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Fit and Strong: Bolstering Maintenance of Physical Activity Among Older Adults With Lower-extremity Osteoarthritis

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Objectives : 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.

Keywords: arthritis; fit and strong; maintenance; physical activity; trial

Document Type: Research Article


Affiliations: 1 Center for Research on Health and Aging, Institute for Health Research and Policy, University of Illinois Chicago, Chicago, IL.

Publication date: November 1, 2010

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  • The American Journal of Health Behavior seeks to improve the quality of life through multidisciplinary health efforts in fostering a better understanding of the multidimensional nature of both individuals and social systems as they relate to health behaviors.

    The Journal aims to provide a comprehensive understanding of the impact of personal attributes, personality characteristics, behavior patterns, social structure, and processes on health maintenance, health restoration, and health improvement; to disseminate knowledge of holistic, multidisciplinary approaches to designing and implementing effective health programs; and to showcase health behavior analysis skills that have been proven to affect health improvement and recovery.

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