My goal in seeking a Mentored Research Career Development Award is to acquire the necessary training, practical experience, and knowledge to be a leading independent investigator using implementation science to improve the quality of health care delivery for older adults with chronic conditions. The proposed career development award is designed to support this transition. We will apply implementation and behavioral science patient-centered outcomes research aimed at improving the quality and effectiveness of physical therapy. Chronic musculoskeletal (MSK) conditions, such as low back pain, hip or knee osteoarthritis, are the primary cause of disability in mid-life and older adults in the United States. Individuals living with chronic MSK conditions often have trouble being physically active and experience a downward spiral in health and quality- of-life due to the consequences of the pain and disability. Physical therapy (PT) is an important component of treatment for MSK conditions. PT often reduces pain and improves function but fails to support sustained changes in physical activity (PA). Coach2Move is an innovative program developed in the Netherlands that has demonstrated positive results in changing daily PA among older adults with mobility limitations. Using a patient-centered approach based in social cognitive theory, Coach2Move addresses patients' primary medical concerns and supports a change in PA behaviors. Coach2Move has not been implemented in the U.S. or adapted for chronic MSK conditions.
My Specific Aims are to: (1) adapt the Coach2Move intervention to mid- life and older adults with chronic MSK conditions in a U.S. health system, (2) assess the impact of implementing Coach2Move on patient-level PA and function, and (3) assess barriers and facilitators to implementing Coach2Move from both clinician and patient perspectives. As an emerging young investigator, my career development plan is focused on acquiring expertise in implementation science and behavioral science to improve the quality of health care delivery for older adults with chronic conditions. My Specific Career Development Aims will combine mentorship from established experts and targeted coursework to acquire expertise in: (1) implementation science, (2) the design and analysis of behavioral interventions, (3) mixed-methods, and (4) research leadership. The knowledge and experience gained from this proposal will allow me to successfully compete for R01 funding to conduct implementation trials accelerating the translation of evidence-based research. This proposal makes significant, relevant contributions to the field by identifying process steps critical to the translation of physical activity research into physical therapy practice for older adults with chronic conditions.
Chronic musculoskeletal conditions (chronic low back pain, knee osteoarthritis, hip osteoarthritis) are the most common causes of long-term disability resulting in a loss of quality-of life for affected individuals and high costs for society. Regular physical activity can reduce disability and improve quality-of-life but can be challenging in the presence of pain and impaired function. This proposal addresses an urgent need for interventions that support physical activity in this population by leveraging the physical therapy intervention to address symptoms of chronic musculoskeletal conditions and support long-term physical activity engagement.
