# Development of a Mind Body Program to Reduce Knee Pain in Obese Osteoarthritis Patients with Comorbid Depression

> **NIH NIH R34** · UNIVERSITY OF KENTUCKY · 2020 · $215,722

## Abstract

PROJECT SUMMARY
Development of a mind body program to reduce cartilage breakdown and knee pain in obese osteoarthritis
patients with comorbid depression
 This is a R34 application that follows the recently released IMMPACT criteria, and the International
Classification of Functioning, Disability and Health (ICF) framework to adapt a multimodal, theory grounded
mind body program (The Relaxation Response Resilience Program; 3RP) with prior success in patients with
medical illness in pilot and effectiveness studies for the needs of obese patients with knee osteoarthritis (OA)
and depression and to specifically target increased physical activity (p3RP-OA). Depression, obesity and OA
exacerbate one another and share a common pathophysiology involving systemic inflammation and pro-
inflammatory cytokines, reflecting a complex mind-body interaction. Current treatments for knee OA offer
little to no benefit over a placebo, and do not emphasize mind-body practices or physical activity to target the
underlying pathophysiology. Physical activity alone has shown benefit in the treatment of depression, obesity
and OA individually, but adequate implementation remains challenging. Our guiding hypothesis is that the
synergistic interaction between mindfulness, adaptive thinking, positive psychology and healthy living skills of
the 3RP adapted for the needs of OA patients and to target increased physical activity reduces pro-
inflammatory cytokine expression while also promoting optimal mechanical loading of the cartilage will slow
the progression of symptomatic knee OA. Toward this goal, this R34 proposal aims to 1) adapt the 3RP for the
needs of knee OA patients with depression (PHQ-910) and obesity (BMI30 kg/m2) with a focus of increasing
physical activity; and 2) establish the feasibility, credibility and acceptability of the programs and research
procedures. Using the R34 NCCIH mechanism, we propose to use an iterative mixed methods strategy to adapt
the 3RP for the specific needs of obese OA patients with depression including increased activity to maximize
their feasibility, acceptability, and credibility. This R34 grant will set the stage for us to conduct a fully powered
RCT through the R61/R33 mechanisms to assess the biopsychosocial mechanisms associated with OA
progression.

## Key facts

- **NIH application ID:** 9896561
- **Project number:** 1R34AT010370-01A1
- **Recipient organization:** UNIVERSITY OF KENTUCKY
- **Principal Investigator:** Cale Jacobs
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $215,722
- **Award type:** 1
- **Project period:** 2020-01-01 → 2022-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9896561

## Citation

> US National Institutes of Health, RePORTER application 9896561, Development of a Mind Body Program to Reduce Knee Pain in Obese Osteoarthritis Patients with Comorbid Depression (1R34AT010370-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9896561. Licensed CC0.

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