Chronic knee symptoms (CKS) are associated with pain, loss of independence, and increased
mortality. Rates of CKS are increasing, fueled by an aging, obese, and sedentary society.
Because CKS first presents in working age adults, it is a major cause of work disability
and work productivity loss.
Being physically active improves the health of adults who have ongoing (chronic)
complaints of knee pain, knee stiffness, or challenges with moving around. Physical
activity helps decrease pain, improve stiffness, and improve physical function as it
relates to the knee. It also helps people improve their general health. Unfortunately, it
is hard for many people to become more physically active. Physical activity can be
inconvenient and uncomfortable for many people, and people who join physical activity
programs often drop out of them after a short time (3-6 months). However, people are more
likely to reach their physical activity goals if they work with a health coach who
supports the process.
Health coaching often includes a combination of self-monitoring such as using smart
devices to monitor outcomes plus the support of goal-directed behavior. Previous research
has found that Fitbit tracking can improve behavior for some people who have CKS but not
for others. Whereas we know people can receive benefit from coaching, the exact amount of
coaching needed remains unknown. Discussion with employee stakeholders have informed our
intervention desire as they have asked for a low resource form of coaching available
through the workplace. The potential exists to support employees with CKS using an
acceptable, low-resource coaching strategy.
The goal of this program is to test a brief, scalable PA coaching intervention that can
assist employees with CKS attain and maintain healthy PA behavior in worksites in the
Midwest. CAPPA is a 12-week pilot randomized controlled trial that will 1) use
computer-guided action-planning behavioral intervention to support employees in making
physical activity action plans for their health, 2) use data transmitted from a personal
fitness tracker (Fitbit) to support coach and employee knowledge about PA performance,
and 3) Inform on optimal step up times for participants who do not substantially increase
PA. The CAPPA system will put PA feedback in a Movement Dashboard to support study
participants. The CAPPA intervention will primarily use video chat to attain and sustain
healthy PA behavior across worksites at Advocate Aurora Health.
Follow-up measures of PA, pain and physical function are planned at treatment completion
and three months following study completion. Specific aims are to: 1) Estimate the
efficacy of the intervention to increase objectively measured physical activity, 2)
Examine the feasibility, acceptability and sustainability of the CAPPA intervention for
the respective workplaces, and 3) Inform the initial step up time for future stepped
interventions among participants not substantially increasing their physical activity.
This study leverages the combined clinical and technologic expertise of the members of
the Physical Activity in Rheumatology Research group at Northwestern University,
Northwestern's Arthritis Center Accelerometer unit, Marquette University's Behavior,
Engagement and Technology Assessment Lab and Ubiquitous Computing Lab, and Advocate
Aurora Health.
This research could have a tremendous impact on improving symptoms and quality of life
for those with CKS and early KOA. If treatments are successful at Advocate Aurora Health
they may be employed in the services they provide to other organizations.