Scale up evaluation of a physical activity program for adults with physical disability

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 DESCRIPTION (provided by applicant): Rates of physical inactivity among people with physical disability (PWD) are significantly higher than in the general population. PWD have less access to indoor and outdoor physical activity (PA); get less unstructured PA across the day due to high rates of unemployment or underemployment; and their incidence of chronic health conditions are substantially higher than in the general population. As disability-associated health care expenditures continue to rise, there is a strong and growing need to provide opportunities for PWD to achieve higher levels of regular physical activity. The growing availability of internet access among PWD today compared to 5 years ago provides a unique and unprecedented opportunity to use telehealth as a mechanism for reaching this underserved population. The study uses a theory-driven eHealth platform and innovative PA program referred to as movement-to-music (M2M) to deliver a customized, home-based PA intervention for adults with physical disability. Participants will be recruited through a large physical medicine and rehabilitation network of clinics specializing in treating patients with physical disability. Cliniians and their patients will be cluster randomized to one of three groups: a) M2M; b) M2M plus social networking (M2Mplus); and c) attention control (AC). Participants will be followed for 48 weeks to obtain objective measures on physical activity, fitness and self-reported measures on health at four time points. Participant physicians will receive information on their patients' progress (ie., adherence and outcomes) across the 48-week study period. The study will compare the effectiveness of M2M and M2Mplus in increasing physical activity and adherence compared to the AC group, estimate the improvements in health of M2M and M2Mplus compared to the AC group, and examine the mediators and moderators of the hypothesized treatment effect to understand for whom and how the intervention is effective. This multi-level, scalability study will strengthen our understanding of the potential benefits of eHealth to eliminate barriers to PA participation among PWD.