# Preventing Disability from MSK Pain in Northern Tanzania

> **NIH NIH R03** · DUKE UNIVERSITY · 2020 · $79,555

## Abstract

Abstract
Musculoskeletal pain can be debilitating. Left untreated, musculoskeletal pain leads to functional decline,
independent of other health conditions, that for older adults is known to increase the risk for cognitive decline
and even mortality. Common practice for addressing chronic pain—pain that is lasting more than three
months—is to refer people to specialists such as rheumatologists or orthopaedic surgeons, or to obtain
expensive imaging and medications. Less often are non-pharmacological interventions prescribed with a
particular focus on exercise as therapy despite demonstrated effectiveness. Physical therapy-led exercise
therapy holds great promise for delivering high value care for individuals with musculoskeletal pain or
limitations in daily activities. The significance of the physical therapists role in caring for people with joint pain
or with arthritis is heightened in low-income settings where access to specialists is limited, and greater
attention to unnecessary prescribing of images and medications is needed. There is a critical need to establish
new models of musculoskeletal care in low-income countries like where we will focus in Northern Tanzania
because life expectancy is increasing and yet, more people are living with disability. Low back pain, for
example, is the second leading cause of disability in Tanzania and the rate of disabling low back pain has
increased 36% from 2007 to 2017. Research collaborations across countries can help build capacity and
support translation of effective care models for improved population health. Our five year goal is to have
implemented a model of care that expands access to physical therapists using text and telephone support of
exercise at home in even rural and remote villages. Our proposed two-year implementation research study
builds on existing partnerships to adapt and plan for scaling up an intervention we found effective with older
adult Veterans in the United States. Guided by the Institute for Healthcare Improvement Framework for Going
to Full Scale, we will accomplish two specific aims. (1) Explore the feasibility, reach, appropriateness,
acceptability, and costs of an innovative MSK care model for Northern Tanzania compared with current
practice. (2) Adapt and refine the physical therapy, text message and telephone counseling components of the
model to be locally relevant and expand availability and access to care. The scalable intervention and new
knowledge generated from the proposed implementation research will guide our research team to go full scale
in Northern Tanzania and spread to other regions for improved population health.

## Key facts

- **NIH application ID:** 10095260
- **Project number:** 1R03AG069848-01
- **Recipient organization:** DUKE UNIVERSITY
- **Principal Investigator:** Janet Alexandria Prvu Bettger
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $79,555
- **Award type:** 1
- **Project period:** 2020-09-15 → 2022-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10095260

## Citation

> US National Institutes of Health, RePORTER application 10095260, Preventing Disability from MSK Pain in Northern Tanzania (1R03AG069848-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10095260. Licensed CC0.

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