Web-based Support to Manage Arthritis Pain

描述（由申请人提供）：美国每五个成年人中就有一个（4640万人）患有关节炎。增加个人免于关节炎疼痛的天数是2010年健康人的目标之一。尽管有各种各样的医学治疗和药物可用，自我管理是帮助关节炎患者学习如何识别、避免和帮助控制疼痛的关键组成部分。不幸的是，临床医生面临着巨大的时间压力，几乎没有时间进行所需的患者-提供者教育和合作。这是一个重要的遗漏，因为来自卫生服务提供者的量身定制的建议（例如，减少疼痛的特定练习）可以使行为改变并改善结果。因此，需要广泛可及和量身定制的干预措施来解决动机问题，以促进关节炎患者的自我管理教育。由于其覆盖人口统计群体，互联网是一个极好的工具，为关节炎患者提供自我管理程序。我们建议为患有骨关节炎、类风湿关节炎、强直性脊柱炎和其他关节炎（如银屑病关节炎）相关疼痛的成年人开发一个交互式的在线疼痛自我管理程序，使用社会认知理论的原理（Bandura, 1977,1997）。这个在线健康干预，疼痛行动：关节炎，将提供关于关节炎的诊断、治疗和管理的临床可靠信息，以清晰和引人入胜的方式为健康消费者撰写，以帮助提高他们使用自我管理策略的技能和信心。此外，它将被设计成补充和连接我们其他SBIR支持的疼痛在线健康干预措施（慢性背痛，偏头痛，神经性疼痛），为那些寻求疼痛管理援助的人提供更全面的资源。painACTION：关节炎最独特的方面是它包括三个技术创新——一个支持Web 2.0的平台，一个定制推荐引擎和动态课程——来帮助人们自我管理关节炎疼痛。在第一阶段，我们完成了两个重要目标：1)确定了painACTION: Arthritis作为干预和技术项目的可行性；2)生成了painACTION: Arthritis的内容、设计和技术开发的初步计划。在第二阶段，我们将制作程序并测试其有效性。

DESCRIPTION (provided by applicant): One of every five adults in the United States (46.4 million people) is affected by arthritis. Increasing the number of days individuals are free of arthritis pain is one of the Healthy People 2010 objectives. Although there are a variety of medical treatments and medications available, self-management is a critical component in helping arthritis sufferers learn how to identify, avoid, and help manage their pain. Unfortunately, clinicians face significant time pressure, leaving little time for desired patient-provider education and collaboration. This is an important omission as tailored advice (e.g., specific exercises to reduce pain) from health providers could enable behavior change and improve outcomes. Therefore, widely accessible and tailored interventions that address motivational issues are needed to facilitate self-management education among arthritis patients. Because of its reach across demographic groups, the Internet is an excellent vehicle for offering a self- management program to arthritis sufferers. We propose to develop an interactive, online pain self- management program for adults who suffer from pain associated with osteoarthritis, rheumatoid arthritis, Ankylosing spondylitis, and other arthritic conditions (e.g., psoriatic arthritis) using principles from Social Cognitive Theory (Bandura, 1977, 1997). This online health intervention, painACTION: Arthritis, will provide clinically reliable information about diagnosis, treatment, and management of arthritis, written for health consumers in a clear and engaging manner to help increase their skills and confidence to use self- management strategies. Moreover, it will be designed to complement and connect to our other SBIR- supported pain online health interventions (chronic back pain, migraine pain, neuropathic pain) to be a more comprehensive resource for those seeking pain management assistance. The most unique aspect of painACTION: Arthritis is that it includes three technological innovations -- a Web 2.0-enabled platform, a Custom Recommendation Engine, and Dynamic Lessons - to help people self manage their arthritis pain. In Phase I we accomplished two important objectives: 1) established the feasibility of painACTION: Arthritis as an intervention and a technical project and 2) generated preliminary plans for the content, design, and technical development of painACTION: Arthritis. In Phase II we will produce the program and test its efficacy. PUBLIC HEALTH RELEVANCE: One of every five adults in the United States (46.4 million people) is currently affected by arthritis and this number is expected to continue to grow to 67 million over the next twenty years. In 2003, $128 billion was spent on arthritis treatment in the United States alone. During the Phase I project we worked with consultants, people with arthritis pain, health professionals, and technical staff to: a) establish the feasibility of creating an online self management program for people with arthritis pain and b) develop plans for content, design, and features for a fully functional painACTION: Arthritis program. In Phase II, we propose to create painACTION: Arthritis then conduct a study to find out if it helps people with arthritis pain to increase their self management skills and functioning.