Motivational Interviewing and Physical Activity Behavior Change in Arthritis

描述（由申请人提供）：我对关节炎患者的适应能力很感兴趣，以及他们争取独立的动机如何影响他们控制疾病的能力。2005年，罗兰·张博士找到我，让我参加他的R01资助的改善关节炎患者体育活动动机临床试验（IMPAACT）的干预小组。我在IMPAACT干预方面的工作重点是动机性访谈，这为这种类型的咨询风格在帮助客户改变行为方面的潜在好处提供了背景。IMPAACT干预的重点是增加类风湿关节炎（RA）和膝骨关节炎（OA）患者的生活方式体力活动。我的职业目标是成为物理医学和康复系的一名学术上成功的教员，同时兼任护理工作，为健康促进干预研究提供研究支持，包括对慢性疾病或残疾患者的动机性访谈。本次K23奖申请的目的是1)增加我在行为改变方面的理论知识，2)增加我在临床研究中的方法技能，3)增加我在论文和拨款写作以及负责任的研究行为方面的技能和经验，4)建立我在医疗康复和健康促进实践相关护理领域的声誉。这些目标将通过课程学习、参加讲习班和讨论会、在区域和国家会议上发言、出版物和赠款写作来实现。我的K23研究项目旨在开发和验证一种工具，用于测量客户对健康专业人员执行的动机性访谈过程强度的评估。使用该仪器，将对30名RA患者和30名膝关节OA患者进行初步研究，以确定客户对动机性访谈过程强度的评估是否与积极的身体活动行为改变有关。此外，我们将探讨动机性访谈过程对增加体力活动的影响是否如Cox客户健康行为互动模型所假设的那样，是由客户动机、情感反应和认知评价的变化所介导的。我有一个强大的指导团队和一个支持性的环境。芝加哥康复研究所（RIC）是一家专业的、独立的、非营利性的医院，致力于照顾和治疗包括关节炎在内的各种残疾患者。RIC的康复结果研究中心专注于记录患者结果和护理成本的研究，确定康复护理过程中影响患者结果的无效和低效率领域。最后，NIAMS p60资助的风湿病多学科临床研究中心和NCRR ul1资助的CTSA为我的职业发展提供了西北大学的资源和支持。

DESCRIPTION (provided by applicant): I have been intrigued with the adaptability of people with arthritis, and how their motivation to strive for independence influences their ability to manage their disease. In 2005, Dr. Rowland Chang sought me out to participate in the intervention team for his R01 funded Improving Motivation for Physical Activity in People with Arthritis Clinical Trial (IMPAACT). My work on the IMPAACT intervention focusing on motivational interviewing has provided background as to the potential benefit of this type of counseling style in helping clients change their behavior. The IMPAACT intervention focuses on increasing lifestyle physical activity in persons with rheumatoid arthritis (RA) and knee osteoarthritis (OA). My career goal is to become an academically successful faculty member in the Department of Physical Medicine and Rehabilitation with an adjunct appointment in nursing with research support for studies of health promotion interventions that incorporate motivational interviewing for persons with chronic illness or disability. The objectives of this K23 award application are 1) to increase my theoretical knowledge in behavior change, 2) to increase my methodological skills in clinical research, 3) to increase my skills and experience in manuscript and grant writing and the responsible conduct of research, and 4) to establish my reputation in the fields of medical rehabilitation and nursing pertaining to health promotion practices. These goals will be achieved through coursework, attendance at workshops and seminars, presentations at regional and national meetings, publications and grant writing. My K23 research project aims to develop and validate an instrument that measures the client's assessment of the strength of the motivational interviewing processes performed by a health professional. Using this instrument, a pilot study of 30 persons with RA and 30 persons with knee OA will be performed to determine if the client's assessment of the strength of the motivational interviewing processes is associated with positive physical activity behavior change. In addition, we will explore if the effect of motivational interviewing processes on increased physical activity is mediated by changes in client motivation, affective response, and cognitive appraisal as hypothesized by Cox's Interaction Model of Client Health Behavior. I have a strong mentoring team and a supportive environment. The Rehabilitation Institute of Chicago (RIC) is a specialized, freestanding, not-for-profit hospital dedicated to the care and treatment of individuals with a variety of disabling conditions, including arthritis. The Center for Rehabilitation Outcomes Research at RIC focuses on research that documents patient outcomes and cost of care, identifies areas of ineffectiveness and inefficiency in the rehabilitation care process which have an impact on patient outcome. Finally, the NIAMS P60-funded Multidisciplinary Clinical Research Center in Rheumatology and the NCRR UL1-funded CTSA provide Northwestern University resources and support for my career development. PUBLIC HEALTH RELEVANCE: Relevance Motivational interviewing is a counseling style designed to help people change their behavior. This research will help health professionals understand how people with arthritis view the motivational interviewing process and how it helps them improve their physical activity behavior.