JointADventure: A Worksite Activity-Diet Intervention for Chronic Knee Pain

JointADventure：针对慢性膝痛的工作场所活动饮食干预

• 批准号: 8456132
• 负责人: ROWLAND W CHANG
• 金额: $ 16.34万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-04-06 至 2014-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8456132
• 关键词: Absenteeism; Activities of Daily Living; Address; Affective; Aging; Arthritis; Behavior; Behavior Therapy; Behavioral; Belief; Blue Cross; Blue Shield; Body Weight decreased; Chronic; Clinical; Clinical Research; Control Groups; Counseling; Data Collection; Degenerative polyarthritis; Development; Diet; Diet Habits; Dietary Intervention; Disease; Economics; Education; Effectiveness; Effectiveness of Interventions; Employee; Enrollment; Environment; Epidemic; Evaluation; Exercise; Food; Frequencies; Future; Generic Drugs; Goals; Growth; Health; Health Care Costs; Health Club; Health Professional; Health Status; Illinois; Individual; Intake; Internet; Intervention; Investments; Joints; Knee; Knee Osteoarthritis; Life Style; Measures; Mediating; Modeling; Motivation; Obesity; Overweight; Pain; Patient Self-Report; Performance; Persons; Physical Function; Physical activity; Population; Prevalence; Public Health; Quality of life; Questionnaires; Randomized; Randomized Controlled Trials; Recording of previous events; Research; Risk; Sampling; Secondary to; Shapes; Site; Symptoms; Testing; Training; Walking; Weight; Weight Gain; Wellness Program; Work; Workplace; administrative database; aging population; base; behavior change; cost; cost effectiveness; diabetes prevention program; disability; eligible participant; follow-up; health care service utilization; improved; innovation; knee pain; knee replacement arthroplasty; meter; motivational enhancement therapy; nutrition; prevent; response; theories

DESCRIPTION (provided by applicant): Because the US population is aging and obesity is rising dramatically, the epidemic of arthritis-associated disability and its associated costs will significantly worsen, largely due to the consequences of knee osteoarthritis (OA). Knee OA is already a major cause of work disability and work absenteeism/presenteeism, and it is responsible for more than 400,000 total knee replacements annually. Weight reduction and increased physical activity can relieve the pain and activity limitations of individuals with knee OA, but these healthy lifestyle behaviors have not been embraced by this large population. The overarching goal of this study is to find an effective, replicable, and sustainable intervention strategy that can assist large groups of employees with or at risk for knee OA to attain and maintain these healthy behaviors. The worksite is an ideal setting to access persons who do not yet have severe knee OA and thus may be more amenable to and benefit more from a behavioral intervention. It is also ideal because both the individual and the environment can be targeted. Our research objective is to further refine, implement, and test the effectiveness of an innovative worksite intervention called JointADventure to reduce the symptoms and activity limitations of knee OA, utilizing a partnership with Blue Cross Blue Shield of Illinois (BCBSIL). BCBSIL is a highly supportive wellness partner, with a strong history of investment in the health of its employees and subscribers. The combined Activity/Dietary (AD) intervention is administered by health professionals trained in motivational interviewing as healthy lifestyle coaches. Over 6 months, they provide 1) individualized counseling based on a comprehensive assessment of baseline clinical, functional and behavioral factors that are barriers to healthy physical activity and dietary behaviors and 2) group education, the content of which is modeled after the highly successful Diabetes Prevention Program physical activity/dietary intervention and customized for those with knee symptoms. Follow-up assessments continue for 6 additional months. Specific aims are to: 1) assess the feasibility of conducting a randomized controlled trial of the JointADventure intervention at this worksite, 2) estimate the effectiveness of the intervention to decrease body weight, improve dietary habits, and increase objectively-measured physical activity, 3) to improve objectively measured functional performance, and 4) to improve self-reported arthritis-specific and generic health status and health utility. If successful, a multi-site randomized controlled trial/R01 proposal will follow to demonstrate the effectiveness/ cost-effectiveness of the JointADventure intervention in larger worksite populations. Given the influence that BCBS has in shaping future health practices and the scalability/generalizability of the proposed intervention, this research could have a tremendous impact on improving symptoms and quality of life for those with early knee OA as well as preventing the work absenteeism/presenteeism, work disability, and increased healthcare costs associated with knee OA.

描述（由申请人提供）：由于美国人口老龄化和肥胖率急剧上升，关节炎相关残疾的流行及其相关费用将显着恶化，这主要是由于膝关节骨关节炎（OA）的后果。膝关节OA已经是导致工作残疾和工作缺勤/出勤的主要原因，每年有超过40万例全膝关节置换术。减轻体重和增加体力活动可以缓解膝关节OA患者的疼痛和活动限制，但这些健康的生活方式尚未被这一庞大的人群所接受。本研究的总体目标是找到一种有效的，可复制的和可持续的干预策略，可以帮助大量患有膝关节骨性关节炎或有膝关节骨性关节炎风险的员工实现并保持这些健康的行为。工作场所是一个理想的设置，以访问的人谁还没有严重的膝关节骨性关节炎，因此可能更容易接受和受益于行为干预。它也是理想的，因为个人和环境都可以成为目标。我们的研究目标是进一步完善，实施和测试一种名为JointADventure的创新工地干预措施的有效性，以减少膝关节OA的症状和活动限制，利用与伊利诺伊州蓝十字蓝盾（BCBSIL）的合作关系。BCBSIL是一个高度支持健康的合作伙伴，在其员工和用户的健康投资方面有着悠久的历史。联合活动/饮食（AD）干预由健康专业人员管理，他们作为健康生活方式教练接受过动机访谈培训。在6个月的时间里，他们提供1）基于对基线临床，功能和行为因素的综合评估的个性化咨询，这些因素是健康体力活动和饮食行为的障碍，2）小组教育，其内容以非常成功的糖尿病预防计划体力活动/饮食干预为蓝本，并为那些有膝盖症状的人定制。后续评估将持续6个月。具体目标是：1）评估进行随机对照试验的可行性 2）评估干预措施在降低体重、改善饮食习惯和增加客观测量的体力活动方面的有效性，3）改善客观测量的功能表现，以及4）改善自我报告的关节炎特异性和一般健康状况和健康效用。如果成功，将进行多中心随机对照试验/R 01提案，以证明JointADventure干预在较大工作场所人群中的有效性/成本效益。考虑到BCBS在塑造未来健康实践方面的影响力以及拟议干预措施的可扩展性/普遍性，这项研究可能对改善早期膝关节OA患者的症状和生活质量以及预防与膝关节OA相关的工作缺勤/出勤、工作残疾和医疗费用增加产生巨大影响。