Study of Physical Activity Rewards after Knee Surgery (SPARKS)

膝关节手术后体力活动奖励研究 (SPARKS)

• 批准号: 8576870
• 负责人: Elena Losina
• 金额: $ 21.96万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-05 至 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8576870
• 关键词: Activities of Daily Living; Address; Adherence; Adult; Affect; Arthritis; Attitude; Behavior; Behavioral; Belief; Centers for Disease Control and Prevention (U.S.); Chronic; Chronic Disease; Clinical Research; Clinical Trials; Comorbidity; Costs and Benefits; Data; Degenerative polyarthritis; Diabetes Mellitus; Diet; Economics; Elderly; Exercise; Fatigue; Future; General Population; Growth; Guidelines; Health; Health Benefit; Heart Diseases; Incentives; Individual; Intervention; Investments; Knee; Knee Osteoarthritis; Knowledge; Lead; Life; Lung; Lung diseases; Musculoskeletal Diseases; Obesity; Operative Surgical Procedures; Outcome; Pain; Patients; Perception; Persons; Physical activity; Population; Prevention; Procedures; Public Health; Quality of life; Reporting; Research Infrastructure; Research Project Grants; Rewards; Testing; Time; Translating; United States; United States Dept. of Health and Human Services; Ursidae Family; Work; World Health Organization; base; behavior change; cost; cost effective; cost effectiveness; design; disorder prevention; effective intervention; experience; functional status; improved; improved functioning; innovation; knee pain; knee replacement arthroplasty; motivational enhancement therapy; prevent; programs; public health relevance; randomized trial; skin disorder; standard of care

DESCRIPTION (provided by applicant): Physical activity (PA) has been shown to improve pain and function in persons with knee osteoarthritis (OA), reduce obesity, and prevent the onset and progression of heart disease, diabetes, and chronic pulmonary disease. The US Department of Human and Health Services (DHHS) guidelines recommend that adults engage in >150 minutes of moderate physical activity per week. However, adherence to PA guidelines is poor in the general population, particularly in persons with knee OA. Total knee replacement (TKR) is widely used in patients with symptomatic, advanced knee OA. While the vast majority of persons undergoing TKR experience considerable reduction in pain and improvement in functional capacity, far fewer take this opportunity to become more physically active. Since physical activity has a direct relationship with quality of life and with prevention and amelioratin of many chronic conditions, many TKR recipients do not derive maximum benefits from the procedure. The focus of this proposal is to conduct a proof of concept RCT to establish the efficacy and cost-effectiveness of a behavioral economics-based intervention that would facilitate engagement in physical activity and improve adherence to PA guidelines in the growing population of TKR recipients. We address the innovative hypothesis that the period following TKR presents a window of opportunity to fundamentally change attitudes and beliefs regarding PA, and that tangible economic incentives will effectively induce behavior change and facilitate adherence to PA guidelines. We propose 'Study of Physical Activity Rewards after Knee Surgery (SPARKS)' with the following specific aims: 1. To design and conduct a proof-of- concept RCT to establish the feasibility and efficacy of a personalized intervention built upon the principles of behavioral economics - as compared with standard of care - in improving physical activity among patients who have undergone TKR. 2. To estimate the costs and cost-effectiveness of this behavioral economics intervention to improve physical activity in persons who have undergone TKR. This proof of concept trial will serve as a building block for planning a multicenter RCT and developing an infrastructure to facilitate rewards-based programs to encourage health-promoting behavior. In addition to assessing efficacy we will develop a framework to evaluate the value and budgetary impact of implementing such interventions on a large scale.

描述（由申请人提供）：已显示体育活动（PA）可改善膝关节骨关节炎（OA）的人的疼痛和功能，减少肥胖，并防止心脏病，糖尿病和慢性肺部疾病的发作和进展。美国人类和卫生服务部（DHHS）指南建议成年人每周进行> 150分钟的适度体育锻炼。但是，对PA指南的遵守在普通人群中很差，尤其是在膝盖OA的人中。总膝盖置换（TKR）广泛用于有症状的晚期膝关节OA。尽管绝大多数经历TKR的人会大大减轻疼痛和功能能力改善，但抓住这个机会变得更加活跃的机会却很少。由于体育锻炼与许多慢性病的生活质量以及预防和amelioratin有直接关系，因此许多TKR接受者不会从该过程中获得最大的收益。该提案的重点是进行概念证明，以确立基于行为经济学的干预措施的功效和成本效益，这将促进从事体育活动并提高对TKR接收者人数不断增长的PA指南的依从性。我们解决了创新的假设，即TKR之后的时期为从根本上改变对PA的态度和信念提供了机会之窗，而有形的经济激励措施将有效地引起行为改变并促进遵守PA指南。我们提出“研究膝盖手术后的体育活动奖励（SPARKS）”，其特定目的是：1。设计和执行概念证明RCT，以确定基于该措施的个性化干预的可行性和功效 与护理标准相比，行为经济学原则在改善了接受TKR的患者的体育锻炼方面。 2。估计这种行为经济学干预的成本和成本效益，以改善接受TKR的人的体育锻炼。该概念验证试验将成为计划多中心RCT并开发基础设施以促进基于奖励的计划以鼓励促进健康行为的基础设施的基础。除了评估功效外，我们还将开发一个框架来评估大规模实施此类干预措施的价值和预算影响。