Helping seniors with osteoarthritis use their SilverSneakers fitness benefits

Activating SilverSneakers Benefits for Seniors With Osteoarthritis: Proactive Versus Usual Care

We will test whether a brief outreach with mailed materials and two phone calls helps older adults with osteoarthritis start using their SilverSneakers benefits, improve physical and social well-being, and reduce related healthcare use.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 1454 (estimated)
• Ages: 65 Years and up
• Sex: All
• Sponsor: Milton S. Hershey Medical Center (Academic / other)
• Locations: 1 site (Hershey, Pennsylvania)
• Trial ID: NCT06782347 on ClinicalTrials.gov

What this trial studies

This pragmatic randomized trial will compare a Proactive Care outreach (mailed information, two phone calls, and a faxed note to primary care providers) to Usual Care (standard insurance benefit packet) among older adults with osteoarthritis who have SilverSneakers access but have not used it. About 1,454 participants aged 65+ enrolled at least one year in a Humana Medicare Advantage plan that includes SilverSneakers will be randomized and followed for two years. Primary outcomes include initiation and sustained participation in SilverSneakers programs, patient-reported physical, social, and psychological outcomes, and osteoarthritis-related health service use and costs. The intervention is delivered nationally with Penn State Milton S. Hershey Medical Center as lead site and collaborators including Humana and Kaiser Permanente.

Who should consider this trial

Good fit: Ideal candidates are adults 65 or older with a diagnosis of hip, knee, or general osteoarthritis who are continuously enrolled in a Humana Medicare Advantage plan that provides SilverSneakers, have not previously used SilverSneakers, and can consent in English or Spanish.

Not a fit: Patients already using SilverSneakers, those not enrolled in a qualifying Medicare Advantage plan, or those with dementia or severe cognitive impairment preventing informed consent are unlikely to benefit from this intervention.

Why it matters

Potential benefit: If successful, this low-cost outreach could increase exercise participation among older adults with osteoarthritis, improving function and social well-being and potentially reducing costly osteoarthritis-related healthcare visits.

How similar studies have performed: Outreach and behavior-change programs have previously increased participation in community exercise programs, but evidence is limited on whether such outreach to activate insurance-covered benefits like SilverSneakers leads to sustained clinical improvements or reduced healthcare use.

Eligibility criteria

Inclusion Criteria:

* Aged 65 and older.
* ICD-9 or ICD-10 code for hip, knee, or general osteoarthritis.
* Positive response to a standardized question from the Medical Expenditure Panel Survey that asks if patient was diagnosed with osteoarthritis/arthritis and self-report confirmation of hip and/or knee pain due to their osteoarthritis/arthritis.
* Continuous enrollment for at least one year in a Humana Medicare Advantage plan which provides free SilverSneakers access and both medical and prescription drug coverage.
* Not currently or previously enrolled in SilverSneakers.
* Speak English or Spanish.
* Physical/mental capacity to provide informed consent, based on not having an ICD-9 or ICD-10 code for dementia and being able to answer three questions to verify comprehension of the informed consent form.

Exclusion Criteria:

* Another person in the same household is enrolling/enrolled in the study (to prevent treatment contamination, only one participant per household can participate).
* Medicare/Medicaid dual enrollment due to limited data accessibility for this group.
* Receiving hospice care or under long-term institutional care (Part C) due to limited data accessibility for this group.
* Receiving care from a provider credentialed through a delegated arrangement (i.e., delegated provider), due to limited data accessibility for this group.
* Lack of a valid mailing address in the Humana medical claims databases.

Where this trial is running

Hershey, Pennsylvania

• Penn State College of Medicine — Hershey, Pennsylvania, United States (Recruiting)

Study contacts

• Principal investigator: Liza S. Rovniak, PhD, MPH — Penn State College of Medicine
• Study coordinator: Liza S. Rovniak, PhD, MPH

Conditions Osteoarthritis; Physical Inactivity