INTERNET EDUCATION FOR BETTER OUTCOMES IN OA AND RA

2010年国家健康人目标首次包括一个发展目标，即“增加关节炎患者的比例，他们接受了有效的、基于证据的关节炎教育，作为其病情管理的一个组成部分。“尽管有150多项研究表明特定关节炎患者教育计划的有效性，但有效的计划只研究了一小部分患者。我们建议开发，实施，评估和传播新一代的小团体关节炎自我管理计划，将通过互联网和电子邮件提供。这一干预措施将：1）为那些不愿意或不能参加面对面会议的人提供更多的访问机会，2）将更方便，不需要真实的出席，3）提供更多的隐私，4）提供更大的监控和丰富互动的能力。由于这些属性，互联网关节炎自我管理计划（IASMP）有可能比传统计划研究更大比例的人群。有四个具体目标：1）在一项随机意向治疗试验中开发和评估ISAMP;主要结局将集中在6个月和1年的健康状况和医疗保健利用的变化。2)在一项为期2年的纵向队列研究中评估IASMP的健康状况和卫生保健利用情况。3)确定受试者对IASMP的使用和满意度，并确定自我效能和自我效能变化如何与主要结局相关。4)进行传播和推广研究。如果成功，这些研究将开始一个新的关节炎教育研究的推广，可能有助于实现健康的人2010年的目标。

For the first time, the Healthy People 2010 Objectives for the Nation include a developmental objective to "Increase the proportion of persons with arthritis who have had effective, evidence-based arthritis education as an integral part of the management of their condition." Despite more than 150 studies indicating the effectiveness of specific arthritis patient education programs, effective programs research only a small percentage of patients. We propose to develop, implement, evaluate and disseminate a new generation small group Arthritis Self-Management Program that will be delivered via the Internet and email. This intervention will: 1) offer greater access for those for those who are unwilling or unable to attend face-to-face meetings, 2) will be more convenient with no real attendance required, 3) offer more privacy, 4) offer greater ability to monitor and enrich interactions. Because of these attributes the Internet Arthritis Self-Management Program (IASMP) has the potential to research a much larger proportion of the populations than do more traditional programs. There are four specific aims: 1) To develop and evaluate in aa randomized intention-to-treat trial, the ISAMP; primary outcomes will focus on 6 month and 1-year changes in health status and health care utilization. 2) To evaluate in a 2-year longitudinal cohort study the health status and health care utilization of the IASMP. 3) To determine subjects' use and satisfaction with the IASMP as well as to determine how self-efficacy and changes in self-efficacy are associated with the primary outcomes. 4) To conduct dissemination and generalization studies. If successful, these studies will begin a new generalization of arthritis education studies that may help to fulfill the Healthy People 2010 objective.