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, 5 (6), 1264-1272

Operation Change: A New Paradigm Addressing Behavior Change and Musculoskeletal Health Disparities

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Operation Change: A New Paradigm Addressing Behavior Change and Musculoskeletal Health Disparities

Lynne C Jones et al. J Racial Ethn Health Disparities.

Abstract

Background: In this study, we examined the implementation and efficacy of Operation Change, a community-based, culturally sensitive program to stimulate behavioral changes in activity level and improve musculoskeletal health in African-American (AA) and Hispanic/Latina (H/L) women with obesity and early-stage osteoarthritis.

Methods: Sixty-two women (32 AA and 30 H/L), 40-75 years old, with nontraumatic knee pain and body mass index values > 30, participated in a 12-week program of presentations, motivational interviewing, goal setting, and physical activities. Assessments (at 0, 6, and 12 weeks) included a demographic questionnaire, physical assessment, timed 50-ft walking test, Western Ontario and McMaster Universities Arthritis Index (WOMAC), Short Form-36 Health Survey (SF-36), 8-Item Physical Health Questionnaire (PHQ-8), and motivational interview assessment.

Results: Walking time improved significantly for H/L women (P < 0.0001) but not AA women (P = 0.0759). Both groups had significant mean weight loss (P < 0.05) with high variability among individuals. WOMAC scores for both groups indicated decreased pain (P < 0.0001) and stiffness (P < 0.0001) and improved physical functioning (P < 0.0001) by 12 weeks. SF-36 results were comparable to those of the WOMAC. PHQ-8 results improved significantly for H/L women (P < 0.0001) but not AA women (P = 0.077). Participants scored the motivational interviewing component of the program favorably.

Conclusions: Participation in Operation Change increased physical activity, resulting in improvements in pain and function scores. This supports a new paradigm for behavioral modification that helps AA and H/L women take an active role in living with osteoarthritis.

Keywords: Behavioral change program; Early-stage osteoarthritis; Knee pain; Obesity; Outcomes; Physical activity level.

Conflict of interest statement

The Operation Change Program was underwritten by a grant from Zimmer, Inc., Warsaw, IN. Dr. Watkins reports personal fees received from Zimmer Biomet. Dr. Alva and Dr. Jones report consulting fees from Zimmer Biomet.

Figures

Fig. 1
Fig. 1
Rate of participation of African-American and Hispanic/Latina women in Operation Change. Session participation is the percentage of sessions that were attended by each participant
Fig. 2
Fig. 2
Frequency distribution of weight change in 32 African-American women and 30 Hispanic/Latina women who completed the 12-week community-based Operation Change program
Fig. 3
Fig. 3
Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores for the a 32 African-American women (scores unavailable at 6 weeks for one woman) and b 30 Hispanic/Latina women who participated in the Operation Change Program. The results are presented as means and 95% confidence intervals. Asterisk represents statistical significance at P < 0.05. The change in each WOMAC domain score is presented for the c African-American and d Hispanic/Latina women
Fig. 4
Fig. 4
The mean Short Form-36 Health Survey scores for the a 32 African-American women (scores unavailable at 6 weeks for one woman) and b 30 Hispanic/Latina women who participated in the 12-week Operation Change program. The change in each SF-36 domain score is presented for the c African-American and d Hispanic/Latina women. The results are presented as means and 95% confidence intervals. Asterisk represents statistical significance at P < 0.05. BP bodily pain, GH general health, MH mental health, PF physical functioning, RE role emotional, RP role physical, SF social functioning, V vitality
Fig. 5
Fig. 5
For the 8-Item Patient Health Questionnaire (PHQ-8), the frequency of each score category of a 32 African-American women (scores unavailable at 6 weeks for one woman) and b 30 Hispanic/Latina women who participated in the 12-week Operation Change program. The PHQ-8 uses the following score categories: 0–4 not significant, 5–9 mild, 10–14 moderate, 15–19 moderately severe, and 20–24 severe

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References

    1. Centers for Disease Control and Prevention, Prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation—United States, 2003–2005. MMWR Morb Mortal Wkly Rep. 2006;55(40):1089–92. - PubMed
    1. Dillon CF, Rasch EK, Gu Q, Hirsch R. Prevalence of knee osteoarthritis in the United States: arthritis data from the Third National Health and Nutrition Examination Survey 1991-94. J Rheumatol. 2006;33(11):2271–2279. - PubMed
    1. Centers for Disease Control and Prevention Racial/ethnic differences in the prevalence and impact of doctor-diagnosed arthritis—United States, 2002. MMWR Morb Mortal Wkly Rep. 2005;54(5):119–123. - PubMed
    1. Theis KA, Helmick CG, Hootman JM. Arthritis burden and impact are greater among U.S. women than men: intervention opportunities. J Women's Health (2002). 2007;16(4):441–53. doi:10.1089/jwh.2007.371. - PubMed
    1. Losina E, Walensky RP, Reichmann WM, Holt HL, Gerlovin H, Solomon DH, Jordan JM, Hunter DJ, Suter LG, Weinstein AM, Paltiel AD, Katz JN. Impact of obesity and knee osteoarthritis on morbidity and mortality in older Americans. Ann Intern Med. 2011;154(4):217–226. doi: 10.7326/0003-4819-154-4-201102150-00001. - DOI - PMC - PubMed

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