Studying Physical Activity Rewards and Telephonic Active Coaching

体力活动（PA），定义为任何身体运动，需要更多的能量比休息，已被证明 改善膝关节骨关节炎（OA）患者的疼痛和功能。疾控中心 预防PA指南为所有年龄的成年人，包括那些与OA建议至少150分钟/周 中度至重度PA。然而，对PA指南的依从性较差，特别是在膝关节炎患者中， OA。全膝关节置换术（TKR）被广泛用于缓解疼痛和改善患者的功能， 晚期膝关节OA。鉴于对全膝关节置换术的大量投资和记录PA益处的丰富证据， 如果全膝关节置换术接受者变得更加积极，全膝关节置换术的价值可以显著增加。在这 应用我们提出了关键的规划活动，以设计和开发多中心临床试验的方案。 本试验旨在解决以下创新假设，即TKR后的时期提供了一个机会窗口， 改变对PA的基本态度和信念。我们假设，小的经济激励加上 通过定期的支持性辅导，将诱导行为改变并促进对PA指南的遵守。的 规划活动包括：（1）制定研究方案和监管材料，以指导研究 （2）开展登记准备活动，以收集关于 来自潜在中心的合格受试者，并最终确定供应商和中心的选择，（3）器械的选择 客观地监测PA以测试并选择最适合研究目的的监测器，（4） 编制辅导干预材料，使干预标准化，并测试其交付情况， 优化可靠性，（5）制定财务激励机制、协议和时间表 干预措施，以优化实现PA里程碑的财务奖励的时间和金额，（6） 最后确定评估工具，以确定和评估工具和监测协议，以及（7）创建 制定标准化数据收集计划和数据监测系统， 优化精度并最大限度地减少缺失元素。具体地说，我们将测试的假设，立即 经济奖励可以抵消延迟满足固有的承诺PA，这些奖励 再加上健康教练的定期支持和指导， 并改善对PA准则的遵守情况。这些规划活动的顺利完成将 使研究团队能够成功地执行高度重要和创新的个性化干预 建立在健康指导和行为经济学的原则之上。

Physical activity (PA), defined as any body movement that requires more energy than resting, has been shown to improve pain and function in persons with knee osteoarthritis (OA). Center for Disease Control and Prevention PA guidelines for adults of all ages including those with OA recommend at least 150 min/week of moderate-to-vigorous PA. However, adherence to PA guidelines is poor, particularly among persons with knee OA. Total knee replacement (TKR) is widely used to relieve pain and improve function in patients with advanced knee OA. Given the large investment in TKR and the rich evidence documenting the benefits of PA, the value of TKR could be increased substantially if TKR recipients became more physically active. In this application we propose key planning activities to design and develop the protocols for a multicenter clinical trial to address the innovative hypothesis that the period following TKR presents a window of opportunity to change fundamental attitudes and beliefs regarding PA. We hypothesize that small financial incentives coupled with regular supportive coaching will induce behavior change and facilitate adherence to PA guidelines. The planning activities include: (1) development of study protocols and regulatory materials to guide the study operations and its monitoring, (2) undertaking enrollment preparation activities to gather data on number of eligible subjects from potential centers and finalize selection of providers and centers, (3) selection of devices to objectively monitor PA to test and to select the monitor that fits the purpose of the study the best, (4) development of coaching intervention materials to standardize the intervention and test its delivery to optimize reliability, (5) development of the mechanisms, protocols, and schedules for the financial incentives intervention to optimize the timing and amount of the financial rewards for meeting PA milestones, (6) finalization of assessment tools to determine and assessment tools and monitoring protocols, and (7) creation of a data management plan to develop a standardized data capture plan and data monitoring system to optimize accuracy and minimize missing elements. Specifically, we will test the hypothesis that immediate financial rewards can offset the delay in gratification inherent in a commitment to PA and that these rewards coupled with regular support and guidance from health coaching will further increase the rate of engagement in PA and improve compliance with PA guidelines. Successful completion of these planning activities will position the research team to execute successfully a highly significant and innovative personalized intervention built on the principles of health coaching and behavioral economics.