Arthritis

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Intervention Programs

CDC Arthritis Program Intervention “Promising Programs”*

Intervention	Program Components
The Arthritis Toolkit (mail delivered) https://www.bullpub.com/catalog/the-arthritis-toolkit/ Stanford University Patient Education Research Program, University of North Carolina School of Nursing	The Arthritis Toolkit provides much of the same information as the Arthritis Foundation Self Management Program in a self study format that can be mailed to participants. The self study kit includes the Arthritis Self-Help book, information sheets, 4 exercise CD’s and an illustrated exercise guide. The kit is available in both English and Spanish from Bull Publishing.
Better Choices Better Health® for Arthritis (ASMP – Internet Based) Stanford University Patient Education Research Center Contact: Annie Parr at: aparr@arthritis.org	Internet-based group workshop using the content from the Arthritis Self-Management Program (ASMP) that focuses on arthritis management skills including decision-making, problem-solving and action-planning. This has also been known as “Healthy Living with Arthritis.” The National Council on Aging (NCOA) and the Arthritis Foundation (AF) are collaborating to provide the BCBH for Arthritis intervention. Program dissemination is currently in a pilot test phase.
Walk With Ease (self-directed) (Arthritis Foundation) www.arthritis.org	The Walk With Ease (WWE) arthritis self-management program was developed by the Arthritis Foundation. This version of the program is self-directed.
Fitness & Exercise for People with Arthritis (FEPA): (San Diego State University/ Carol Macera, Susan Levy) Contact: Susan S. Levy slevy@mail.sdsu.edu	Multi-component exercise program with additional emphasis on aerobic conditioning along with strength and balance exercises.

*Promising Program—An intervention with promising preliminary data and are developing the infrastructure to support wide-spread dissemination.

For Further Information:

A journal article outlining the CDC Arthritis Program's screening criteria and selection process for recommending interventions for people with arthritis has been published. An overview of each recommended intervention and the implementation details are also included.

Brady TJ, Jernick SL, Hootman JM, Sniezek JE. Public health interventions for arthritis: expanding the toolbox of evidence-based interventions. Journal of Women’s Health 2009;18(12):19051917. abstract

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CDC Arthritis Program Intervention “Watch List”*

Intervention	Program Components
People Exercising Program (formerly Strong Living) (Northeastern/Layne) www.peopleexercising.org	Strength training, balance and flexibility exercise class.
First Step to Active Health (National Blueprint) www.firststeptoactivehealth.com	Progressive activity program including cardio/aerobic, flexibility, strength and balance activities.
A Matter of Balance (MOB/VLL) Partnership for Healthy Aging 465 Congress Street, Suite 701 Portland, ME 04101 (207) 775-1095 Fax: (207) 541-7540 http://www.mainehealth.org/ mh_body.cfm?id=432	A cognitive-behavioral intervention program that emphasizes practical strategies to reduce fear of falling and increase activity levels.
Tai Chi (Arthritis Foundation) www.arthritis.org	An exercise program designed to improve quality of life for people with arthritis using 12 Sun Style Tai Chi movements.
Active Choices: The School of Rural Public Health, Texas A&M Health Science Center www.activeforlife.info/about_the_program/ program_information	A program designed and tested by “Active for Life”. Lifestyle modification intervention including a six month program of individually selected activities facilitated with ongoing, brief telephone and mail follow-up delivered to the home.
Better Choices Better Health® (CDSMP internet-based) Stanford University Patient Education Research Center ttp://www.ncoa.org/improve-health/chronic-conditions/better-choices-better-health.html	Better Choices Better Health® (BCBH) is the online version of the internationally recognized Chronic Disease Self-Management Program, developed and tested at the Stanford University Patient Education Center. BCBH is a group workshop using the content from the Chronic Disease Self-Management Program (CDSMP) that focuses on chronic disease management skills including decision-making, problem-solving and action-planning.

*Watch List—indicates that an interventions’ prospects for recommendation are promising, while awaiting the results of current evaluation project(s).

For Further Information:

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CDC Arthritis Program Intervention Screening
Criteria List

Physical Activity Interventions	Self Management Education Interventions
Arthritis-appropriateness	Arthritis-appropriateness
A. Characteristics of Intervention Design Participant control over activity intensity, frequency, duration Instructor training reinforces participant control Instruction is hands off (no touch) Provides background information on fitness Flexibility in measures of success (so participant feels competent and successful)	A. Characteristics of Intervention Design Addresses content and outcomes of the importance in managing arthritis ( as specified in the CDC Arthritis Program framework: pain, disability, and physical, psychological, or work function) Based on a theoretical foundation that enhances behavior change
B. Characteristics of the Physical Activity No contact/collision sports No competitive sports No jumping or high joint impact activity	B. Characteristics of Self- Management Education Fosters skills important in managing arthritis, such as goal-setting, decision-making, problem-solving and self monitoring. Consists of more than information dissemination (as provided through print materials; oral instruction)
C. Characteristics of the Research Data available on a general adult community population (no military, elite athlete, or child-based populations) Dropout rates and reasons reported No safety/injury concerns raised	C. Characteristics of the Research Data available on a general adult community population Dropout rates and reasons reported No concerns raised re: participant harm
Adequacy of Evidence base	Adequacy of Evidence base
A. Intervention Evaluated in Present Form B. Measured Arthritis Relevant Outcomes of Interest— meaningful improvements in at least two of the following categories: relieving pain, improving function (physical, mental, social, work, activity, participation), or level of physical activity. C. Documentation of Evidence Published journal article or written report Sample size a minimum of 75 subjects in the treatment group, and pre- and post-test measurement or more rigorous study design A six month (or greater) study follow-up. D. Consistency of Evidence: Consistent trends in study results E. Studies documenting evidence are judged to have reasonable rigor	A. Intervention Evaluated in Present Form B. Measured Arthritis Relevant Outcomes of Interest— meaningful improvements in at least two of the following categories: relieving pain, improving function (physical, mental, social, work, activity, participation), or level of physical activity. C. Documentation of Evidence Published journal article or written report Sample size a minimum of 75 subjects in the treatment group, and a pre-test (3-month or more) post-test measurement or more rigorous study design D. Consistency of Evidence: Consistent trends in study results E. Studies documenting evidence are judged to have reasonable rigor
Implementability as Public Health Intervention	Implementability as Public Health Intervention
A. Leader/Implementer requirements Academic degree not required Leader training available, if necessary B. Site requirements: No special facilities beyond a community room (except warm pool for aquatic program) C. Equipment Requirements: no special equipment more expensive than a pedometer required D. Cost to Participants less than $50 E. Implementation Guide available G. Supporting structures (i.e., training, technical assistance) judged to be adequate to support wide-spread implementation	A. Leader/Implementer requirements Academic degree not required Leader training available, if necessary B. Site Requirements: No special facilities beyond a community room C. Equipment Requirements: No special equipment required more expensive than book, CD/DVD, or videotape required D. Cost to Participants less than $50 E. Implementation Guide available G. Supporting structures (i.e., training, technical assistance) judged to be adequate to support wide-spread implementation