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Weight Loss and Exercise for Communities with Arthritis in North Carolina (WE-CAN)

Award Number: R01AR068658
ORGANIZATION: NATIONAL INSTITUTE OF ARTHRITIS & MUSCULOSKELETAL & SKIN DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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DESCRIPTION (provided by applicant): Obesity is a modifiable risk factor for knee osteoarthritis (OA), and weight loss is an effective non- pharmacologic treatment to reduce pain. Recently, we determined that under ideal, highly controlled circumstances, a diet-induced weight loss of 10% combined with exercise was significantly better at reducing pain than either intervention alone. Compared to previous long-term weight loss and exercise trials of knee OA, our diet-induced weight loss and exercise group was twice as effective at relieving pain. Whether our groundbreaking results can be generalized to less rigorously monitored patient cohorts is unknown. Thus, the policy relevant and clinically significant question is: How can we adapt this successful solution to a pervasive public health problem so that it provides a cost-effective intervention for real-world clinical and community settings? This study aims to develop and to demonstrate the effectiveness of a systematic, practical, cost-effective diet-induced weight loss and exercise intervention that communities can implement to reduce pain and improve other clinical outcomes in knee OA patients. This pragmatic community-based trial will determine if the important benefits realized by participants in our previous trial translate to rea-world settings. Participants will be 820 ambulatory, community-dwelling, overweight and obese (BMI = 27 kg/m2) men and women aged = 50 years who meet the American College of Rheumatology clinical criteria for knee OA which includes knee pain on most days of the week plus at least 3 of the following 6: age = 50 years; stiffness < 30 min/day; crepitus; bony tenderness; bony enlargement; no palpable warmth. The primary aim is to determine whether a pragmatic, community-based 18-month diet-induced weight loss and exercise intervention implemented in three North Carolina counties with diverse residential (from urban to rural) and socioeconomic composition significantly decreases knee pain in overweight and obese adults with knee OA relative to an attention control group. Secondary aims will determine whether this intervention improves self-reported function, health-related quality of life, and mobility. We will also establish the cost-effectiveness of this pragmatic, community-based intervention by conducting cost-effectiveness and budgetary impact analyses using data from the current trial in a validated computer-simulated model of knee OA. Many physicians who treat people with knee OA have no practical means to implement weight loss and exercise treatments. This study is significant in that it will test the effectiveness of a long-awaited and much needed community program that will serve as a blueprint for clinicians and public health officials in urban and rura communities to implement a weight loss and exercise program designed to reduce knee pain and improve other clinical outcomes in overweight and obese adults with knee OA.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = -$74,079 )
2025	2020	WAKE FOREST UNIVERSITY	1834 WAKE FOREST RD	WINSTON SALEM	NC	27109	FORSYTH	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	5	10/1/2024	SUPPLEMENT FOR EXPANSION	-$74,079
														Subtotal = -$74,079

Issue Date FY: 2023 ( Subtotal = -$25,832 )
2023	2020	WAKE FOREST UNIVERSITY	1834 WAKE FOREST RD	WINSTON SALEM	NC	27109	FORSYTH	USA	Arthritis, Musculoskeletal and Skin Diseases Research	001	5	5/8/2023	SUPPLEMENT FOR EXPANSION	-$4,745
2023	2020	WAKE FOREST UNIVERSITY	1834 WAKE FOREST RD	WINSTON SALEM	NC	27109	FORSYTH	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	5	4/21/2023	SUPPLEMENT FOR EXPANSION	-$21,087
														Subtotal = -$25,832

Issue Date FY: 2021 ( Subtotal = $0 )
2021	2020	WAKE FOREST UNIVERSITY	1834 WAKE FOREST RD	WINSTON SALEM	NC	27109	FORSYTH	USA	Arthritis, Musculoskeletal and Skin Diseases Research	001	5	8/9/2021	SUPPLEMENT FOR EXPANSION	$0
2021	2019	WAKE FOREST UNIVERSITY	1834 WAKE FOREST RD	WINSTON SALEM	NC	27109	FORSYTH	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	5	8/6/2021	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2020 ( Subtotal = $720,917 )
2020	2020	WAKE FOREST UNIVERSITY	1834 WAKE FOREST RD	WINSTON SALEM	NC	27109	FORSYTH	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	5	12/20/2019	SUPPLEMENT FOR EXPANSION	$720,917
2020	2019	WAKE FOREST UNIVERSITY	1834 WAKE FOREST RD	WINSTON SALEM	NC	27109	FORSYTH	USA	Arthritis, Musculoskeletal and Skin Diseases Research	001	5	7/29/2020	NON-COMPETING CONTINUATION	$0
														Subtotal = $720,917

Issue Date FY: 2019 ( Subtotal = $1,107,441 )
2019	2019	WAKE FOREST UNIVERSITY	1834 WAKE FOREST RD	WINSTON SALEM	NC	27109	FORSYTH	USA	Arthritis, Musculoskeletal and Skin Diseases Research	001	5	7/1/2019	NON-COMPETING CONTINUATION	$1,107,441
2019	2018	WAKE FOREST UNIVERSITY	1834 WAKE FOREST RD	WINSTON SALEM	NC	27109	FORSYTH	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	4	12/14/2018	NON-COMPETING CONTINUATION	$0
														Subtotal = $1,107,441

Grand Total All Awards = $1,728,447

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Weight Loss and Exercise for Communities with Arthritis in North Carolina (WE-CAN)

Award Number: R01AR068658

ORGANIZATION: NATIONAL INSTITUTE OF ARTHRITIS & MUSCULOSKELETAL & SKIN DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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