FUNDING SOURCE: Centers for Disease Control and Prevention & Association of Schools of Public Health (2002-2003)


CO-INVESTIGATOR: Patricia A. Sharpe, PhD

Arthritis encompasses more than 100 diseases and conditions and affects nearly one of every six Americans.  Due to its high prevalence and negative impact on functioning, arthritis is the leading cause of disability in the US.  The "National Arthritis Action Plan: A Public Health Strategy" underscores the importance of physical activity (PA) as a tertiary prevention strategy among persons with arthritis.  However, persons with arthritis have higher rates of physical inactivity than those without arthritis.  Very little research has examined why some individuals with arthritis can successfully adopt and maintain a program of PA, whereas others cannot.  The purpose of this study was to examine barriers to and enablers for PA, motivations for PA, and benefits and outcomes of PA that are most meaningful to persons with arthritis.   A systematic literature review of PA correlates or determinants was first conducted.  Unpublished papers were also be solicited for this review through listserves, consultation with CDC partners in the Arthritis Program, and through internet search engines.  An expert panel was then identified and convened to solicit potential barriers to and enablers for physical activity in persons with arthritis.  Factors identified through the literature review and the expert panel were combined, and the expert panelists rated the relevance and importance of each factor and recommended questions for the focus group discussion guide.  Based on the literature review and expert panel findings and input, a focus group discussion guide was developed.  The guide was pretested with one group of persons with arthritis and modified as needed for the subsequent groups.  Separate focus groups were conducted with persons with osteoarthritis, rheumatoid arthritis, and fibromyalgia, as these are the three most common types of arthritis.  Within each arthritis type, separate groups will be conducted with individuals who are "successful" exercisers and with individuals are not  successful exercisers.  Two focus groups, led by an experienced moderator, were conducted with each strata (arthritis type x success with PA), for a total of 12 groups.  Between 5 and 12 participants took part in each focus group, thus, up to 144 participants took part in the study.  Focus group discussions will be audiotaped, transcribed verbatim, and analyzed using NUD*IST software for emerging themes.  Manuscripts based on the literature review and focus group findings were submitted for publication and were summarized in a final report. 


Wilcox, S., Der Ananian, C., Abbott, J., Vrazel, J., Ramsey, C., Sharpe, P.A., Brady, T. (2006). Perceived exercise barriers, enablers, and benefits among exercising and non-exericising adults with arthritis: results from a qualitative study. Arthritis and Rheumatism, 55(4), 616-627. 2.

Der Ananian, C., Wilcox, S., Saunders, R., Watkins, K., Evans, S. (2006). Factors that influence exercise among non-exercisers, insufficiently active individuals and regular exercisers with arthritis. Preventing Chronic Disease [serial online]. July. Available from: URL:http://www.cdc.gov/pcd/issues/2006/july/05-0220.htm.

Der Ananian, C.A., Wilcox, S., Abbott, J., Vrazel, J., Ramsey, J., Sharpe, P.A., Brady, T (2006). The exercise experience in adults with arthritis: A qualitative approach. American Journal of Health Behavior, 30(6), 731-744. 4.

Wilcox, S., DerAnanian, C., Sharpe, P.A., Robbins, J., Brady, T. (2005). Correlates of physical activity in persons with arthritis: Review and recommendations. Journal of Physical Activity and Health, 2, 230-252.

Der Ananian, C.A., Wilcox, S., Watkins, K., Saunders, R., Evans, A.E. (2008). Factors associated with exercise participation in adults with arthritis. Journal of Aging and Physical Activity, 16(2), 125-143.