# Efficacy and mechanism of a community wellness promotion program for middle-aged adults living with long-term physical disability

> **NIH NIH R01** · UNIVERSITY OF WASHINGTON · 2021 · $595,621

## Abstract

Project Summary/Abstract
Middle-age (45-64) is a time of health vulnerability for millions of Americans. More than 50% of individuals in the U.S.
will have two or more chronic conditions by age 60, contributing to increased risk of later disability. However, for
individuals with long-term physical disabilities (LTPDs) such as spinal cord injury or multiple sclerosis, these risks are
magnified. This vulnerable population is especially in need of interventions to promote community participation and
improve disease self-management during midlife.
Over the past 5 years, our research team has adapted an evidence-based health promotion intervention designed for older
adults to serve middle-aged and older adults with LTPD. We now have a trial version of this intervention (called
“EnhanceWellness for Disability”; EW-D) with promising findings in pilot testing, ready for a larger community trial.
Through a new partnership with 3 regional Centers for Independent Living, we can now test this program for people with
LTPD in 14 counties in the Northwest U.S.A.
The broad, long-term aims of this proposal are to test the efficacy of this program relative to two control conditions (an
attention-matched health education control, and treatment as usual), in 600 community dwelling adults aged 45-64 with
LTPD, using modern outcome scales appropriate for people with LTPD. Our primary outcome is ability to participate in
valued community activities. We will seek to determine whether the intervention was effective, and if so, what
mechanisms of change drove the effect. In addition to self-report, we will also collect objective measures of community
activity, via GPS and travel diaries, in a randomly selected subset of 300 participants. Our specific aims are as follows:
Specific Aim 1. To determine the efficacy of eight sessions of EW-D, relative to an attention control condition or
treatment as usual, in middle-aged adults with LTPD. Our primary outcome will be self-reported ability to participate in
valued community activities.
Specific Aim 2. To determine if observed intervention effects are due to (1) improved disease management self-efficacy,
(2) decreased interference due to pain and fatigue, or (3) improvements in psychological resilience.
Secondary Analyses. To determine if 1) intervention effects are maintained at 12 months; and 2) intervention effects can
be detected in objective, GPS based measures of activity (quantified as number of trips outside the home, time outside the
home, area of travel, and activity in established categories). We will also examine the potential moderating effects of
biological sex on treatment response.
This approach is consistent with goals described in recent NIA and NINR program announcements, including those
calling for age-appropriate interventions to improve self-management of chronic conditions (PA 14-344) and those calling
for prevention research for adults in midlife (PA-15-098). If hypotheses are confirmed, this work would ...

## Key facts

- **NIH application ID:** 10120736
- **Project number:** 5R01NR016942-04
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** IVAN R MOLTON
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $595,621
- **Award type:** 5
- **Project period:** 2018-06-08 → 2023-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10120736

## Citation

> US National Institutes of Health, RePORTER application 10120736, Efficacy and mechanism of a community wellness promotion program for middle-aged adults living with long-term physical disability (5R01NR016942-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10120736. Licensed CC0.

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