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. Mobil Wise is a 12-week pilot RCT to test technology that transmits data via mobile phone between an affordable accelerometer-based personal monitor (Fitbit Flex) and a customized remote-coach interface to: 1) allow a remote coach to view and collect objective PA data generated by the personal monitor, and 2) use that data to formulate and provide tailored behavioral phone support, using motivational interviewing. The Mobil Wise 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 who have participated in an in- person, intensive intervention currently in progress. Six month follow-up measures are planned.
Specific aims are to: 1) to develop/refine the customized remote coach-interface, dashboard, and coach protocol and assess the feasibility of conducting a randomized controlled trial of the Mobil Wise intervention, 2) to estimate the effectiveness of the Mobil Wise intervention (Self-monitor with Fitbit Flex + Remotely-coached with mobile phone) group (N=18) to increase objectively-measured physical activity, compared to both a self-monitor only group [(Fitbit Flex, without remote coaching (N=18)], and a wait-list control group (N=18), and 3) to examine the accuracy of the affordable personal monitor (Fitbit Flex) by comparing that output with simultaneously worn gold standard criterion data from the state-of-the-art GT3X+ triaxial 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.
Mobil Wise, 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 that can assist large groups of employees with or at risk for knee OA to attain and maintain healthy physical activity behavior. Mobil Wise is a 12-week pilot RCT to test technology that transmits data via mobile phone between an affordable accelerometer-based personal monitor (Fitbit Flex) and a customized remote-coach interface to: 1) allow a remote coach to view and collect objective PA data generated by the personal monitor, and 2) use that data to formulate and provide tailored behavioral phone 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.
