Live Video Mind-Body Program for Patients With Knee Osteoarthritis, Comorbid Depression, and Obesity: Development and Feasibility Pilot Study
BackgroundKnee osteoarthritis (KOA) is the most common joint disorder in the United States and a leading cause of disability. Depression and obesity are highly comorbid with KOA and accelerate knee degeneration and disability through biopsychosocial mechanisms. Mind-body phys...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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JMIR Publications
2022-04-01
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| Series: | JMIR Formative Research |
| Online Access: | https://formative.jmir.org/2022/4/e34654 |
| _version_ | 1797735149371129856 |
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| author | Ryan A Mace Jonathan Greenberg Nicole Lemaster Brooke Duarte Terence Penn Millan Kanaya James D Doorley Jessica L Burris Cale A Jacobs Ana-Maria Vranceanu |
| author_facet | Ryan A Mace Jonathan Greenberg Nicole Lemaster Brooke Duarte Terence Penn Millan Kanaya James D Doorley Jessica L Burris Cale A Jacobs Ana-Maria Vranceanu |
| author_sort | Ryan A Mace |
| collection | DOAJ |
| description |
BackgroundKnee osteoarthritis (KOA) is the most common joint disorder in the United States and a leading cause of disability. Depression and obesity are highly comorbid with KOA and accelerate knee degeneration and disability through biopsychosocial mechanisms. Mind-body physical activity programs can engage biological, mechanical, and psychological mechanisms to improve outcomes in KOA, but such programs are not currently available.
ObjectiveThis mixed methods study aims to adapt a mind-body activity program for the unique needs of patients with KOA, depression, and obesity (GetActive-OA) delivered via live video.
MethodsParticipants were adults (aged ≥45 years) from rural Kentucky with obesity (BMI≥30 kg/m2), idiopathic KOA with mild to moderate radiographic changes, and elevated depressive symptoms (9-item Patient Health Questionnaire ≥10) recruited from 2 orthopedic centers. In phase 1, we developed GetActive-OA and the study protocol using qualitative focus group feedback from the study population (N=9; 2 focus groups, 90 minutes) and multidisciplinary expertise from clinical psychologists and orthopedic researchers. In phase 2, we explored the initial feasibility, credibility, and acceptability of GetActive-OA, live video delivery, and study procedures via an open pilot with exit interviews (N=5; 1 group). This research was guided by National Institutes of Health (NIH) model stage IA.
ResultsPhase 1 qualitative analyses revealed nuanced information about challenges with coping and increasing activity, high interest in a mind-body activity program, program participation facilitators (flexibility with technology) and barriers (amotivation and forgetfulness), and perceived challenges with data collection procedures (blood and urine samples and homework). Phase 2 quantitative analyses showed that GetActive-OA met most a priori feasibility markers: acceptability (80%), expectancy (100%), credibility (100%), clinician adherence (90%), homework adherence (80%), questionnaire data collection (100%), program satisfaction (100%), and safety (100%). Adherence to ActiGraph wear (80% baseline, 20% posttest) and collection of blood samples (60%) were low. Participation in GetActive-OA was associated with signals of improvements in general coping (Cohen d=2.41), pain catastrophizing (Cohen d=1.24), depression (Cohen d=0.88), anxiety (Cohen d=0.78), self-efficacy (Cohen d=0.73), pain (Cohen d=0.39), and KOA symptoms (Cohen d=0.36). Qualitative exit interviews confirmed quantitative findings and provided valuable information to optimize the program and protocol.
ConclusionsPatients with KOA, depression, and obesity from rural Kentucky were interested in a live video mind-body activity program. GetActive-OA shows promise; however, the program and protocol require further NIH stage I refinement before formal efficacy testing (NIH model stage II).
International Registered Report Identifier (IRRID)RR2-10.1016/j.conctc.2021.100720 |
| first_indexed | 2024-03-12T12:54:50Z |
| format | Article |
| id | doaj.art-b01c3432d1054241ad43d0ee370590c7 |
| institution | Directory Open Access Journal |
| issn | 2561-326X |
| language | English |
| last_indexed | 2024-03-12T12:54:50Z |
| publishDate | 2022-04-01 |
| publisher | JMIR Publications |
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| series | JMIR Formative Research |
| spelling | doaj.art-b01c3432d1054241ad43d0ee370590c72023-08-28T21:30:09ZengJMIR PublicationsJMIR Formative Research2561-326X2022-04-0164e3465410.2196/34654Live Video Mind-Body Program for Patients With Knee Osteoarthritis, Comorbid Depression, and Obesity: Development and Feasibility Pilot StudyRyan A Macehttps://orcid.org/0000-0001-5738-8606Jonathan Greenberghttps://orcid.org/0000-0002-4875-2207Nicole Lemasterhttps://orcid.org/0000-0003-4600-6849Brooke Duartehttps://orcid.org/0000-0002-8732-1768Terence Pennhttps://orcid.org/0000-0001-9262-2584Millan Kanayahttps://orcid.org/0000-0003-1538-8012James D Doorleyhttps://orcid.org/0000-0001-9080-4915Jessica L Burrishttps://orcid.org/0000-0003-2263-2757Cale A Jacobshttps://orcid.org/0000-0002-9300-5550Ana-Maria Vranceanuhttps://orcid.org/0000-0003-3994-6488 BackgroundKnee osteoarthritis (KOA) is the most common joint disorder in the United States and a leading cause of disability. Depression and obesity are highly comorbid with KOA and accelerate knee degeneration and disability through biopsychosocial mechanisms. Mind-body physical activity programs can engage biological, mechanical, and psychological mechanisms to improve outcomes in KOA, but such programs are not currently available. ObjectiveThis mixed methods study aims to adapt a mind-body activity program for the unique needs of patients with KOA, depression, and obesity (GetActive-OA) delivered via live video. MethodsParticipants were adults (aged ≥45 years) from rural Kentucky with obesity (BMI≥30 kg/m2), idiopathic KOA with mild to moderate radiographic changes, and elevated depressive symptoms (9-item Patient Health Questionnaire ≥10) recruited from 2 orthopedic centers. In phase 1, we developed GetActive-OA and the study protocol using qualitative focus group feedback from the study population (N=9; 2 focus groups, 90 minutes) and multidisciplinary expertise from clinical psychologists and orthopedic researchers. In phase 2, we explored the initial feasibility, credibility, and acceptability of GetActive-OA, live video delivery, and study procedures via an open pilot with exit interviews (N=5; 1 group). This research was guided by National Institutes of Health (NIH) model stage IA. ResultsPhase 1 qualitative analyses revealed nuanced information about challenges with coping and increasing activity, high interest in a mind-body activity program, program participation facilitators (flexibility with technology) and barriers (amotivation and forgetfulness), and perceived challenges with data collection procedures (blood and urine samples and homework). Phase 2 quantitative analyses showed that GetActive-OA met most a priori feasibility markers: acceptability (80%), expectancy (100%), credibility (100%), clinician adherence (90%), homework adherence (80%), questionnaire data collection (100%), program satisfaction (100%), and safety (100%). Adherence to ActiGraph wear (80% baseline, 20% posttest) and collection of blood samples (60%) were low. Participation in GetActive-OA was associated with signals of improvements in general coping (Cohen d=2.41), pain catastrophizing (Cohen d=1.24), depression (Cohen d=0.88), anxiety (Cohen d=0.78), self-efficacy (Cohen d=0.73), pain (Cohen d=0.39), and KOA symptoms (Cohen d=0.36). Qualitative exit interviews confirmed quantitative findings and provided valuable information to optimize the program and protocol. ConclusionsPatients with KOA, depression, and obesity from rural Kentucky were interested in a live video mind-body activity program. GetActive-OA shows promise; however, the program and protocol require further NIH stage I refinement before formal efficacy testing (NIH model stage II). International Registered Report Identifier (IRRID)RR2-10.1016/j.conctc.2021.100720https://formative.jmir.org/2022/4/e34654 |
| spellingShingle | Ryan A Mace Jonathan Greenberg Nicole Lemaster Brooke Duarte Terence Penn Millan Kanaya James D Doorley Jessica L Burris Cale A Jacobs Ana-Maria Vranceanu Live Video Mind-Body Program for Patients With Knee Osteoarthritis, Comorbid Depression, and Obesity: Development and Feasibility Pilot Study JMIR Formative Research |
| title | Live Video Mind-Body Program for Patients With Knee Osteoarthritis, Comorbid Depression, and Obesity: Development and Feasibility Pilot Study |
| title_full | Live Video Mind-Body Program for Patients With Knee Osteoarthritis, Comorbid Depression, and Obesity: Development and Feasibility Pilot Study |
| title_fullStr | Live Video Mind-Body Program for Patients With Knee Osteoarthritis, Comorbid Depression, and Obesity: Development and Feasibility Pilot Study |
| title_full_unstemmed | Live Video Mind-Body Program for Patients With Knee Osteoarthritis, Comorbid Depression, and Obesity: Development and Feasibility Pilot Study |
| title_short | Live Video Mind-Body Program for Patients With Knee Osteoarthritis, Comorbid Depression, and Obesity: Development and Feasibility Pilot Study |
| title_sort | live video mind body program for patients with knee osteoarthritis comorbid depression and obesity development and feasibility pilot study |
| url | https://formative.jmir.org/2022/4/e34654 |
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