Title: MovIng to Support Sustained Improvement of Outcomes iN Rheumatoid Arthritis – MISSION-RA
The aim of the study is to develop an intervention to help people with Rheumatoid Arthritis (RA) increase their overall physical activity. It will be the first tailored digital behaviour change intervention to support people with RA to increase their overall volume of physical activity.
We gave advice to the client ahead of her NIHR Advanced Fellowship application on 14th January 2021 and additional advice ahead of her interview on July 7 th 2021. The RDS front line advisor stressed the importance of having patient and public involvement (PPI) at an early stage. We discussed the importance of including PPI feedback on the digital component of the intervention, including the body worn camera. We discussed PPI recruitment from the National Rheumatoid Arthritis Society (NRAS). Further advice included involving PPI members as co-researchers during the fellowship. We emphasised the importance of training and development and research support. This included supervision on machine learning (University of Oxford) and digital health and health behaviour change (University of Bristol).
As there were several work packages in the fellowship application, including qualitative research and a randomised feasibility study, the fellowship was formally discussed at the Birmingham RDS advisors meeting. This enabled input from colleagues with expertise in different applied health research backgrounds, including in feasibility studies, qualitative research and statistics. Feedback included: there needs to be a simpler flow to the study in terms of presentation; the feasibility study outcomes needed to be clearer; statistical support as part of the fellowship was important and advice was given on setting up an IT infrastructure to support the project.
The main applicant submitted her NIHR Advanced Fellowship on 17th December 2020, ahead of the deadline of 14th January 2021. The client made several changes to the application based on support from the RDS. The training and development and research support is strong. Regarding the digital component of the intervention, the PPI group suggested that a commercial activity tracker would be preferable for the intervention. As a result, the main applicant established a collaboration with a chief investigator of a commercial activity tracker. Additional PPI feedback included the importance of guaranteeing the body worn camera would protect participants’ privacy. The applicant met with the founder of NRAS and she facilitated the inclusion of PPI members as co-researchers during the fellowship.
The key parameters which the feasibility study intended to estimate were clarified, including recruitment rate, retention rate, protocol compliance and acceptability of the commercial activity tracker. Furthermore, the Birmingham Clinical Trials Unit agreed statistical support as part of their mentorship and training programme.
The application was successful in receiving the £1,012,089.00 amount of funding they applied for (July 2021). With this successfully funded NIHR Advanced Fellowship there will be potential impact and benefit for patients. This research aims to produce an intervention with potential to increase physical activity in patients with Rheumatoid Arthritis, and in the long-term reduce NHS costs. In the longer term there will be a progression to a full RCT to test the efficacy of the intervention. A further potential impact is a pioneering approach for developing a tailored physical activity digital behaviour change intervention. This novel approach would join machine learning and a Person-based Approach to inform future research in Rheumatoid Arthritis, and other populations.