Physical Activity Management for Clients with Arthritis

关节炎患者的身体活动管理

• 批准号: 7485085
• 负责人: ROWLAND W CHANG
• 金额: $ 49.34万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 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/7485085
• 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' 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

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。在美国近7000万患有关节炎和/或慢性关节症状的人中，近800万人因关节炎而残疾。膝关节骨关节炎（OA）和类风湿性关节炎（RA）是其最常见和致残的形式。尽管有证据表明，体力活动可以改善功能和健康相关的生活质量（HRQOL）的结果，并降低医疗保健成本，但美国人口中从事推荐量的体力活动的比例很低，关节炎患者的比例甚至更低。此外，临床医生对关节炎患者进行体力活动的促进存在相当大的差异。护理人员很少询问客户关于他们的体育活动行为，并报告感觉没有准备好促进体育活动。本申请研究了旨在促进体力活动（包括生活方式体力活动）的行为干预对关节炎特异性和一般HRQOL结果的影响。拟议的体力活动管理计划（PAM）是基于慢性病护理模式，其中专职医疗人员促进患者的自我管理活动以外的传统医生办公室的遭遇。该计划是一个个性化的咨询和转介干预，由身体活动管理人员进行，由一个基于理论的综合评估个别患者的障碍和力量与身体活动的表现。这项随机对照试验的具体目的是， 480例RA和膝关节OA患者随访24个月，以测试与医生体力活动促进相结合的体力活动管理（PAM组）与仅医生体力活动促进（对照组）相比，在改善关节炎特异性和一般HRQOL，观察功能指标以及客观测量和自我报告的体力活动水平方面的有效性。此外，将进行探索性分析，以评估与PAM计划相关的HRQOL和体力活动表现的改善是否分别通过体力活动水平和基于理论的动机变量的增加来介导。本研究旨在产生可行的方法，通过这些方法，卫生保健提供者和卫生保健系统可以增加关节炎患者的体力活动水平，并产生广泛适用的健康行为改变策略。