Justin Robison, Jason Fanning. Wake Forest University, Winston Salem, NC.

The experience of chronic pain is both a cause and consequence of excess sitting and insufficient volume of physical activity (PA). The Mobile Intervention to Reduce Chronic Pain and Improve Health-II (MORPH-II) trial aimed to develop a remote PA intervention focused on moving more, more often to meet the unique needs of older adults with chronic pain. The purpose of this study was to identify trajectories of change in daily Fitbit-measured steps among MORPH-II intervention participants. METHODS: Men and women from across North Carolina were randomly assigned to a 12-week remote group-mediated physical activity intervention (MORPH) or a minimal contact control. The MORPH condition received an iPad equipped with Zoom and a study-specific mHealth app, a Fitbit, and wireless scale. Participants engaged in weekly small group meetings led by a professional behavioral coach via Zoom. Real-time Fitbit and scale data were integrated into a set of mHealth tools based in social cognitive theory designed to enhance social connection and to promote movement throughout the day. Participants completed the PROMIS 8-item pain interference scale at week 0 and week 12 via phone. We fit a series of multilevel models to investigate trajectories of change in steps among those in the MORPH condition and whether these trajectories are affected by pain interference. RESULTS: Participants (N=21) were 68.62 ± 8.21 years of age on average, 81% white, and 76.2% female. The best fitting model explained 39.0% variance between participants and 3.1% variance within participants. This model was adjusted for age and included a three-way interaction between quadratic day in the study, baseline pain interference, and change in pain interference (B=-0.031, p = 0.002). Plotting of predicted values indicated that lower baseline pain interference was associated with greater steps overall and that individuals tended to increase steps over time in response to the program, except for those with low baseline pain interference that improved. CONCLUSIONS: These results underscore that an intervention focused on using movement to manage pain symptoms appears effective for increasing steps among those challenged by pain interference, and alternative techniques are required for those for whom pain does not interfere with daily life.

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