Motivational Interviewing and Physical Activity Behavior Change in Arthritis

描述(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管理疾病的能力。2005年，Rowland Chang博士找我参加了他的R01资助的改善关节炎患者体力活动动机临床试验(IMPAACT)的干预团队。我在IMPAACT干预方面的工作侧重于激励性访谈，为这种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资料。IMPAACT干预的重点是增加类风湿性关节炎(RA)和膝骨性关节炎(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在学术上取得成功的教员，在护理方面担任兼职，并为健康促进干预研究提供研究支持，其中包括对慢性病或残疾患者进行激励性访谈。这个K23奖项申请的目的是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)增加我在手稿和赠款撰写以及负责任的研究方面的技能和经验，4)在与健康促进实践相关的医疗康复和护理领域建立我的声誉。这些目标将通过课程作业、参加讲习班和研讨会、在区域和国家会议上发言、出版出版物和撰写赠款来实现。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激励性访谈过程的强度的评估。使用这一工具，将对30名RA患者和30名膝关节骨性关节炎患者进行初步研究，以确定客户对激励性面谈过程的强度的评估是否与积极的身体活动行为变化有关。此外，我们将探索激励性访谈过程对增加体力活动的影响是否像考克斯的客户健康行为交互模型所假设的那样，通过客户动机、情感反应和认知评估的变化而起中介作用。我有一个强大的指导团队和一个支持的环境。芝加哥康复研究所(RIC)是一家专门的、独立的、非营利性的医院，致力于护理和治疗患有包括关节炎在内的各种残疾状况的个人。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对患者结果有影响的无效和低效领域。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。 公共健康相关性：相关性动机访谈是一种旨在帮助人们改变行为的咨询风格。这项研究将帮助健康专业人员了解关节炎患者如何看待激励性面谈过程，以及它如何帮助他们改善身体活动行为。

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.