Clarifying critical processes linking partner support to insufficiently active

由于骨关节炎(OA)是一个非常普遍的公共卫生问题，即使是对骨关节炎(PWOA)患者的健康和福祉的微小改善也可以产生重大影响。体力活动是管理OA的核心，但大多数PWO不够活跃，因此他们不能从中受益。这项建议针对不够活跃的PWOA，目的是开发一种新的干预方法，帮助他们在生活方式的体力活动(LPA)中做出小幅但持续的增加。伴侣支持(例如，来自配偶的)有可能成为实现这一目标的特别强大的资源；社会支持是PWOA中身体活动的最可靠的心理社会预测因素之一，而伴侣处于帮助和鼓励改变生活方式的理想位置。然而，有证据表明，伴侣的支持可能会阻碍而不是促进行为改变。目前对伙伴支助流程的了解不足以指导制定可靠有效的伙伴支助或夫妻干预措施。我们的社会支持有效性(SSE)框架可以帮助阐明这些过程。它规定了合作伙伴支持的特点，最大限度地发挥其在不够活跃的PWOA中推广LPA的潜力，并建议当夫妻双方都拥有足够的支持相关技能时，合作伙伴支持的这些有益特征最有可能出现。此外，证据表明，最关键的支持相关技能涉及情绪调节能力，能够理解自己和他人的情绪，并对不和谐做出适应性反应。我们提出了一个两阶段的研究路线。基础阶段是对来自约翰斯顿县办公自动化项目的167对夫妇进行的二元纵向研究。它将确定伴侣支持过程、PWOA和伴侣情绪调节技能之间的相互关系，以及这些因素在一年的过程中影响不够活跃的PWOA的LPA启动和维持的途径(目标1-3)。翻译阶段是一系列的三项研究，旨在评估将这些新知识转化为新的培训计划的潜力，以提高夫妇的情绪调节技能，以及他们应用这些技能接受和提供有效的伴侣支持LPA的能力(目标4)。这项建议得益于招募我们人口的成熟资源、具有成熟合作关系的专家团队和强大的理论基础。它针对一个重大的公共卫生问题，并承诺通过利用合作伙伴作为支持其生活方式改变的有效资源，加强对不够积极的PWO的LPA干预的有效性。

Because osteoarthritis (OA) is a highly prevalent public health problem, even small improvements in health and well-being among people with OA (PWOA) can have a substantial impact. Physical activity is central to managing OA, but most PWO are insufficiently active so they do not benefit from it. This proposal targets insufficiently active PWOA, with the goal of developing a novel intervention approach to help them make small but sustained increases in lifestyle physical activity (LPA). Partner support (e.g., from a spouse) has the potential to be a particularly powerful resource for achieving this goal; social support is one of the most reliable psychosocial predictors of physical activity in PWOA and partners are ideally situated to assist with and encourage lifestyle change. Yet, evidence shows partner support can hinder instead of promote behavior change. Current understanding of partner support processes is insufficient to guide development of partner support or couples interventions that are reliably effective. Our social support effectiveness (SSE) framework can help elucidate these processes. It specifies features of partner support that maximize its potential to promote LPA among insufficiently active PWOA and suggests that these beneficial features of partner support are most likely to be present when both members of a couple have adequate support-related skills. Further, evidence shows that the most critical support-related skills involve emotion regulation¿ability to understand one's own and another's emotions and to respond adaptively to discordance. We propose a 2- phase line of research. The Foundational Phase is a dyadic longitudinal study of 167 couples from the Johnston County OA Project. It will identify interrelations among partner support processes, PWOA and partner emotion regulation skills, and pathways through which these factors influence initiation and maintenance of LPA among insufficiently active PWOA over the course of a year (Aims 1-3). The Translational Phase is a series of three studies to evaluate potential to translate this new knowledge into a novel training program that improves couples' emotion regulation skills and their ability to apply them to receiving and providing effective partner support for LPA (Aim 4). This proposal benefits from a well established resource for recruiting our population, an expert team with established collaborations, and a strong theoretical basis. It targets a significant public health problem and promises to enhance the effectiveness of LPA interventions for insufficiently active PWO by leveraging partners as an effective resource to support their lifestyle change.