# Helping Adults with RA PREVAIL: Developing a model to Preserve Valued Activities In Life

> **NIH NIH K23** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2024 · $828

## Abstract

PROJECT ABSTRACT.
Disability continues to be common in adults with RA despite pharmacological advances two decades ago that
reduced disease activity. Physical therapy and exercise are effective in reducing disability in adults with RA,
however they are underutilized in rheumatologic care, particularly in the United States. Key contributors to this
underutilization includes lack of sufficient specificity for physical therapy and exercise recommendations in
treatment guidelines leaving rheumatologists unclear when to refer and lack of systematic processes for
integrating rehabilitation in routine RA care. To facilitate appropriate referral to physical therapy and exercise
for adults with RA, we created a model to PREserve Valued Activities In Life (PREVAIL) based on the premise
that early identification of functional decline will help direct physical therapy and exercise referrals to address
impairments before irreversible disability ensues. PREVAIL inserts disability screening into routine RA care
and uses the results of the screening to direct a physical therapy referral matched to disability level and RA-
specific exercise guidance. The objective of this research proposal is to develop and pilot test a scalable model
(PREVAIL) for integrating rehabilitation into routine care to preserve function and delay disability in adults with
RA. The aims will (1) define the distribution of disability levels and related functional needs in adults with RA,
(2) obtain key information from patients and providers on the acceptability and feasibility of the PREVAIL
model, and (3) conduct a pilot trial to determine feasibility and acceptability of the refined PREVAIL model in at
least 50 adults with RA. Successful completion of this proposal will establish feasibility and acceptability, and
set the stage for to integrate PREVAIL into rheumatologic care on a larger scale. My long-term goal is to
mitigate disability in adults with rheumatic and musculoskeletal diseases. The objectives of this career
development award are to (1) deepen my current knowledge of rheumatic disease, specifically in rheumatoid
arthritis (RA) care to better understand how to integrate rehabilitation, (2) train in health services research,
particularly intervention development and clinical trials, and (3) prepare to design and execute a larger clinical
trial in my next phase. My mentors are experts in health services research, rheumatologic care, and RA
disability measurement. Together, we developed this research proposal and career development plan to
accelerate my scientific development towards my long-term goal and research independence.

## Key facts

- **NIH application ID:** 11002525
- **Project number:** 3K23AR079037-03S1
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** Louise M. Thoma
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $828
- **Award type:** 3
- **Project period:** 2021-07-01 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11002525

## Citation

> US National Institutes of Health, RePORTER application 11002525, Helping Adults with RA PREVAIL: Developing a model to Preserve Valued Activities In Life (3K23AR079037-03S1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/11002525. Licensed CC0.

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