Couples-based approaches to increasing initiation and maintenance of physical activity for older adults with osteoarthritis

Physical activity is a central component of multimodal treatments for osteoarthritis (OA), a common cause of disability in older adults. Yet, an estimated 76% of Americans with OA do not reach recommended activity levels. Physical activity interventions seek to address this problem. Education is a central feature of these interventions; it focuses on teaching participants how to increase their physical activity safely, overcome barriers to activity, and maintain new activities. Although this knowledge is necessary to produce behavior change, it is not sufficient. Participants who learn educational content but who do not put it to use cannot benefit optimally from interventions. To make interventions as powerful as possible it is necessary to enhance learning and mastery of new information, help learners transform knowledge into behavior change, and help them develop ways to maintain new behaviors. Engaging partners in this effort (i.e., by developing couples-based interventions) may be helpful, but there are benefits and potential pitfalls of involving a partner in a behavioral intervention. We will describe key areas of theory and research from behavioral science interventions for physical activity, focusing on those related to motivation and enduring behavior change. We will also discuss reasons and ways for creating a couples-based intervention and address methods for overcoming difficulties couples may experience as they mobilize and provide support for physical activity. Our discussion will draw on our ongoing study investigating ways that couples work together effectively and ineffectively in physical activity interventions.