MobilWise: Mobile Phone Remote Coaching After Worksite Joint ADventure Exposure
| Status: | Completed |
|---|---|
| Conditions: | Arthritis, Osteoarthritis (OA) |
| Therapuetic Areas: | Rheumatology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 5/26/2018 |
| Start Date: | September 2015 |
| End Date: | August 30, 2017 |
MobilWise, a worksite physical activity intervention for employees at high risk for knee
osteoarthritis (OA), is being tested in a developmental randomized controlled trial at a
collaborating worksite to determine if remotely- coached physical activity counseling can
increase and sustain physical activity in this population. Knee osteoarthritis is a major
public health problem and a leading cause of disability and work absenteeism/presenteeism in
the US workforce. The overarching goal of this program is to develop and disseminate an
affordable, efficient, efficacious physical activity intervention to large groups of
employees at risk for knee OA. The Mobil Wise intervention is administered by health
professionals, who will use data transmitted from an affordable accelerometer-based personal
monitor (Fitbit Flex) via customized remote coach interface to 1) allow the remote coach to
view and collect physical activity data generated by the personal monitor, and 2) use that
data to formulate and provide tailored behavioral support, using motivational interviewing.
This project has the potential to have a tremendous impact on improving symptoms and quality
of life of persons with chronic knee pain and decreasing the functional limitation, work
absenteeism/presenteeism, and soaring healthcare utilization associated with knee OA.
osteoarthritis (OA), is being tested in a developmental randomized controlled trial at a
collaborating worksite to determine if remotely- coached physical activity counseling can
increase and sustain physical activity in this population. Knee osteoarthritis is a major
public health problem and a leading cause of disability and work absenteeism/presenteeism in
the US workforce. The overarching goal of this program is to develop and disseminate an
affordable, efficient, efficacious physical activity intervention to large groups of
employees at risk for knee OA. The Mobil Wise intervention is administered by health
professionals, who will use data transmitted from an affordable accelerometer-based personal
monitor (Fitbit Flex) via customized remote coach interface to 1) allow the remote coach to
view and collect physical activity data generated by the personal monitor, and 2) use that
data to formulate and provide tailored behavioral support, using motivational interviewing.
This project has the potential to have a tremendous impact on improving symptoms and quality
of life of persons with chronic knee pain and decreasing the functional limitation, work
absenteeism/presenteeism, and soaring healthcare utilization associated with knee OA.
Because the US population is aging and obesity is rising dramatically, the epidemic of
arthritis-associated disability and its associated costs will significantly worsen, largely
due to the consequences of knee osteoarthritis (OA). Knee OA is already a major cause of work
disability and work absenteeism/presenteeism, especially among obese and overweight
employees. In addition, total knee replacement surgeries have increased by 161.5% among
Medicare participants over the past 20 years and are expected to quadruple in the next 20
years. Increased physical activity can relieve the pain and activity limitations of
individuals with knee OA, but this healthy lifestyle behavior has not been embraced by a
substantial proportion of the employed population. The overarching goal of this program is to
develop and disseminate an affordable, efficient, efficacious physical activity intervention
that can assist large groups of employees with or at risk for knee OA to attain and maintain
healthy physical activity behavior. MobilWise is a 12-week RCT pilot that will use data
transmitted from an affordable accelerometer-based personal monitor (Fitbit Flex) via
customized remote- coach interface to 1) allow a remote coach to view and collect physical
activity data generated by the personal monitor, and 2) use that data to formulate and
provide tailored behavioral support via mobile phone, ba sed on the supportive accountability
model and using motivational interviewing. The MobilWise intervention will use the media
communication mode preferred by the participant (text, voice call, or video chat) to attain
and sustain healthy physical activity behavior in Blue Cross Blue Shield of Illinois
employees with knee symptoms after previous completion of an in-person, intensive
intervention (Joint ADventure). Six month follow-up measures are planned. Specific aims are
to: 1) assess the feasibility of conducting a randomized controlled trial of the Mobil Wise
intervention at this worksite, 2) estimate the effectiveness of the intervention to increase
objectively-measured physical activity, 3) to develop/refine the customized remote
coach-interface, dashboard, and coaching protocol, and 4) to examine the accuracy of the
affordable personal monitor (Fitbit Flex) by comparing that output with data from the
state-of-the-art GT3X+ accelerometer. This study leverages the combined clinical and
technologic expertise of Northwestern's Arthritis Center Accelerometer Unit and its Center
for Behavioral Intervention Technologies, in cooperation with the Fitbit technology team and
the Blue Cross Blue Shield of Illinois Corporation. If successful, a multi-site randomized
controlled trial/R01 proposal will follow to demonstrate the effectiveness/cost-effectiveness
of the Mobil Wise intervention in larger worksite populations. Given the influence that BCBS
has in shaping future health practices and the scalability/generalizability of the proposed
intervention, this research could have a tremendous impact on improving symptoms and quality
of life for those with early knee OA as well as preventing the work absenteeism/presenteeism,
work disability, and increased healthcare costs associated with knee OA.
arthritis-associated disability and its associated costs will significantly worsen, largely
due to the consequences of knee osteoarthritis (OA). Knee OA is already a major cause of work
disability and work absenteeism/presenteeism, especially among obese and overweight
employees. In addition, total knee replacement surgeries have increased by 161.5% among
Medicare participants over the past 20 years and are expected to quadruple in the next 20
years. Increased physical activity can relieve the pain and activity limitations of
individuals with knee OA, but this healthy lifestyle behavior has not been embraced by a
substantial proportion of the employed population. The overarching goal of this program is to
develop and disseminate an affordable, efficient, efficacious physical activity intervention
that can assist large groups of employees with or at risk for knee OA to attain and maintain
healthy physical activity behavior. MobilWise is a 12-week RCT pilot that will use data
transmitted from an affordable accelerometer-based personal monitor (Fitbit Flex) via
customized remote- coach interface to 1) allow a remote coach to view and collect physical
activity data generated by the personal monitor, and 2) use that data to formulate and
provide tailored behavioral support via mobile phone, ba sed on the supportive accountability
model and using motivational interviewing. The MobilWise intervention will use the media
communication mode preferred by the participant (text, voice call, or video chat) to attain
and sustain healthy physical activity behavior in Blue Cross Blue Shield of Illinois
employees with knee symptoms after previous completion of an in-person, intensive
intervention (Joint ADventure). Six month follow-up measures are planned. Specific aims are
to: 1) assess the feasibility of conducting a randomized controlled trial of the Mobil Wise
intervention at this worksite, 2) estimate the effectiveness of the intervention to increase
objectively-measured physical activity, 3) to develop/refine the customized remote
coach-interface, dashboard, and coaching protocol, and 4) to examine the accuracy of the
affordable personal monitor (Fitbit Flex) by comparing that output with data from the
state-of-the-art GT3X+ accelerometer. This study leverages the combined clinical and
technologic expertise of Northwestern's Arthritis Center Accelerometer Unit and its Center
for Behavioral Intervention Technologies, in cooperation with the Fitbit technology team and
the Blue Cross Blue Shield of Illinois Corporation. If successful, a multi-site randomized
controlled trial/R01 proposal will follow to demonstrate the effectiveness/cost-effectiveness
of the Mobil Wise intervention in larger worksite populations. Given the influence that BCBS
has in shaping future health practices and the scalability/generalizability of the proposed
intervention, this research could have a tremendous impact on improving symptoms and quality
of life for those with early knee OA as well as preventing the work absenteeism/presenteeism,
work disability, and increased healthcare costs associated with knee OA.
Inclusion Criteria:
- 18 y/o men and women after completion of the Joint ADventure intervention (included
only overweight or obese persons over age 18 with chronic knee symptoms)
- naive to Joint ADventure (no Minimum BMI) but with knee symptoms of pain, aching or
stiffness on most days over the past 3 months, and have the ability to ambulate at
least household distances (50ft), the ability to speak and read English.
Exclusion Criteria:
- no primary diagnosis of fibromyalgia or inflammatory arthritis
- no co-morbidity that is more functionally limiting than the knee symptoms (e.g. spinal
stenosis, peripheral vascular disease or residual effects of stroke)
- no co-morbid condition (based on medical history review) that contraindicates a
physical activity intervention
- no total joint re- placement surgery within the past 1 year and no plans for total
joint replacement in the next 12 months
- no plans to relocate away from the Chicago-land area in the next 12 months.
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