Randomized Controlled Trial of an Educational Intervention Using an Online Risk Calculator for Knee Osteoarthritis: Effect on Risk Perception
Randomized Controlled Trial of an Educational Intervention Using an Online Risk Calculator for Knee Osteoarthritis: Effect on Risk Perception
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DOI：
10.1002/acr.23136
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发表时间：
2017-08-01
影响因子：
4.7
通讯作者：
Katz, Jeffrey N.
中科院分区：
文献类型：
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作者：
Losina, Elena;Michl, Griffin L.;Katz, Jeffrey N.
目标。一般来说，年轻人没有意识到他们患膝骨关节炎（OA）的风险。了解风险和风险因素对预防膝关节炎至关重要。我们测试了个性化风险计算器对膝OA风险感知的准确性和改变与膝OA风险因素相关行为的意愿的有效性。我们进行了一项随机对照试验，使用亚马逊土耳其机器人招募了375名受试者。受试者被随机分为两组，一组使用基于人口统计学和风险因素信息的个性化风险计算器（干预），另一组查看常规OA风险信息（对照组）。在基线和干预后，受试者估计其10年和终生膝关节炎的风险，并对衡量改变饮食、运动或体重控制行为的意愿的思考阶梯做出反应。两组受试者在10年和一生中发生症状性膝关节炎的几率分别为3.6%和25.3%。两组在基线时都大大高估了膝关节炎的风险，估计10年风险为26.1%，终生风险为47.8%。干预后，风险计算器受试者的10年感知风险降低12.9个百分点至12.5%，终生感知风险降低19.5个百分点至28.1%。对照组受试者的感知风险保持不变。风险计算器的受试者更有可能进入运动沉思阶梯的行动阶段（相对风险2.1）。两组之间在饮食和体重控制方面没有差异。风险计算器是膝关节OA教育的有效干预手段，并可能激发一些与运动相关的行为改变。
Objective. Young adults, in general, are not aware of their risk of knee osteoarthritis (OA). Understanding risk and risk factors is critical to knee OA prevention. We tested the efficacy of a personalized risk calculator on accuracy of knee OA risk perception and willingness to change behaviors associated with knee OA risk factors.Methods. We conducted a randomized controlled trial of 375 subjects recruited using Amazon Mechanical Turk. Subjects were randomized to either use a personalized risk calculator based on demographic and risk-factor information (intervention), or to view general OA risk information (control). At baseline and after the intervention, subjects estimated their 10-year and lifetime risk of knee OA and responded to contemplation ladders measuring willingness to change diet, exercise, or weight-control behaviors.Results. Subjects in both arms had an estimated 3.6% 10-year and 25.3% lifetime chance of developing symptomatic knee OA. Both arms greatly overestimated knee OA risk at baseline, estimating a 10-year risk of 26.1% and a lifetime risk of 47.8%. After the intervention, risk calculator subjects' perceived 10-year risk decreased by 12.9 percentage points to 12.5% and perceived lifetime risk decreased by 19.5 percentage points to 28.1%. Control subjects' perceived risks remained unchanged. Risk calculator subjects were more likely to move to an action stage on the exercise contemplation ladder (relative risk 2.1). There was no difference between the groups for diet or weight-control ladders.Conclusion. The risk calculator is a useful intervention for knee OA education and may motivate some exercise-related behavioral change.