Motivational Interviewing and Physical Activity Behavior Change in Arthritis

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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.