Mobile Motivational Physical Activity Targeted Intervention

More than 50% of older persons with osteoarthritis (OA) experience disrupted sleep and insomnia symptoms of difficulty falling asleep, awakening during the night, and awakening too early and being unable to fall back to sleep. Because OA pain has been implicated in sleep problems and because physical exercise interventions have been found to improve pain and sleep quality, staying physically active during the daytime is likely advantageous in terms of improving sleep. Physical exercise interventions with a duration between 10 and 16 weeks have been shown to improve quality of sleep in older adults with self-reported disrupted sleep. Unfortunately, recent reports show that older adults with OA are mainly sedentary and few meet national guidelines for recommended amounts of daily physical activity. A self-management intervention that integrates use of mobile technology to prompt older adults to be physically active, provides ongoing monitoring of the amount of their physical activity and includes self-efficacy enhancements is a novel non-pharmacological intervention both for prevention and treatment of sleep deficiency in persons with OA.

The proposed study will involve delivery of automatic physical activity-focused text messages, a novel sleep self-management diary (SleepTight) and motivational interviewing in participants with OA of the hip or knee (most commonly affected joints). The purpose of this Project is to pilot test a new self-management program: MobMPATI, a multidimensional, tailored intervention for sleep deficiency in for older adults with OA. The specific aims are to:

1. Test the acceptability of MobMPATI for older adults with OA and poor sleep quality as a manifestation of sleep deficiency.
2. Test the feasibility of implementing MobMPATI for older adults with OA, as well as collecting electronic data from the sample.
3. Explore pre/posttest changes in self-efficacy, motivation and sleep deficiency measures \[total sleep time (TST) and sleep efficiency (SE)\] with the MobMPATI intervention.

This study will provide feasibility/acceptability and preliminary data necessary for a larger clinical trial of MobMPATI intervention to encourage physical activity and reduce sedentary behavior in older adults with OA as a way of reducing sleep deficiency. Preliminary testing of the intervention will indicate what measures are more sensitive in promoting self-efficacy and motivation so that a smaller number of outcomes could be monitored to reduce participant burden. This study is the first step in this innovative program of research. The knowledge gained will provide data on the benefit of a potentially cost-effective intervention that could be implemented on a large scale to improve health of older adults with OA.


Eligibility Criteria:
Inclusion Criteria:

\>65 years of age

Clinically diagnosed OA of hip or knee

Positive for sleep deficiency, defined as Insomnia Severity Index\>=12

Low physical activity based on Rapid Assessment of Physical Activity \<=2

Stable use of pain, sleep and/or mood regulating medications over the past month

Resides in Seattle metropolitan area

Exclusion Criteria:

Acute injury associated with hip or knee pain

Inability to stand up without assistance

Memory Impairment Screen for Telephone (MIS-T) score of \<4, suggesting cognitive impairment

Severe hearing or visual impairment

An acute episode or change in the treatment of psychiatric problems within the past 3 months

Diagnosed sleep disorder (e.g., sleep disordered breathing; insomnia).