ABSTRACT
BACKGROUND: Chronic neck pain (CNP) is prevalent, and it reduces functional status and quality of life and is associated with deleterious psychological outcomes in affected individuals. Despite the desirability of massage and its demonstrated effectiveness in CNP treatment, multiple accessibility barriers exist. Caregiver-applied massage has demonstrated feasibility in various populations but has not been examined in Veterans with CNP or compared in parallel to therapist-delivered massage. OBJECTIVE: This manuscript described the original study design, lessons learned, and resultant design modifications for the Trial Outcomes for Massage: Care Ally-Assisted Versus Therapist-Treated (TOMCATT) study. METHODS: TOMCATT began as a 3-arm, randomized controlled trial of 2 massage delivery approaches for Veterans with CNP with measures collected at baseline, 1 and 3 months after intervention, and 6 months (follow-up). Arm I, care ally-assisted massage, consisted of an in-person, 3.5-hour training workshop, an instructional DVD, a printed treatment manual, and three 30-minute at-home care ally-assisted massage sessions weekly for 3 months. Arm II, therapist-treated massage, consisted of two 60-minute sessions tailored to individual pain experiences and treatments per week for 3 months. The treatments followed a standardized Swedish massage approach. Arm III consisted of wait-list control. RESULTS: Retention and engagement challenges in the first 30 months were significant in the care ally-assisted massage study arm (63% attrition between randomization and treatment initiation) and prompted modification to a 2-arm trial, that is, removing arm I. CONCLUSIONS: The modified TOMCATT study successfully launched and exceeded recruitment goals 2.5 months before the necessary COVID-19 pause and is expected to be completed by early 2023. TRIAL REGISTRATION: ClinicalTrials.gov NCT03100539; https://clinicaltrials.gov/ct2/show/NCT03100539. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/38950.
ABSTRACT
This exploratory study builds upon the expertise of a panel of faculty, administrators, students, and instructional designers (IDs) who lived through the pandemic and dealt with the associated challenges firsthand. These participants provided insight on how to establish systems that would create successful online teaching and learning opportunities in the post-vaccine and post-pandemic world. Four major themes emerged: (a) integrating technology to facilitate and enhance education;(b) structural support and resources needed to build sound processes for effective online education;(c) establishing faculty presence to facilitate learning;and (d) joint ownership and responsibility of learning?everyone must play a part. These themes have been described in light of theoretical frameworks, such as the Technological Pedagogical and Content Knowledge (TPACK) model, Community of Inquiry (COI), and Continuous Quality Improvement (CQI). Finally, evidence-based tips will allow academic institutions to successfully emerge out of the pandemic while still making plans to adjust and adapt in the post-vaccine world.