Computer-guided Action Planning to Support Physical Activity (CAPPA) for Employees with Chronic Knee Symptoms

计算机引导的行动计划，支持患有慢性膝关节症状的员工进行体力活动 (CAPPA)

• 批准号: 10585564
• 负责人: ROWLAND W CHANG
• 金额: $ 29.34万
• 依托单位: MARQUETTE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-12-21 至 2024-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10585564
• 关键词: Accelerometer; Address; Adult; Advocate; Age; Aging; Arthritis; Behavior; Behavior Therapy; Behavioral; Blue Cross; Blue Shield; COVID-19; Caring; Chronic; Clinical; Clinical Trials; Communication; Communities; Computers; Data; Development; Devices; Disease; Dose; Education; Effectiveness; Employee; Employee Health; Feedback; Future; Goals; Guidelines; Health; Health Care Costs; Health Resources; Health Technology; Healthcare; Illinois; Incentives; Individual; Infrastructure; Intervention; Interview; Knee; Knee Osteoarthritis; Knowledge; Life Style; Link; Measures; Midwestern United States; Monitor; Movement; Obesity; Outcome; Pain; Participant; Patient Self-Report; Pattern; Performance; Persons; Physical Function; Physical activity; Pilot Projects; Population; Predictive Value; Productivity; Protocols documentation; Public Health; Quality of life; Randomized, Controlled Trials; Recommendation; Replacement Arthroplasty; Research; Resources; Rheumatology; Risk; Risk Factors; Services; Site; Societies; Structure; Symptoms; Technology; Technology Assessment; Testing; Text; Time; Treatment Efficacy; Universities; Voice; Wellness Program; Work; Workplace; actigraphy; attentional control; clinical care; cost; dashboard; data exchange; design; disability; effective intervention; evidence base; exercise intervention; exercise program; experience; fitbit; fitness; follow-up; functional improvement; health administration; improved; knee pain; knee replacement arthroplasty; meetings; member; modifiable risk; mortality; novel; pain relief; peer; person centered; prevent; primary outcome; productivity loss; programs; recruit; research study; secondary outcome; sedentary; support tools; symptomatic improvement; telecoaching; tool; treatment arm; treatment effect; ubiquitous computing; video chat

PROJECT SUMMARY Society needs effective non-operative therapies to manage chronic knee symptoms (CKS) resulting from knee osteoarthritis (KOA). CKS is associated with pain, loss of independence, and increased mortality. Rates of CKS are increasing, fueled by an aging, obese, and sedentary society. Because CKS first presents in working age adults, it is a major cause of work disability and work productivity loss. Over 13 million US adults 45 years and older have symptomatic KOA and CKS,1 and one-third of working adults (45-64 years) have arthritis.2-4 Of those with KOA, over half have severe disability and will have a total knee replacement (TKR). Sadly, persons with CKS engage in treatments with low effectiveness while waiting for TKR, in part due to the behavioral challenges of engaging in regular physical activity(PA). Physical activity has been shown to relieve pain, improve function, and prevent losses in independence in individuals across the KOA disease spectrum. Despite its value, PA levels remain low among adults with CKS and for adults in the workplace. Low PA is linked to high healthcare spending and losses in worker productivity creating an incentive for employer-support PA initiatives. Many workplaces have embraced wellness programs to support employees in improving their health, however employees with CKS struggle with lower rates of PA than their peers without CKS. Previous research has found that Fitbit tracking can improve behavior for some with CKS but others benefit from more intensive forms of coaching. The exact amount of coaching needed remains unknown. Employee stakeholders have asked for low resource forms of coaching available through the workplace. The potential exists to support employees with CKS using an acceptable, low-resource coaching strategy. The goal of this program is to test a brief, scalable PA coaching intervention that can assist employees with CKS attain and maintain healthy PA behavior in two worksites in the Midwest. CAPPA is a 12-week pilot randomized controlled trial that will 1) use computer-guided action-planning behavioral intervention to support employees in making PA action plans for their health, 2) use data transmitted from a personal fitness tracker (Fitbit) to support coach and employee knowledge about PA performance, and 3) Inform on optimal step up times for participants who do not substantially increase PA. CAPPA will put PA feedback in a Movement Dashboard to support study participants. The CAPPA intervention will use each participant’s preferred communication mode (text, voice call, or video chat) to attain and sustain healthy PA behavior at Blue Cross Blue Shield of Illinois and Advocate Aurora Health. Follow-up measures of PA, pain and physical function are planned at treatment completion and three months following study completion. Specific aims are to: 1) Estimate the efficacy of the intervention to increase objectively- measured physical activity, 2) Examine the feasibility, acceptability and sustainability of the CAPPA intervention for the respective workplaces, and 3) Inform the initial step up time for future stepped interventions among participants not substantially increasing their physical activity. This study leverages the combined clinical and technologic expertise of the members of the Physical Activity in Rheumatology Research group at Northwestern University, Northwestern’s Arthritis Center Accelerometer unit, Marquette University’s Behavior, Engagement and Health Technology Assessment Lab and Ubiquitous Computing Lab, the Blue Cross Blue Shield of Illinois Corporation, and Advocate Aurora Health. If CAPPA is feasible and shows preliminary effectiveness, a multi-site randomized controlled trial/U01 proposal will follow to demonstrate the effectiveness of the CAPPA intervention in larger worksite populations. This research could have a tremendous impact on improving symptoms and quality of life for those with CKS and early KOA. If treatments are successful at Blue Cross Blue Shield of Illinois and Advocate Aurora Health they may be employed in the services they provide to other organizations.

项目摘要 社会需要有效的非手术疗法来管理慢性膝关节症状（CKS） 膝关节骨关节炎（KOA）导致。 CKS与疼痛，独立丧失有关， 并增加死亡率。 CK的速率正在增加，衰老，肥胖和久坐不动 社会。由于CKS首先出现在工作年龄的成年人中，所以这是工作障碍的主要原因 和工作生产力损失。超过1300万的美国成年人45岁及以上有症状 KOA和CKS，1和三分之一的成年人（45 - 64年）患有关节炎。2-4 KOA超过一半具有严重的残疾，并且总膝盖置换（TKR）。可悲的是 在等待TKR时，患有CK的人从事效率低下的治疗 应对常规体育锻炼（PA）的行为挑战。体育锻炼有 被证明可以挽救疼痛，改善功能并防止个体独立损失 跨越KOA病谱。尽管有价值，但PA的水平仍然很低。 CKS和工作场所的成年人。低PA与高医疗保健支出和损失有关 工人的生产力为员工支持PA计划创造了激励措施。许多工作场所 已经接受了健康计划，以支持员工改善健康状况，但是 患有CKS的员工的PA比率低于没有CK的同行。 先前的研究发现，Fitbit跟踪可以改善某些CK的行为 但是其他人则从更密集的教练形式中受益。确切的教练数量 仍然未知。员工利益相关者要求提供低资源的教练形式 可通过工作场所获得。潜在的潜力是使用CK的员工使用 可以接受的低资源教练策略。该程序的目的是测试简短，可扩展的 PA指导干预措施，可以帮助CKS的员工达到并保持健康的PA 中西部的两幅作品的行为。 CAPPA是一个为期12周的飞行员随机控制 试验1）使用计算机引导的行动规划行为干预来支持 员工为健康制定PA行动计划，2）使用从个人身上传递的数据 健身追踪器（FITBIT）支持教练和员工有关PA绩效的知识，3） 告知没有大幅增加PA的参与者的最佳步骤时间。卡帕 将把PA反馈放入运动仪表板中，以支持研究参与者。卡帕 干预将使用每个参与者的首选通信模式（文本，语音通话或视频 聊天）在伊利诺伊州的蓝十字蓝盾上获得并维持健康的PA行为 提倡Aurora Health。计划在PA，疼痛和身体机能的后续措施 治疗完成和研究完成后三个月。 具体目的是：1）估计干预效率以客观的增加 - 测量的体育活动，2）检查 CAPPA干预各自的作品，3）告知第一步 未来的逐步干预措施在参与者之间没有大大增加其身体 活动。这项研究利用了合并的临床和技术专业知识 西北大学风湿病研究小组的体育活动成员， 西北部的关节炎中心加速度计，马奎特大学的行为， 参与和卫生技术评估实验室和无处不在的计算实验室，蓝色 伊利诺伊州公司的横跨蓝盾，并提倡Aurora Health。如果Cappa是可行的，并且 显示了初步有效性，将遵循多站点的随机对照试验/U01提案 证明在较大的工作场所种群中CAPPA干预的有效性。这 研究可能会对人们改善症状和生活质量产生巨大影响 与CK和早期的KOA。如果在伊利诺伊州的蓝十字蓝盾和 提倡Aurora Health，他们可能会在提供给其他服务的服务中雇用 组织。