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）受到关节炎的影响。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。虽然有各种各样的医疗和药物可用，自我管理是帮助关节炎患者学习如何识别，避免和帮助管理他们的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，因为量身定制的建议（例如，具体的练习，以减少疼痛）的健康提供者可以使行为改变和改善结果。因此，需要广泛使用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。由于其覆盖人口群体，互联网是一个很好的工具，提供了一个自我管理计划，关节炎患者。我们建议为患有与骨关节炎、类风湿性关节炎、强直性脊柱炎和其他关节炎疾病（例如，银屑病性关节炎）的患者（Bandura，1977，1997）。这种在线健康干预，painACTION：Arthritis，将提供有关关节炎诊断，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，它将被设计为补充和连接到我们的其他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），成为那些寻求疼痛管理帮助的人更全面的资源。关节炎最独特的方面是它包括三项技术创新-支持Web 2.0的平台，自定义推荐引擎和动态课程-以帮助人们自我管理他们的关节炎疼痛。在第一阶段，我们完成了两个重要的目标：1）建立painACTION：Arthritis作为干预和技术项目的可行性，2）为painACTION：Arthritis的内容，设计和技术开发制定初步计划。在第二阶段，我们将制定计划并测试其有效性。 公共卫生相关性：在美国，每五个成年人中就有一个（4640万人）目前受到关节炎的影响，预计这个数字在未来二十年内将继续增长到6700万。2003年，仅在美国就有1280亿美元用于关节炎治疗。在第一阶段的项目中，我们与顾问、关节炎疼痛患者、健康专业人士和技术人员合作：a）确定为关节炎疼痛患者创建在线自我管理程序的可行性，以及B）为功能齐全的painACTION：关节炎程序制定内容、设计和功能计划。在第二阶段，我们建议创建painACTION：Arthritis，然后进行一项研究，以了解它是否有助于关节炎疼痛患者提高自我管理技能和功能。

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.