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      Exploring Beliefs and Preferences for Reducing Sedentary Behavior Among Adults With Symptomatic Knee Osteoarthritis or Knee Replacement

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          Abstract

          Objective

          Physical activity has numerous benefits for those with symptomatic knee osteoarthritis (KOA) or knee replacement, yet many individuals engage in insufficient activity. The purpose of this study was to explore beliefs about sedentary behavior, barriers to standing, and program preferences for adults with symptomatic KOA or knee replacement.

          Methods

          Forty‐two individuals ≥50 years with symptomatic KOA or knee replacement completed an online survey assessing current knee pain and function, sitting time, physical activity participation, beliefs about sedentary behavior, and preferences for a sedentary reduction program.

          Results

          Participants indicated barriers to standing were pain, discomfort, or working on a computer. Most participants shared interest to participate in a program to reduce sitting time. Participants chose education, self‐monitoring, and activity tracking as most preferable components for an intervention design.

          Conclusion

          Future interventions to reduce sedentary time may utilize these results to tailor programs for those with symptomatic KOA or knee replacement.

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          Most cited references50

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          The theory of planned behavior

          Icek Ajzen (1991)
          Organizational Behavior and Human Decision Processes, 50(2), 179-211
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            Sedentary time and its association with risk for disease incidence, mortality, and hospitalization in adults: a systematic review and meta-analysis.

            The magnitude, consistency, and manner of association between sedentary time and outcomes independent of physical activity remain unclear. To quantify the association between sedentary time and hospitalizations, all-cause mortality, cardiovascular disease, diabetes, and cancer in adults independent of physical activity. English-language studies in MEDLINE, PubMed, EMBASE, CINAHL, Cochrane Library, Web of Knowledge, and Google Scholar databases were searched through August 2014 with hand-searching of in-text citations and no publication date limitations. Studies assessing sedentary behavior in adults, adjusted for physical activity and correlated to at least 1 outcome. Two independent reviewers performed data abstraction and quality assessment, and a third reviewer resolved inconsistencies. Forty-seven articles met our eligibility criteria. Meta-analyses were performed on outcomes for cardiovascular disease and diabetes (14 studies), cancer (14 studies), and all-cause mortality (13 studies). Prospective cohort designs were used in all but 3 studies; sedentary times were quantified using self-report in all but 1 study. Significant hazard ratio (HR) associations were found with all-cause mortality (HR, 1.240 [95% CI, 1.090 to 1.410]), cardiovascular disease mortality (HR, 1.179 [CI, 1.106 to 1.257]), cardiovascular disease incidence (HR, 1.143 [CI, 1.002 to 1.729]), cancer mortality (HR, 1.173 [CI, 1.108 to 1.242]), cancer incidence (HR, 1.130 [CI, 1.053 to 1.213]), and type 2 diabetes incidence (HR, 1.910 [CI, 1.642 to 2.222]). Hazard ratios associated with sedentary time and outcomes were generally more pronounced at lower levels of physical activity than at higher levels. There was marked heterogeneity in research designs and the assessment of sedentary time and physical activity. Prolonged sedentary time was independently associated with deleterious health outcomes regardless of physical activity. None.
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              The Patient-Reported Outcomes Measurement Information System (PROMIS): progress of an NIH Roadmap cooperative group during its first two years.

              The National Institutes of Health (NIH) Patient-Reported Outcomes Measurement Information System (PROMIS) Roadmap initiative (www.nihpromis.org) is a 5-year cooperative group program of research designed to develop, validate, and standardize item banks to measure patient-reported outcomes (PROs) relevant across common medical conditions. In this article, we will summarize the organization and scientific activity of the PROMIS network during its first 2 years. The network consists of 6 primary research sites (PRSs), a statistical coordinating center (SCC), and NIH research scientists. Governed by a steering committee, the network is organized into functional subcommittees and working groups. In the first year, we created an item library and activated 3 interacting protocols: Domain Mapping, Archival Data Analysis, and Qualitative Item Review (QIR). In the second year, we developed and initiated testing of item banks covering 5 broad domains of self-reported health. The domain mapping process is built on the World Health Organization (WHO) framework of physical, mental, and social health. From this framework, pain, fatigue, emotional distress, physical functioning, social role participation, and global health perceptions were selected for the first wave of testing. Item response theory (IRT)-based analysis of 11 large datasets supplemented and informed item-level qualitative review of nearly 7000 items from available PRO measures in the item library. Items were selected for rewriting or creation with further detailed review before the first round of testing in the general population and target patient populations. The NIH PROMIS network derived a consensus-based framework for self-reported health, systematically reviewed available instruments and datasets that address the initial PROMIS domains. Qualitative item research led to the first wave of network testing which began in the second year.
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                Author and article information

                Contributors
                cpellegrini@sc.edu
                Journal
                ACR Open Rheumatol
                ACR Open Rheumatol
                10.1002/(ISSN)2578-5745
                ACR2
                ACR Open Rheumatology
                John Wiley and Sons Inc. (Hoboken )
                2578-5745
                05 January 2021
                January 2021
                : 3
                : 1 ( doiID: 10.1002/acr2.v3.1 )
                : 55-62
                Affiliations
                [ 1 ] Missouri State University Springfield Missouri
                [ 2 ] University of South Carolina Columbia
                [ 3 ] Northwestern University Chicago Illinois
                Author notes
                [*] [* ] Address correspondence to Christine A. Pellegrini, PhD, Arnold School of Public Health, Technology Center to Promote Healthy Lifestyles, Department of Exercise Science, University of South Carolina, Discovery 1 Building, Suite 403d, 915 Greene Street, Columbia, SC 29208. Email: cpellegrini@ 123456sc.edu .

                Author information
                https://orcid.org/0000-0001-6175-9852
                https://orcid.org/0000-0002-0922-0195
                Article
                ACR211216
                10.1002/acr2.11216
                7811694
                33400397
                12af59d9-5897-4eb9-9d6b-5c60755a3618
                © 2021 The Authors. ACR Open Rheumatology published by Wiley Periodicals LLC on behalf of American College of Rheumatology.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 16 September 2020
                : 03 December 2020
                Page count
                Figures: 2, Tables: 1, Pages: 8, Words: 6301
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                January 2021
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.9.6 mode:remove_FC converted:17.01.2021

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