Physical Activity Management for Clients with Arthritis

关节炎患者的身体活动管理

基本信息

批准号：
7281154
负责人：
ROWLAND W CHANG
金额：
$ 51.24万
依托单位：
NORTHWESTERN UNIVERSITY AT CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2005
资助国家：
美国
起止时间：
2005-09-01 至 2010-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7281154
关键词：
Adult Affect Ally American Arthritis Behavior Behavior Therapy Cardiac Caring Chronic Chronic Disease Client Clinical Condition Control Groups Counseling Count Daily Degenerative polyarthritis Disabled Persons Disease Disease Management Effectiveness Exercise Expenditure Feeling Generic Drugs Health Health Care Costs Health Personnel Health Professional Health Promotion Health behavior change Healthcare Systems Household Individual Intervention Joints Knee Osteoarthritis Life Life Style Living Wills Measures Mediating Medicine Methods Motivation Multivariate Analysis Occupational Ontario Outcome Pain Participant Patient Self-Report Patients Performance Persons Physical activity Physical activity scale Physicians Physicians&apos Offices Population Program Effectiveness Provider Psyche structure Public Health Quality of life Questionnaires Randomized Controlled Trials Rate Recruitment Activity Reliance Reporting Research Research Personnel Research Project Grants Research Proposals Rheumatoid Arthritis Rheumatology SF-36 Score Secondary to Self Management Symptoms Testing Tissues Variant Walking arthropathies base behavior change chronic care model cost day disability fitness follow-up foot health related quality of life improved improved functioning knowledge base prescription document prescription procedure prevent programs theories treatment planning

项目摘要

DESCRIPTION (provided by applicant): Arthritis is a major cause of disability. Of the nearly 70 million persons in the US with arthritis and/or chronic joint symptoms, nearly 8 million are disabled because of their arthritis. Knee osteoarthritis (OA) and rheumatoid arthritis (RA) are two of its most common and disabling forms. Despite evidence that physical activity can improve functional and health related quality of life (HRQOL) outcomes and lower health care costs, the proportion of the US population engaging in the recommended amount of physical activity is low and even lower among those with arthritis. Moreover, there is considerable variation in clinicians' promotion of physical activity for arthritis clients. Care providers infrequently ask clients about their physical activity behavior and report feeling unprepared to promote physical activity. This application studies the effects of a behavioral intervention aimed at promoting physical activity, including lifestyle physical activity, on arthritis-specific and generic HRQOL outcomes. The proposed physical activity management program (PAM) is based on a chronic care model in which allied health professionals promote patient self-management activities outside of traditional physician office encounters. The program is an individualized counseling and referral intervention, conducted by physical activity managers, directed by a theory-based comprehensive assessment of individual patient barriers and strengths related to physical activity performance. The specific aims of this randomized, controlled trial of 480 clients with RA and knee OA followed for 24 months are to test the effectiveness of physical activity management combined with physician physical activity promotion (PAM group) compared to physician physical activity promotion only (control group) in improving arthritis-specific and generic HRQOL, observed measures of function, and objectively measured and self-reported physical activity levels. In addition, exploratory analyses will be done to assess whether the improvements in HRQOL and physical activity performance associated with the PAM program are mediated by increases in physical activity levels and theory-based motivational variables, respectively. This study is intended to generate feasible methods by which health care providers and health care systems can increase physical activity levels in clients with arthritis and to result in widely applicable strategies for health behavior change.

描述（由申请人提供）：关节炎是残疾的主要原因。在美国有关节炎和/或慢性关节症状的近7000万人中，由于其关节炎，将近800万人被残疾。膝关节骨关节炎（OA）和类风湿关节炎（RA）是其最常见和残疾的两种形式。尽管有证据表明体育锻炼可以改善功能和健康相关的生活质量（HRQOL）的结果和降低的医疗保健成本，但在关节炎患有关节炎的人中，从事建议的体育活动的比例很低，甚至更低。此外，临床医生促进关节炎患者的体育活动有很大差异。护理提供者很少向客户询问他们的体育锻炼行为，并报告没有准备好促进体育锻炼的感觉。该应用研究了旨在促进体育活动（包括生活方式体育锻炼）的行为干预措施对关节炎特异性和通用HRQOL结果的影响。拟议的体育活动管理计划（PAM）基于慢性护理模型，在该模型中，盟军卫生专业人员在传统医师办公室遭遇之外促进患者自我管理活动。该计划是由体育活动经理进行的个性化咨询和推荐干预措施，由基于理论的全面评估与体育活动相关的个人障碍和优势进行了全面评估。这个随机对照试验的具体目的 480名患有RA和膝关节OA的客户遵循24个月的时间，是为了在改善关节炎特异性和通用的HRQOL，观察到的功能测量以及对象测量和自我培养的体育活动水平上，与仅医师的身体活动促进（对照组）相比，与医师的身体活动促进（PAM组）相比，与医师身体活动促进（PAM组）相比，测试体育活动的有效性（PAM组）。此外，将进行探索性分析，以评估与PAM计划相关的HRQOL和体育活动绩效的改善是由体育活动水平和基于理论的动机变量的提高所介导的。这项研究旨在产生可行的方法，通过这些方法，医疗保健提供者和医疗保健系统可以提高关节炎患者的体育活动水平，并为改变健康行为改变而广泛适用。