title: Fit and Strong! Plus: design of a comparative effectiveness evaluation of a weight management program for older adults with osteoarthritis.
abstract: Osteoarthritis (OA) is the most common chronic condition and principal cause of disability among older adults. The current obesity epidemic has contributed to this high prevalence rate. Fortunately both OA symptoms and obesity can be ameliorated through lifestyle modifications. Physical activity (PA) combined with weight management improves physical function among obese persons with knee OA but evidence-based interventions that combine PA and weight management are limited for this population. This paper describes a comparative effectiveness trial testing an evidence-based PA program for adults with lower extremity (LE) OA, Fit and Strong!, against an enhanced version that also addresses weight management based on the evidence-based Obesity Reduction Black Intervention Trial (ORBIT). Adult participants (n=400) with LE OA, age 60+, overweight/obese, and not meeting PA requirements of ≥ 150 min per week, are randomized to one of the two programs. Both 8-week interventions meet 3 times per week and include 60 min of strength, flexibility, and aerobic exercise instruction followed by 30 min of education/group discussion. The Fit and Strong! education sessions focus on using PA to manage OA; whereas Fit and Strong! Plus addresses PA and weight loss management strategies. Maintenance of behavior change is reinforced in both groups during months 3-24 through telephone calls and mailed newsletters. Outcomes are assessed at baseline, and 2, 6, 12, 18, and 24 months. Primary outcomes are dietary change at 2 months followed by weight loss at 6 months that is maintained at 24 months. Secondary outcomes assess PA, physical performance, and anxiety/depression.
authors: University of Illinois at Chicago, Institute for Health Research and Policy, Center for Research on Health and Aging, 486 Westside Research Office Bldg., 1747 West Roosevelt Road, Chicago, IL 60608, United States. Electronic address: rsmith27@uic.edu.
authors: Renae L
authors: RL
authors: Smith-Ray
authors: University of Illinois at Chicago, Department of Medicine, Division of Health Promotion Research, 1747 West Roosevelt Road, Chicago, IL 60608, United States; University of Illinois at Chicago, Institute for Health Research and Policy, Health Promotion Research Program, 486 Westside Research Office Bldg., 1747 West Roosevelt Road, Chicago, IL 60608, United States; University of Illinois Cancer Center, Population Health, Behavior and Outcomes Program, 1747 West Roosevelt Road, Chicago, IL 60608, United States.
authors: Marian L
authors: ML
authors: Fitzgibbon
authors: University of Illinois at Chicago, Department of Medicine, Division of Health Promotion Research, 1747 West Roosevelt Road, Chicago, IL 60608, United States; University of Illinois at Chicago, Institute for Health Research and Policy, Health Promotion Research Program, 486 Westside Research Office Bldg., 1747 West Roosevelt Road, Chicago, IL 60608, United States; University of Illinois Cancer Center, Population Health, Behavior and Outcomes Program, 1747 West Roosevelt Road, Chicago, IL 60608, United States.
authors: Lisa
authors: L
authors: Tussing-Humphreys
authors: University of Illinois at Chicago, Department of Medicine, Division of Health Promotion Research, 1747 West Roosevelt Road, Chicago, IL 60608, United States.
authors: Linda
authors: L
authors: Schiffer
authors: University of Illinois at Chicago, Institute for Health Research and Policy, Center for Research on Health and Aging, 486 Westside Research Office Bldg., 1747 West Roosevelt Road, Chicago, IL 60608, United States.
authors: Amy
authors: A
authors: Shah
authors: Northwestern University, Feinberg School of Medicine, Physical Therapy and Human Movement Sciences, 645 N Michigan Avenue, Suite 1100, Chicago, IL 60611, United States.
authors: Gail M
authors: GM
authors: Huber
authors: University of Illinois at Chicago, Department of Kinesiology and Nutrition, 646 Applied Health Sciences Building, 1919 West Taylor Street, Chicago, IL 60612, United States.
authors: Carol
authors: C
authors: Braunschweig
authors: University of Illinois at Chicago, Institute for Health Research and Policy, Center for Research on Health and Aging, 486 Westside Research Office Bldg., 1747 West Roosevelt Road, Chicago, IL 60608, United States; University of Illinois at Chicago, Institute for Health Research and Policy, Health Promotion Research Program, 486 Westside Research Office Bldg., 1747 West Roosevelt Road, Chicago, IL 60608, United States.
authors: Richard T
authors: RT
authors: Campbell
authors: University of Illinois at Chicago, Institute for Health Research and Policy, Center for Research on Health and Aging, 486 Westside Research Office Bldg., 1747 West Roosevelt Road, Chicago, IL 60608, United States; University of Illinois Cancer Center, Population Health, Behavior and Outcomes Program, 1747 West Roosevelt Road, Chicago, IL 60608, United States; University of Illinois at Chicago, Department of Kinesiology and Nutrition, 646 Applied Health Sciences Building, 1919 West Taylor Street, Chicago, IL 60612, United States.
authors: Susan L
authors: SL
authors: Hughes
mesh_terms: D000368:Aged; D001837:Body Weights and Measures; D057186:Comparative Effectiveness Research / Q000458:organization & administration*; D004032:Diet; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology / Q000628:therapy; D010003:Osteoarthritis / Q000453:epidemiology*; D050177:Overweight / Q000453:epidemiology* / Q000628:therapy*; D010353:Patient Education as Topic / Q000458:organization & administration; D012107:Research Design; D015431:Weight Loss
keywords: Comparative effectiveness; Older adults; Osteoarthritis; Physical activity; Weight management