Feasibility Of The Online Collaborative Lifestyle Intervention Program For Knee Osteoarthritis Patients

Community-based, multi-component, behavioral weight management interventions for knee osteoarthritis (KOA) patients provide critical support for symptom management and health promotion. However, reach and scalability may be limited. Approaches leveraging online delivery may represent a promising alternative. PURPOSE: To qualitatively explore the preliminary feasibility and efficacy of an online group-mediated cognitive behavioral weight management intervention for older, KOA patients in a subsample from a larger randomized controlled trial during the COVID-19 pandemic. METHODS: This mixed-method qualitative study used a survey with individual and focus group semi-structured interviews. A total of 7 participants and 1 community instructor were contacted. RESULTS: 6 of 7 patients (86%) survey responses were completed. 6 patients and 1 instructor completed individual semi-structured interviews, and 4 of 6 patients (67%) completed focus groups. Patients reported high satisfaction, 8.67 out of 10, with online delivery (SD = 0.69). Reflexive-thematic analysis revealed 7 domains, 13 main themes and 26 sub-themes: Knowledge and Skills, Enablers, Barriers, Intervention Perceptions, Accessibility, Non-Intervention Barriers, and Pandemic Perceptions. Within the Knowledge and Skills domain, the Self-Regulatory Skills theme had the highest discussion frequency (23.64%), which is a primary target of intervention efficacy. Within Self-Regulatory Skills, the sub-theme of Self-Monitoring was deemed the most satisfactory skill acquired and most frequently discussed (39.62%) as a critical element related to intervention efficacy. The top enablers were consistency and accountability of the online delivery with the group environment and the top barriers were overall challenges in learning and effectively using technology. CONCLUSIONS: Emergent domains and themes from this study highlighted insights into participant perceptions and judgments of the preliminary efficacy of the online intervention. Participants reliably identified the practice and mastery of self-regulation skills as essential to behavioral adherence, while barriers and enablers were also revealed. These results are vital to the successful development, translation and scalability of the intervention for KOA populations.