With the aging of the American population, the numbers of adults with peripheral arterial disease (PAD) will increase significantly over the next several decades. Patients with PAD are at increased risk for morbidity and mortality including both cardiovascular and all cause mortality. While regular physical activity reduces risk for vascular events and is recommended for treatment of PAD patients, few patients meet recommended goals. Exercise programs which increase long-term adherence to walking be an important contribution to PAD treatment. Our internet-based intervention, with an online community builds on a walking enhancement program develop by members of our team and shown to improve adherence among patients with vascular disease such as patients with coronary artery disease (CAD). Using a randomized, controlled trial study design, we propose to test an automated internet-mediated walking program with a social media component, to improving long-term adherence to walking while increasing walking distance, and health-related quality of life (HRQOL), among patients with PAD. Subjects will be randomized to a supervised walking program, supervised walking with an additional online walking intervention or an online walking intervention alone. This internet based walking intervention with a social media component has been shown to increase both adherence to walking and overall walking duration in populations with chronic complex conditions such as coronary artery disease and diabetes. There is a strong need to develop interventions, easily generalizable to a real-world population, to improve the reach of lifestyle interventions which result in improved physical function and adherence to regular exercise among complex medical patients. High risk patients such as those with PAD (a CAD risk equivalent) stand the most to benefit from such programs.

Public Health Relevance

Among patients with peripheral arterial disease, walking programs have been shown to improve functional capacity and walking distance while reducing claudication symptoms, as good or better then medical management or surgical intervention. The purpose of this study is to test an online walking program with a social media component which will result in improved long-term adherence and increase walking distance among PAD patients. There is a strong need to develop interventions to improve the reach of lifestyle interventions which result in improved physical function and adherence to regular exercise among complex medical patients.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project (R01)
Project #
5R01AG045136-02
Application #
8699655
Study Section
Behavioral Medicine, Interventions and Outcomes Study Section (BMIO)
Program Officer
Joseph, Lyndon
Project Start
2013-07-15
Project End
2018-06-30
Budget Start
2014-08-01
Budget End
2015-06-30
Support Year
2
Fiscal Year
2014
Total Cost
$397,295
Indirect Cost
$141,800
Name
University of Michigan Ann Arbor
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
073133571
City
Ann Arbor
State
MI
Country
United States
Zip Code
48109
Janket, Sok-Ja; Baird, Alison E; Jones, Judith A et al. (2014) Number of teeth, C-reactive protein, fibrinogen and cardiovascular mortality: a 15-year follow-up study in a Finnish cohort. J Clin Periodontol 41:131-40