The Mountain West Arthritis Secondary Prevention Program

Utah State Higher Education System--University Of Utah, Salt Lake City UT

Investigators

Abstract

PROJECT SUMMARY Osteoarthritis (OA) impacts about 1 in 4 adults in the U.S and is responsible for considering costs and loss of quality of life for impacted individuals. The prevalence and adverse impacts of OA are greater for persons from racial/ethnic minoritized groups, with lower income and/or living in rural communities. Secondary prevention of arthritis-attributable activity limitations is a critical goal for persons with OA. Arthritis-appropriate evidence- based interventions (AAEBIs) are available. A core component of AAEBIs is physical activity, which is often decreased for persons with OA. Available AAEBIs include counseling from a healthcare provider about physical activity, and CDC-endorsed programs to increase physical activity and promote self-management. Despite the potential benefits, uptake of AAEBIs is low, particularly in communities that experience disparities. The Mountain West Arthritis Secondary Prevention Program (MW-ASP) is special interest project situated in the Mountain-West Prevention Research Center (MW-PRC). The MW-PRC seeks to increase the reach of EBIs to persons in communities experiencing disparities and to disseminate, scale and sustain strategies and tools to community, public health and academic audiences. The MW-ASP aligns with these goals and will work with the MW-PRC to connect persons with OA to physical activity counseling and community-based AAEBIs. We will conduct a hybrid type 3 effectiveness-implementation trial using sequential, multiple assignment, randomization to evaluate 1) two text messaging (TM) strategies to reach persons with OA and enroll them in physical activity counseling provided by physical therapists; and 2) two strategies to engage enrolled persons in the Walk with Ease (WWE) AAEBI for sustained self-management. Persons with OA receiving care in clinics partnering with the MW-PRC will be identified via a population health management strategy through the electronic health record and randomized to; 1) TM outreach, or 2) TM outreach + motivational messages to enroll in activity counseling. Enrolled persons are then randomly assigned to activity counseling and information to engage in WWE delivered with one of two formats promoted by the Arthritis Foundation; 1) self-directed; or 2) enhanced self-directed. The trial has 3 Aims; 1) Determine differences in reach between two TM strategies to enroll persons with OA in activity counseling (primary outcome), 2) Determine differences in reach between two strategies to engage enrolled persons in the WWE AAEBI (secondary outcomes), and 3) Examine outcomes across additional RE- AIM domains (effectiveness, adoption, implementation, maintenance). The findings from the MW-ASP will produce generalizable tools to increase the reach of effective interventions for persons with OA.