Clarifying critical processes linking partner support to insufficiently active

由于骨关节炎（OA）是一个非常普遍的公共卫生问题，即使是OA（PWOA）患者的健康和福祉的微小改善也会产生重大影响。身体活动是管理OA的核心，但大多数PWO都不够活跃，所以他们没有从中受益。这项建议针对不够活跃的PWOA，目的是开发一种新的干预方法，以帮助他们在生活方式身体活动（LPA）中进行小而持续的增加。合作伙伴支持（例如，来自配偶的支持（来自配偶的支持）有可能成为实现这一目标的特别强大的资源;社会支持是PWOA中身体活动最可靠的心理社会预测因素之一，伴侣是协助和鼓励生活方式改变的理想人选。然而，有证据表明，伴侣的支持会阻碍而不是促进行为改变。目前对伴侣支持过程的理解不足以指导制定可靠有效的伴侣支持或夫妇干预措施。我们的社会支持有效性（SSE）框架可以帮助阐明这些过程。它指定功能的合作伙伴的支持，最大限度地发挥其潜力，以促进LPA之间不够活跃的PWOA，并建议这些有益的功能的合作伙伴的支持是最有可能存在时，双方成员的一对夫妇有足够的支持相关的技能。此外，有证据表明，最关键的支持相关技能涉及情绪调节-理解自己和他人情绪的能力，以及对不一致的适应性反应。我们提出了两阶段的研究路线。基础阶段是对来自约翰斯顿县OA项目的167对夫妇进行的一项二元纵向研究。它将确定合作伙伴的支持过程，PWOA和合作伙伴的情绪调节技能之间的相互关系，并通过这些因素的影响启动和维持LPA之间的不足活跃的PWOA在一年的过程中（目标1-3）的途径。转化阶段是一系列的三项研究，以评估将这些新知识转化为一种新的培训计划的潜力，该培训计划可以提高夫妻的情绪调节技能，以及他们将其应用于接受和提供有效的伴侣支持LPA（目标4）的能力。这一建议得益于一个完善的资源，招募我们的人口，一个专家团队与建立合作，以及一个强大的理论基础。它针对的是一个重大的公共卫生问题，并承诺通过利用合作伙伴作为支持他们改变生活方式的有效资源，提高LPA干预措施对活动不足的PWO的有效性。

Because osteoarthritis (OA) is a highly prevalent public health problem, even small improvements in health and well-being among people with OA (PWOA) can have a substantial impact. Physical activity is central to managing OA, but most PWO are insufficiently active so they do not benefit from it. This proposal targets insufficiently active PWOA, with the goal of developing a novel intervention approach to help them make small but sustained increases in lifestyle physical activity (LPA). Partner support (e.g., from a spouse) has the potential to be a particularly powerful resource for achieving this goal; social support is one of the most reliable psychosocial predictors of physical activity in PWOA and partners are ideally situated to assist with and encourage lifestyle change. Yet, evidence shows partner support can hinder instead of promote behavior change. Current understanding of partner support processes is insufficient to guide development of partner support or couples interventions that are reliably effective. Our social support effectiveness (SSE) framework can help elucidate these processes. It specifies features of partner support that maximize its potential to promote LPA among insufficiently active PWOA and suggests that these beneficial features of partner support are most likely to be present when both members of a couple have adequate support-related skills. Further, evidence shows that the most critical support-related skills involve emotion regulation�ability to understand one's own and another's emotions and to respond adaptively to discordance. We propose a 2- phase line of research. The Foundational Phase is a dyadic longitudinal study of 167 couples from the Johnston County OA Project. It will identify interrelations among partner support processes, PWOA and partner emotion regulation skills, and pathways through which these factors influence initiation and maintenance of LPA among insufficiently active PWOA over the course of a year (Aims 1-3). The Translational Phase is a series of three studies to evaluate potential to translate this new knowledge into a novel training program that improves couples' emotion regulation skills and their ability to apply them to receiving and providing effective partner support for LPA (Aim 4). This proposal benefits from a well established resource for recruiting our population, an expert team with established collaborations, and a strong theoretical basis. It targets a significant public health problem and promises to enhance the effectiveness of LPA interventions for insufficiently active PWO by leveraging partners as an effective resource to support their lifestyle change.