217363 Fit and Strong!: Promoting maintenance to exercise among older adults with lower-extremity osteoarthritis

Monday, November 8, 2010

Susan Hughes, DSW , Institute for Health Research and Policy, Center for Research on Health and Aging, University of Illinois at Chicago, Chicago, IL
Rachel Seymour, PhD , Institute for Health Research and Policy, Center for Research on Health and Aging, University of Illinois at Chicago, Chicago, IL
Richard T. Campbell, PhD , Center for Population Health and Health Disparities, UIC Cancer Center, University of Illinois at Chicago, Chicago, IL
Pankaja Desai, PhD , Institute for Health Research and Policy, Center for Research on Health and Aging, University of Illinois at Chicago, Chicago, IL
Gail Huber, PhD , Institute for Health Research and Policy, Center for Research on Health and Aging, University of Illinois at Chicago, Chicago, IL
Justina Chang, MD, MPH , JAMA, Chicago, IL
Osteoarthritis (OA) is the most common condition affecting older adults today, and the leading cause of disability among older people. Many people with OA become sedentary as a result of painful lower extremity joints. Currently, little is known about effective methods to promote maintenance of physical activity in this high risk group. Fit and Strong! is an evidence-based, low-cost, multiple component program that targets older adults with lower extremity OA. The program meets for eight weeks and combines flexibility, fitness walking/ low-impact aerobics, and strength training with health education and group problem-solving for sustained behavior change. A randomized controlled trial was conducted to test the impact of negotiated vs. mainstreamed follow up with and without telephone reinforcement on maintenance of physical activity after Fit and Strong! ends. Single group random effects analyses of two, six, 12 and 18 month outcomes showed significant improvements on exercise maintenance that were accompanied by decreased lower extremity (LE) pain and stiffness, improved LE function, sit stand, and 6 minute distance walk and decreased anxiety. Analyses by follow-up condition showed benefits associated with negotiated follow up, telephone reinforcement combined with negotiated follow-up and number of reinforcement calls received. Findings indicate that the negotiated follow-up contract that Fit and Strong! uses is associated with positive long-term participant outcomes that can be enhanced by telephone reinforcement.

Learning Areas:
Chronic disease management and prevention
Implementation of health education strategies, interventions and programs

Learning Objectives:
1. Describe the role of lower extremity OA in causing disability. 2. Review the physical activity and behavior change components of Fit and Strong 3. Review the 2, 6, 12, and 18 month findings from the randomized trial of Fit and Strong!

Keywords: Aging, Physical Activity

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Dr. Susan Hughes is Co-Director of the Center for Research on Health and Aging and Professor at the University of Illinois at Chicago School of Public Health. She has been Principal Investigator of several nationally significant studies. She developed and tested Fit and Strong!-an evidence-based, exercise/behavior change program for older adults with lower extremity osteoarthritis.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.