Promoting physical activity engagement for people with early stage Parkinson's disease (Engage-PD)

The Engage-PD program will consist of 3 elements: 1. Engage-PD coaching program. This program provides the opportunity for individuals recently diagnosed with PD to have access to individualized structured support to facilitate exercise uptake as part of an effective self-management program. The program will use the Pre-Active PD program (3) developed and evaluated by our team to guide the delivery of the intervention. The therapist will use motivational interviewing strategies that include four processes (engaging, evoking, planning, and tracking) and core communication skills (e.g. asking open ended questions, reflective listening, summarizing) (4). The therapist will use the workbook as a tool in order to engage and focus the participant throughout the coaching process, and will educate participants on exercise options and the specific benefits for people with PD. The therapist will facilitate development of specific and measurable goals, and will provide options for tracking progress, such as written or web-based exercise logs or an activity monitor. Participants will have the opportunity to participate in a three month follow up session and assessment. 2. Peer educator and community health worker training. The InTOuCH Health Worker training program is a mechanism for training community healthcare workers at Columbia University. Using the Engage-PD program as a basis, we will conduct educational training sessions with healthcare workers through this program to understand the early signs of Parkinson's disease, and discuss the key aspects of self-management including exercise and physical activity. This program will include training of psychosocial barriers to exercise engagement, skills in motivational interviewing and theory of stages of behavior change, and identification of strategies to address barriers and facilitate exercise engagement. Peer educators will also be informed about the Engage coaching program, and will be encouraged to refer individuals to the program as appropriate. 3. Exercise education classes. We will develop a Mobile Exercise Unit to conduct exercise education classes for people with early stage PD at local community organizations in Washington Heights. These classes will include information on what is PD, common symptoms and treatments, and the role of exercise/physical activity in disease management. We will use a storytelling approach with a 'flipbook' and video stories outlining a particular family's journey with PD. Storytelling is a well-recognized approach in teaching because it grabs an individual's attention, facilitates understanding and fosters action.(5) We will incorporate messages of hope and optimism that empower people who are newly diagnosed, with an emphasis on the role of self-management through exercise and physical activity. Our Spanish-speaking project coordinator and/or translation services will be available through Columbia University and used as need for all aspects of the program.