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Comparing the effects of an adjunct brief action planning intervention to standard treatment in a heterogeneous sample of chronic pain patients
Title
Comparing the effects of an adjunct brief action planning intervention to standard treatment in a heterogeneous sample of chronic pain patients
Creator
Mikrut, Cassandra Leona
Date
2022
Description
Objectives: Behavioral treatments for chronic pain have been associated with positive outcomes, but they are often time consuming in nature....
Show moreObjectives: Behavioral treatments for chronic pain have been associated with positive outcomes, but they are often time consuming in nature. The aim of the present study was to investigate the effectiveness of a brief behavioral treatment for chronic pain and compare Brief Action Planning used in conjunction with treatment as usual (BAP + TAU) to TAU, on changes in pain severity, pain interference, pain self-efficacy, quality of life, and anxiety and depression in a heterogeneous sample of chronic pain patients. Methods: A total of 172 participants were recruited from an urban pain clinic. Eighty-five participants were quasi-randomly assigned to the BAP + TAU group and 87 participants were quasi-randomly assigned to the TAU control group. After completing T1 measures, two iterations of the BAP protocol were delivered to the intervention group by a trained clinician over the phone, with two weeks in between iterations. The TAU group received check-in calls, collecting brief mood and pain scores, to control for clinician contact. All participants completed T2 measures following the last phone call. Validated measures were used at T1 and T2 to examine participant outcomes. Results: Two-way repeated measures analysis of variance (ANOVA) tests were used to test the primary hypotheses that there would be a Group x Time interaction, on pain severity, pain interference, pain self-efficacy, quality of life (QOL), and anxiety and depression, such that participants assigned to the BAP + TAU group would endorse improved scores from T1 to T2, while TAU participants would not. Results showed a significant Group x Time interaction on pain severity and anxiety and depression. However, there was not a significant Group x Time interaction on pain interference, pain self-efficacy, or QOL. Discussion: These findings provide preliminary support for the effectiveness of BAP, as an adjunctive treatment to TAU, when provided by a trained clinician, as a treatment for reducing pain severity and anxiety and depression, in a heterogeneous chronic pain population. These results advance the current BAP literature, providing preliminary support for using BAP with individuals with a wide variety of chronic pain diagnoses.
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PREDICTING AND SIMULATING OUTDOOR THERMAL COMFORT-BASED HUMAN BEHAVIOR IN URBAN ENVIRONMENTS
Title
PREDICTING AND SIMULATING OUTDOOR THERMAL COMFORT-BASED HUMAN BEHAVIOR IN URBAN ENVIRONMENTS
Creator
Khan, Zahida Marzaban
Date
2022
Description
Rapid urban growth due to a constant rise in world population has amplified the need for sustainable design development of cities. Human...
Show moreRapid urban growth due to a constant rise in world population has amplified the need for sustainable design development of cities. Human behavior, a key performance metric of sustainable design, can be rewarding for urban policies and city planning. Due to its complex nature, human behavior prediction and simulation are increasingly challenging. Complexity is associated with multiple factors, among which social and environmental factors are critical, especially in urban conditions with tall buildings that create unique microclimates. Human behavior in this study referred to human spatial behavior. This research hypothesized that the microclimatic variations at seasonal and diurnal levels affect people’s behavior in outdoor urban environments. Additionally, interdisciplinary crossover studies on novel methodologies to predict human behavior is becoming popular. Moreover, architects and urban designers are interested in human behavior simulation tools that can help them make informed design decisions through ‘what-if’ scenarios and assess their designs before execution. This doctoral research investigated the inter-relationship between Outdoor Thermal Comfort (OTC), human behavior, and urban morphology for Plazas in urban conditions with tall buildings and within a specific climate zone. The study focused on two overarching objectives: (1) to present a novel research methodology to investigate and predict OTC-based human behavior in urban conditions; and (2) to develop HuBeSIM - a human behavior simulation framework using an agent-based model (ABM) to simulate OTC integrated human behavior in outdoor spaces. Daley Plaza – an urban public space built-in 1965 in downtown Chicago — was used as (1) a case study to test the feasibility of this research methodology and (2) a pilot study to demonstrate the HuBeSIM framework. The outcome of this study shows a significant impact in the outdoor urban environments with design goals that use human behavior as a key performance indicator. The research contributes to the modeling and simulation of OTC-based human behavior in urban environments to nurture livable communities and sustainable cities. The first part of the dissertation presented a novel research methodology involving data collection through an on-site observational study for behavioral mapping, and microclimatic CFD simulations for OTC index - Physiological Equivalent Temperature (PET). The sample data consisted of two seasons, namely summer and fall, with more than 600 observations collected during the three-hour lunchtime period. The second part of the dissertation involved developing a Human Behavior SIMulation (HuBeSIM) framework in the popular computer aided design platform Rhino® and Grasshopper® (GH). This part integrated OTC using physics-based modeling and human behavior using mathematical agent-based modeling to develop a simulation framework for outdoor urban space design. The findings from the observational study revealed a moderate relationship between microclimate and human behavior in the fall, and a weak correlation in summer. The results showed that people’s behavior is not affected by PET values above 35°C. The proposed Human Behavior SIMulation framework has a high potential to develop into a comprehensive model by incorporating other behavioral factors. This study contributes to the sustainable built environment design that leads to the environmental, social, and economic upliftment of a city.
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