PSYCHOLOGY, PSYCHIATRY, IMAGING & BRAIN NEUROSCIENCE SECTION Original Research Article Testing a Positive Psychological Intervention for Osteoarthritis Leslie R. M. Hausmann, PhD,* ,† Ada Youk, PhD,* ,‡ C. Kent Kwoh, MD, § Said A. Ibrahim, MD, MPH, ¶,k Michael J. Hannon, MA,* ,† Debra K. Weiner, MD, kj,† Rollin M. Gallagher, MD, ¶,k and Acacia Parks, PhD** ,†† *Center for Health Equity Research and Promotion and kj Geriatric Research, Education and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania; † School of Medicine and ‡ Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; § College of Medicine and University of Arizona Arthritis Center, University of Arizona, Tucson, Arizona; ¶ Center for Health Equity Research and Promotion, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania; k School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; **Department of Psychology, Hiram College, Hiram, Ohio; †† Happify, New York, New York, USA Correspondence to: Leslie R. M. Hausmann, PhD, Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, University Drive (151C), Pittsburgh, PA 15240, USA. Tel: 412-360-2112; Fax: 412-360-2285; E-mail: leslie.hausmann@gmail.com. Funding sources: This work was supported by the Veterans Integrated Service Network 4 Center for Health Equity Research and Promotion Pilot Research Program (LIP 72-065; Principal Investigator: LH). SI was sup- ported in part by a K24 Mid-Career Development Award from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (K24AR055259). The views expressed here are those of the authors and do not represent those of the Department of Veterans Affairs, the National Institute of Arthritis and Musculoskeletal and Skin Diseases, the National Institutes of Health, or the United States Government. Disclosure and conflicts of interest: LH: no conflict. AY: no conflict. CK: research funding: Abbvie, EMD Serono; Data Safety Monitoring Board: Novartis, Astellas; Advisory Board: Thusane. SI: no conflict. MH: consultant: EMD Serono. DW: no conflict. RG: no conflict. AP: Chief Scientist of, receives research fund- ing from, and owns shares of Happify. Abstract Objective. Osteoarthritis is a leading cause of disability for which there is no cure. Psychosocial- oriented treatments are underexplored. We devel- oped and tested an intervention to build positive psychological skills (e.g., gratitude) to reduce oste- oarthritis symptom severity, including pain and functioning, and to improve psychosocial well- being in patients with knee or hip osteoarthritis. Design. Two-arm randomized design with six- month follow-up. Setting. An academic Veterans Affairs Medical Center. Subjects. Patients aged 50 years or older with knee or hip osteoarthritis and pain ratings of 4 or higher. Methods. Patients (N 5 42) were randomized to a six- week program containing positive skill-building activ- ities or neutral control activities tailored to the patient population. Adherence was assessed by telephone each week. We assessed osteoarthritis symptom se- verity (WOMAC Osteoarthritis Index) and measures of well-being (positive affect, negative affect, and life satisfaction) at baseline and by telephone one, three, and six months after the program ended. We used linear mixed models to examine changes over time. Results. The majority (64%) of patients completed more than 80% of their weekly activities. Patients in the positive (vs neutral) program reported signifi- cantly more improvement over time in osteoarthritis symptom severity (P 5 0.02, Cohen’s d 5 0.86), neg- ative affect (P 5 0.03, Cohen’s d 5 0.50), and life sat- isfaction (P 5 0.02, Cohen’s d 5 0.36). 2017 American Academy of Pain Medicine. This work is written by US Government employees and is in the public domain in the US. 1908 Pain Medicine 2017; 18: 1908–1920 doi: 10.1093/pm/pnx141 Downloaded from https://academic.oup.com/painmedicine/article-abstract/18/10/1908/3894100 by guest on 31 May 2018