Computer-guided Action Planning to Support Physical Activity (CAPPA) for Employees with Chronic Knee Symptoms

计算机引导的行动计划，支持患有慢性膝关节症状的员工进行体力活动 (CAPPA)

• 批准号: 10585564
• 负责人: ROWLAND W CHANG
• 金额: $ 29.34万
• 依托单位: MARQUETTE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-12-21 至 2024-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10585564
• 关键词: Accelerometer; Address; Adult; Advocate; Age; Aging; Arthritis; Behavior; Behavior Therapy; Behavioral; Blue Cross; Blue Shield; COVID-19; Caring; Chronic; Clinical; Clinical Trials; Communication; Communities; Computers; Data; Development; Devices; Disease; Dose; Education; Effectiveness; Employee; Employee Health; Feedback; Future; Goals; Guidelines; Health; Health Care Costs; Health Resources; Health Technology; Healthcare; Illinois; Incentives; Individual; Infrastructure; Intervention; Interview; Knee; Knee Osteoarthritis; Knowledge; Life Style; Link; Measures; Midwestern United States; Monitor; Movement; Obesity; Outcome; Pain; Participant; Patient Self-Report; Pattern; Performance; Persons; Physical Function; Physical activity; Pilot Projects; Population; Predictive Value; Productivity; Protocols documentation; Public Health; Quality of life; Randomized, Controlled Trials; Recommendation; Replacement Arthroplasty; Research; Resources; Rheumatology; Risk; Risk Factors; Services; Site; Societies; Structure; Symptoms; Technology; Technology Assessment; Testing; Text; Time; Treatment Efficacy; Universities; Voice; Wellness Program; Work; Workplace; actigraphy; attentional control; clinical care; cost; dashboard; data exchange; design; disability; effective intervention; evidence base; exercise intervention; exercise program; experience; fitbit; fitness; follow-up; functional improvement; health administration; improved; knee pain; knee replacement arthroplasty; meetings; member; modifiable risk; mortality; novel; pain relief; peer; person centered; prevent; primary outcome; productivity loss; programs; recruit; research study; secondary outcome; sedentary; support tools; symptomatic improvement; telecoaching; tool; treatment arm; treatment effect; ubiquitous computing; video chat

PROJECT SUMMARY Society needs effective non-operative therapies to manage chronic knee symptoms (CKS) resulting from knee osteoarthritis (KOA). CKS is associated with pain, loss of independence, and increased mortality. Rates of CKS are increasing, fueled by an aging, obese, and sedentary society. Because CKS first presents in working age adults, it is a major cause of work disability and work productivity loss. Over 13 million US adults 45 years and older have symptomatic KOA and CKS,1 and one-third of working adults (45-64 years) have arthritis.2-4 Of those with KOA, over half have severe disability and will have a total knee replacement (TKR). Sadly, persons with CKS engage in treatments with low effectiveness while waiting for TKR, in part due to the behavioral challenges of engaging in regular physical activity(PA). Physical activity has been shown to relieve pain, improve function, and prevent losses in independence in individuals across the KOA disease spectrum. Despite its value, PA levels remain low among adults with CKS and for adults in the workplace. Low PA is linked to high healthcare spending and losses in worker productivity creating an incentive for employer-support PA initiatives. Many workplaces have embraced wellness programs to support employees in improving their health, however employees with CKS struggle with lower rates of PA than their peers without CKS. Previous research has found that Fitbit tracking can improve behavior for some with CKS but others benefit from more intensive forms of coaching. The exact amount of coaching needed remains unknown. Employee stakeholders have asked for low resource forms of coaching available through the workplace. The potential exists to support employees with CKS using an acceptable, low-resource coaching strategy. The goal of this program is to test a brief, scalable PA coaching intervention that can assist employees with CKS attain and maintain healthy PA behavior in two worksites in the Midwest. CAPPA is a 12-week pilot randomized controlled trial that will 1) use computer-guided action-planning behavioral intervention to support employees in making PA action plans for their health, 2) use data transmitted from a personal fitness tracker (Fitbit) to support coach and employee knowledge about PA performance, and 3) Inform on optimal step up times for participants who do not substantially increase PA. CAPPA will put PA feedback in a Movement Dashboard to support study participants. The CAPPA intervention will use each participant’s preferred communication mode (text, voice call, or video chat) to attain and sustain healthy PA behavior at Blue Cross Blue Shield of Illinois and Advocate Aurora Health. Follow-up measures of PA, pain and physical function are planned at treatment completion and three months following study completion. Specific aims are to: 1) Estimate the efficacy of the intervention to increase objectively- measured physical activity, 2) Examine the feasibility, acceptability and sustainability of the CAPPA intervention for the respective workplaces, and 3) Inform the initial step up time for future stepped interventions among participants not substantially increasing their physical activity. This study leverages the combined clinical and technologic expertise of the members of the Physical Activity in Rheumatology Research group at Northwestern University, Northwestern’s Arthritis Center Accelerometer unit, Marquette University’s Behavior, Engagement and Health Technology Assessment Lab and Ubiquitous Computing Lab, the Blue Cross Blue Shield of Illinois Corporation, and Advocate Aurora Health. If CAPPA is feasible and shows preliminary effectiveness, a multi-site randomized controlled trial/U01 proposal will follow to demonstrate the effectiveness of the CAPPA intervention in larger worksite populations. This research could have a tremendous impact on improving symptoms and quality of life for those with CKS and early KOA. If treatments are successful at Blue Cross Blue Shield of Illinois and Advocate Aurora Health they may be employed in the services they provide to other organizations.

项目概要 社会需要有效的非手术疗法来控制慢性膝关节症状（CKS） 由膝骨关节炎（KOA）引起。 CKS 与疼痛、丧失独立性、 并增加死亡率。由于衰老、肥胖和久坐，CKS 的发病率正在上升 社会。由于 CKS 首先出现在工作年龄的成年人中，因此它是导致工作残疾的主要原因 和工作生产力损失。超过 1300 万 45 岁及以上的美国成年人有症状 KOA 和 CKS，1 和三分之一的职业成年人（45-64 岁）患有关节炎。2-4 KOA，超过一半患有严重残疾，将接受全膝关节置换术 (TKR)。可悲的是， 患有 CKS 的人在等待 TKR 期间进行的治疗效果不佳，部分原因是 参加定期体育活动 (PA) 的行为挑战。体力活动有 已被证明可以缓解疼痛、改善功能并防止个体丧失独立性 涵盖 KOA 疾病谱。尽管有其价值，但患有以下疾病的成年人中 PA 水平仍然较低 CKS 和工作场所的成年人。低 PA 与高医疗保健支出和损失有关 工人生产力为雇主支持 PA 计划创造激励。许多工作场所 然而，已经采取了健康计划来支持员工改善健康 与没有 CKS 的同事相比，患有 CKS 的员工的 PA 率较低。 之前的研究发现 Fitbit 追踪可以改善一些患有 CKS 的人的行为 但其他人则受益于更强化的辅导形式。所需辅导的确切数量 仍然未知。员工利益相关者要求低资源形式的辅导 通过工作场所可以获得。存在使用 CKS 支持员工的潜力 可接受的、低资源的辅导策略。该计划的目标是测试一个简短的、可扩展的 PA 辅导干预可以帮助患有 CKS 的员工获得并保持健康的 PA 中西部两个工作地点的行为。 CAPPA 是一项为期 12 周的试点随机对照试验 试验将 1）使用计算机引导的行动计划行为干预来支持 员工在制定 PA 健康行动计划时，2) 使用从个人数据传输的数据 健身追踪器 (Fitbit)，用于支持教练和员工了解 PA 表现，以及 3) 告知未大幅增加 PA 的参与者的最佳提升时间。 CAPPA 将把 PA 反馈放入运动仪表板中以支持研究参与者。 CAPPA 干预将使用每个参与者首选的通信模式（文本、语音通话或视频） 聊天）以在伊利诺伊州 Blue Cross Blue Shield 获得并维持健康的 PA 行为，以及 倡导极光健康。计划对 PA、疼痛和身体功能进行后续测量 治疗完成以及研究完成后三个月。 具体目标是： 1) 估计干预措施的功效，以客观地提高- 测量的身体活动，2）检查可行性、可接受性和可持续性 对各个工作场所进行 CAPPA 干预，以及 3) 告知初始步骤时间 未来参与者之间的逐步干预不会显着增加他们的体力 活动。这项研究结合了临床和技术专业知识 西北大学风湿病学身体活动研究小组成员， 西北大学关节炎中心加速计单位，马凯特大学行为学， 参与和健康技术评估实验室和普适计算实验室，蓝色 伊利诺伊州公司的 Cross Blue Shield 和 Advocate Aurora Health。如果 CAPPA 可行且 显示出初步有效性，随后将进行多中心随机对照试验/U01提案 证明 CAPPA 干预对更多工作场所人群的有效性。这 研究可能会对改善这些人的症状和生活质量产生巨大影响 与 CKS 和早期的 KOA 一起。如果伊利诺伊州 Blue Cross Blue Shield 的治疗成功并且 倡导 Aurora Health 他们可能受雇于向其他人提供的服务 组织。