A Mobile Health Behavior Intervention to Reduce Pain and Improve Health-III (MORPH-III)

PROJECT SUMMARY As many as three in four older adults live with chronic pain; a debilitating condition that affects quality of life and independence. Unfortunately, chronic pain both affects and is affected by low levels of physical activity, excess sustained sedentary time, weight gain, and isolation. Across Stage Ia and Ib pilot trials, we have demonstrated the feasibility, acceptability, and potential benefit of a remote group-mediated behavioral intervention rooted in social cognitive and self-determination theories that targets dietary weight loss via caloric restriction and both increased physical activity and decreased sitting via the accumulation of steps in frequent bouts throughout the day (daylong physical activity). Limitations of previous research include: short duration (12 weeks), small samples (up to 44 participants per study), and the inclusion of heterogeneous pain sites. The primary purpose of this Stage II R01 is to test the efficacy of 6 months of a remotely delivered group-mediated weight loss+daylong movement on daily steps (primary outcome), pain interference (secondary outcome), body weight, pain intensity, quality of life, and key psychosocial antecedents of behavior change in older adults with chronic knee or hip osteoarthritic pain. We will also explore for effects on long-term behavior change over 12 months following the intervention. We propose to randomize low-active older adults with chronic osteoarthritic pain and obesity to the weight loss+daylong physical activity intervention or to an enhanced usual care control. These individuals will receive the same self-monitoring technologies as the intervention condition to account for any effect of basic device provision on activity and diet behavior. The results of this trial will inform future real- world efficacy and effectiveness trials of a package well-suited to broad scale delivery.