Engaging African American Older Adults With Arthritis in a Physical Activity Intervention

Physical activity like walking is one important way to reduce pain and improve wellbeing for older adults with knee and hip arthritis, but most older adults and particularly those who identify as African American struggle to walk regularly. Many African Americans with arthritis have worse outcomes (like worse pain, worse overall health) than other racial and ethnic groups for many reasons including racist policies and ideas that make getting good health care more difficult. It is therefore most important to identify ways to help older adults who identify as African American improve their arthritis pain and improve their daily steps. The current study is designed to learn about older African American's preferences for a brief behavioral intervention to increase daily steps and reduce pain, and to learn about the barriers (things that make walking harder) and facilitators (things that make walking easier) for walking that they experience. Interviews with both patients and healthcare providers will provide important information that will be used to adapt an existing behavioral intervention designed to help patients increase their daily steps and reduce their arthritis pain. The final adapted intervention will be tested in a small clinical trial with older adults who identify as African American to see if it can reduce pain and increase walking over time.

Inclusion Criteria:age 65 or olderEnglish speakingidentify as Black/African Americandiagnosis of osteoarthritis in knee or hipable to ambulate even if assisted with walker or caneendorse worst pain and pain interference as ≥ 3 out of 10 within the last weekExclusion Criteria:hearing or visual impairment that would prevent ability to participate in sessions or use participant worksheets, even with use of adaptive supports/devicesplanned surgery during study duration that would limit mobility (e.g., due to recommended rehabilitation or recovery period) for more than 3 weekscurrent enrollment in cardiac rehabilitationmyocardial infarction in the past 3 monthsmajor surgery requiring limited movement or mobility for recovery within the past 3 monthspresence of a serious psychiatric condition (e.g., schizophrenia, suicidal intent) that would contraindicate safe study participationMedical provider indicating that exercise (even walking) should only be medically supervisedfall or falls within the last 3 months that led to immediate medical treatment/hospitalizationreported or suspected moderate or severe cognitive impairmentbrain tumor/cancer metastases to the brainno other conditions that would preclude safe participation (e.g., unmanaged heart conditions, neurodegenerative condition, unmanaged diabetes, severe respiratory disease), as screened the Physical Activity Readiness Questionnaire (PAR-Q+ 2020, a measure widely utilized by the U.S. National Academy of Sports Medicine and the Public Health Agency of Canada). Answers to the PARQ+2020 may result in review by patient physicians for safety prior to enrollment.