INTERNET EDUCATION FOR BETTER OUTCOMES IN OA AND RA

《2010年全国健康人目标》首次纳入了一项发展目标，即“提高关节炎患者接受有效的循证关节炎教育的比例，将其作为病情管理的一个组成部分”。尽管超过150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。我们建议制定、实施、评估和传播一个新一代的小组关节炎自我管理计划，该计划将通过互联网和电子邮件传递。这种干预将：1)为那些不愿意或无法参加面对面会议的人提供更多的机会，2)将更方便，不需要真正出席，3)提供更多的隐私，4)提供更大的监控和丰富互动的能力。由于这些特性，互联网关节炎自我管理项目（IASMP）比传统项目有潜力研究更大比例的人群。有四个具体目标：1)开发和评估一项随机意向治疗试验（ISAMP）；主要结果将侧重于6个月和1年内健康状况和保健利用的变化。2)通过一项为期2年的纵向队列研究，评估IASMP的健康状况和医疗保健利用情况。3)确定被试对IASMP的使用和满意度，以及确定自我效能感和自我效能感的变化与主要结局的关系。4)进行传播推广研究。如果成功，这些研究将开始一个新的推广关节炎教育研究，这可能有助于实现健康人2010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.