title: Fit and Strong!: bolstering maintenance of physical activity among older adults with lower-extremity osteoarthritis.
abstract: OBJECTIVE
  To compare the impact of negotiated vs. mainstreamed follow-up with telephone reinforcement (TR) on maintenance of physical activity (PA) after Fit and Strong! ended.
  
  
  METHODS
  A multisite comparative effectiveness trial with repeated measures.
  
  
  RESULTS
  Single group random effects analyses showed significant improvements at 2, 6, 12, and 18 months on PA maintenance, lower-extremity (LE) pain and stiffness, LE function, sit-stand, 6-minute distance walk, and anxiety/depression. Analyses by follow-up condition showed persons in the negotiated with TR group maintained a 21% increase in caloric expenditures over baseline at 18 months, with lesser benefits seen in the negotiated-only, mainstreamed-with-TR, and mainstreamed-only groups. Significant benefits of telephone dose were also seen on LE joint stiffness, pain, and function as well as anxiety and anxiety/depression.
  
  
  CONCLUSIONS
  The negotiated follow-up contract that Fit and Strong! uses, bolstered by TR, is associated with enhanced long-term PA maintenance and health outcomes.
authors.affiliation: Center for Research on Health and Aging, 1747 W Roosevelt Road, Chicago, IL 60608, USA. shughes@uic.edu
authors.forename: Susan L
authors.initials: SL
authors.lastname: Hughes
authors.forename: Rachel B
authors.initials: RB
authors.lastname: Seymour
authors.forename: Richard T
authors.initials: RT
authors.lastname: Campbell
authors.forename: Pankaja
authors.initials: P
authors.lastname: Desai
authors.forename: Gail
authors.initials: G
authors.lastname: Huber
authors.forename: H Justina
authors.initials: HJ
authors.lastname: Chang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D015438:Health Behavior; D006801:Humans; D035002:Lower Extremity / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D010003:Osteoarthritis / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010352:Patient Dropouts / Q000706:statistics & numerical data