological well-being by gender and career status.

The impact of social unrest due to systemic racism on underrepresented post-doctoral fellows and early-career faculty.

Introduction: Social unrest tied to racism negatively impacted half of NIH-funded extramural researchers underrepresented (UR) in science. UR early-career scientists encounter more challenges in their research careers, but the impact of social unrest due to systemic racism in this group is unclear. We used mixed methods to describe the impact of social unrest due to systemic racism on mentoring relationships, research, and psychological well-being in UR post-doctoral fellows and early-career faculty.

Characterizing Interprofessional Collaboration and Referral to Mindfulness-Based Stress Reduction Programs.

Background: In 2017, the American College of Physicians (ACP) designated Mindfulness-Based Stress Reduction (MBSR), an eight-week group program, as first-line non-pharmacological treatment for chronic low back pain. However, interprofessional collaboration between mindfulness instructors and Primary Care Providers (PCP) remains largely unknown.

Objective: We developed a survey to assess communication between mindfulness instructors and PCPs, identify predictors of referral to MBSR, and determine areas where interventions could increase patient access to MBSR.

What Are Adverse Events in Mindfulness Meditation?

Mindfulness meditation has become a successful treatment of both physical and psychosocial ailments over the past decade. Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) are now implemented in various clinical and hospital settings for the treatment of stress, depression, substance abuse, and chronic pain. However, given mindfulness meditation's exponential rise in popularity, scientific and media reports have called for the evaluation of mindfulness meditation's safety for those who participate in its programs.

Effects of an integrated mindfulness intervention for veterans with diabetes distress: a randomized controlled trial.

Introduction: US military veterans have disproportionately high rates of diabetes and diabetes-related morbidity in addition to being at risk of comorbid stress-related conditions. This study aimed to examine the effects of a technology-supported mindfulness intervention integrated into usual diabetes care and education on psychological and biobehavioral outcomes.

Research Design And Methods: Veterans (N=132) with type 1 or 2 diabetes participated in this two-arm randomized controlled efficacy trial.

Recruiting underrepresented individuals in a double pandemic: Lessons learned in a randomized control trial.

The Building Up Trial is a cluster-randomized trial that aims to address the issue of the leaky career pathway for underrepresented (UR) faculty in biomedical fields. Regulatory approval and recruitment for the Building Up Trial took place during the COVID-19 pandemic and the anti-racism movement. The pandemic and anti-racism movement personally and professionally impacted the target population and made recruitment challenging at both the institution and participant level.

The impact of the COVID-19 pandemic on underrepresented early-career PhD and physician scientists.

Underrepresented minorities have higher attrition from the professoriate and have experienced greater negative impacts of the COVID-19 pandemic. The purpose of this study was to compare the impact of COVID-19 on the lives of 196 early-career physician-scientists versus PhD researchers who are underrepresented in biomedical research. Participants in the Building Up study answered questions on the impact of the COVID-19 pandemic on their personal and professional lives, and a mixed-methods approach was used to conduct the analysis.

The design and methods of the OPTIMUM study: A multisite pragmatic randomized clinical trial of a telehealth group mindfulness program for persons with chronic low back pain.

Mindfulness-based stress reduction (MBSR) is an evidence-based non-pharmacological approach for chronic low back pain (cLBP), yet it is not readily available or reimbursable within primary care clinics. Primary care providers (PCPs) who wish to avoid prescribing opioids and other medications typically have few options for their cLBP patients. We present the protocol of a pragmatic clinical trial entitled OPTIMUM (Optimizing Pain Treatment In Medical settings Using Mindfulness).

The Impact of Optimism and Pain Interference on Response to Online Behavioral Treatment for Mood and Anxiety Symptoms.

Objective: This study aimed to explore a) if high pain interference has a negative effect on response to computerized cognitive behavioral therapy (cCBT) for anxiety and depression and b) whether high optimism can buffer the negative effects of pain interference on cCBT outcomes.

Methods: We performed a secondary analysis of data on 403 participants from the randomized controlled clinical trial "Online Treatment for Mood and Anxiety Disorders in Primary Care." It examined the impact of cCBT, with and without access to an Internet support group, on health-related quality of life (HRQoL), mood, and anxiety symptoms.

Integrating patient perspectives in the development of a mobile health intervention to address chronic pain and heavy drinking in primary care: a qualitative study of patients in an urban, safety-net hospital setting.

Background: Chronic pain and heavy drinking are conditions that commonly co-occur among primary care patients. Despite the availability of behavioral interventions that target these conditions individually, engagement and adherence to treatment remain a challenge, and there have been no interventions designed to address both of these conditions together for patients presenting to primary care. This study seeks to incorporate the perspectives of patients regarding symptoms, treatment experiences, views on behavior change, and technology use to develop a tailored, integrated mobile health intervention that addresses both pain and heavy drinking among patients in primary care.

Integrated Meditation and Exercise Therapy: A Randomized Controlled Pilot of a Combined Nonpharmacological Intervention Focused on Reducing Disability and Pain in Patients with Chronic Low Back Pain.

Objective: This pilot trial examined the effects of a combined intervention of mindfulness meditation followed by aerobic walking exercise compared with a control condition in chronic low back pain patients. We hypothesized that meditation before exercise would reduce disability, pain, and anxiety by increasing mindfulness prior to physical activity compared with an audiobook control group.

Participants: Thirty-eight adults completed either meditation and exercise treatment (MedExT) (n=18) or an audiobook control condition (n=20).

Association of Obesity With Prescription Opioids for Painful Conditions in Patients Seeking Primary Care in the US.

Importance: Prior studies have identified an association between obesity and prescription opioid use in the US. However, the pain conditions that are factors in this association remain unestablished.

Objective: To investigate the association between obesity and pain diagnoses recorded by primary care clinicians as reasons for prescription of opioids.