{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T02:41:33Z","timestamp":1777516893178,"version":"3.51.4"},"reference-count":44,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2023,3,8]],"date-time":"2023-03-08T00:00:00Z","timestamp":1678233600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100001298","name":"Presbyterian Health Foundation","doi-asserted-by":"publisher","award":["GRF00005992"],"award-info":[{"award-number":["GRF00005992"]}],"id":[{"id":"10.13039\/100001298","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Multimorbidity and Comorbidity"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Approximately 45% of older adults in the U.S. have 2 or more chronic health conditions (e.g., arthritis, hypertension, diabetes) in addition to functional limitations that prevent performance of health self-management activities. Self-management continues to be the gold standard for managing MCC, but functional limitations create difficulty with these activities (e.g., physical activity, symptom monitoring). Restricted self-management accelerates the downward spiral of disability and accumulating chronic conditions which, in turn, increases rates of institutionalization and death by 5-fold. Currently, there are no tested interventions designed to improve independence in health self-management activities in older adults with MCC and functional limitations. Research suggests that older adults are more likely to change behavior with interventions that assist with planning health-promoting daily activities, especially when contending with complex medical regimens and functional limitations. Our team asserts that combining occupational therapy (OT) and behavioral activation (BA) shows promise to improve health self-management in populations with chronic conditions and\/or functional limitations. This innovative combination uses the goal setting, scheduling\/monitoring activities, and problem-solving components of the BA approach as well as the environmental modification, activity adaptation, and focus on daily routines from OT practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We will test the effect of this combined approach in a Stage I, randomized controlled pilot feasibility study compared to enhanced usual care. We will recruit 40 older adults with MCC and functional limitation and randomize 20 to the PI- delivered BA-OT protocol. This research will inform modification and larger-scale testing of this novel intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/26335565231163037","type":"journal-article","created":{"date-parts":[[2023,3,8]],"date-time":"2023-03-08T14:30:45Z","timestamp":1678285845000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["A pilot, randomized, feasibility study to improve health self-management behaviors in older adults with multiple chronic conditions and functional limitations: Protocol for the Behavioral Activation and Occupational Therapy Trial (BA+OT)"],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2560-4631","authenticated-orcid":false,"given":"Tara C","family":"Klinedinst","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Sciences, College of Allied Health, University of Oklahoma Health Sciences Center- Schusterman Campus, Tulsa, OK, USA"},{"name":"Department of Internal Medicine, OU-TU School of Community Medicine, Tulsa, OK, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carrie A","family":"Ciro","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Darla E","family":"Kendzor","sequence":"additional","affiliation":[{"name":"TSET Heath Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA"},{"name":"Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,3,8]]},"reference":[{"key":"bibr1-26335565231163037","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(19)30222-1"},{"key":"bibr2-26335565231163037","volume-title":"Chronic care: making the case for ongoing care","author":"Anderson GF","year":"2010"},{"key":"bibr3-26335565231163037","unstructured":"Institute of Medicine. Living Well with Chronic Illness: A Call for Public Health Action. Washington, DC: The National Academies Press, 2012, p. 350."},{"key":"bibr4-26335565231163037","doi-asserted-by":"publisher","DOI":"10.7249\/TL221"},{"key":"bibr5-26335565231163037","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-019-7066-9"},{"key":"bibr6-26335565231163037","doi-asserted-by":"publisher","DOI":"10.1177\/2377960817752471"},{"key":"bibr7-26335565231163037","unstructured":"Gerteis J, Izrael D, Deitz D, et al. Multiple chronic conditions chartbook. 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Occupational therapy practice framework: Domain & process, 4th Edition. 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