PHYSICAL ACTIVITY MANAGEMENT FOR CLIENTS WITH ARTHRITIS-PILOT STUDY

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Arthritis is a major cause of disability among adults. Of the nearly 70 million persons in the US with arthritis, more than 7 million adults are disabled. Knee osteoarthritis (OA) and Arthritis is a major cause of disability among adults. Of the nearly 70 million persons in the US with arthritis, more than 7 million adults are disabled. Knee osteoarthritis (OA) and Rheumatoid Arthritis (RA) are two of the most common and disabling forms of arthritis. The proportion of the US population who engage in the recommended amount of physical activity is low and even lower among those with arthritis. Moreover, there is considerable variation among clinicians' promotion of physical activity in arthritis patients. The objective of this research project is to evaluate the effectiveness of an exportable practice-based Physical Activity Promotion program applicable to patients with arthritis compared to usual physician counseling. The Physical Activity Promotion Program consists of the Arthritis Comprehensive Treatment Assessment (ACTA) that identifies barriers to participation in physical activity and a client-centered, individualized goal setting, treatment planning, and habit acquisition intervention program. This study will randomize participants to either Physician Counseling (Group 1) or to the Physical Activity Promotion Program with Physician Counseling (Group 2). In both groups, the focus is on increasing participant's participation in lifestyle physical activity, i.e., everyday activities such as housework, walking instead of driving, recreational activities such as swimming and dancing, etc. rather than on traditional formal exercise. All participants will wear an accelerometer (measures physical movement) for seven days, respond to a telephone interview about physical function, quality of life, physical activity, motivation, goals, medication use, and demo-graphic information, and carry out two observed measures of functional status. This series of assessments will be repeated at 3, 6, 12, 18, and 24 months after the baseline visit (except for the observed physical function tests which will be repeated at 12 and 24 months only). Group 1 will receive Physician Counseling at the baseline visit and then at their regularly scheduled clinic visits. Group 2 will receive Physician Counseling and the Physical Activity Promotion Program at baseline, the ACTA assessment at 3 monthly intervals and further intervention meetings with the Physical Activity Advocate as necessary and agreed upon by the Participant and Advocate. The specific aims of this randomized, controlled trial are to: 1. Test the effectiveness of the Physical Activity Promotion Program combined with Physician physical activity counseling (Group 2) compared to Physician Counseling only (Group 1) in im-proving arthritis-specific and generic health-related quality of life, 2. Test the effectiveness of the Physical Activity Promotion Program vs. Physician Counseling intervention in improving observed measures of function and cardiac fitness 3. Test the effectiveness of the Physical Activity Promotion Program vs. Physician Counseling intervention in improving physical activity performance.