How the Plants for Joints multidisciplinary lifestyle intervention achieved its effects: a mixed methods process...

Area of Science:

• Lifestyle Medicine
• Nutritional Science
• Rheumatology

Background:

• The Plants for Joints (PFJ) intervention integrates whole-food plant-based nutrition, physical activity, and stress management.
• PFJ has demonstrated efficacy in improving disease activity and symptoms in rheumatoid arthritis (RA) and osteoarthritis (OA) patients, alongside metabolic health benefits.

Purpose of the Study:

• To conduct a mixed-methods process evaluation of the PFJ intervention.
• To understand the context, implementation, and mechanisms driving the intervention's impact.
• To explore the relationship between the degree of intervention implementation and observed lifestyle changes.

Main Methods:

• A mixed-methods approach was employed, collecting quantitative and qualitative data from participants and coaches.
• Data collection included focus groups, questionnaires, and interviews, analyzed thematically and statistically.
• Implementation fidelity was quantified using a theory-driven index score.

Main Results:

• High participant satisfaction (mean score 9.2/10) and perceived intervention effectiveness were reported.
• Key beneficial components included self-monitoring, social support, practical information, and multidisciplinary guidance.
• No significant differences in healthy lifestyle changes were found across varying implementation index scores.

Conclusions:

• The PFJ intervention is perceived as feasible, coherent, and effective by participants.
• Findings support the use of plant-based lifestyle interventions as an adjunct therapy for RA, OA, and other chronic conditions.
• The process evaluation provides insights for optimizing future implementations of the PFJ intervention.