An Internet-based Self-management Program with Telephone Support for Adolescents with Arthritis: A Pilot Randomized Controlled Trial

• Published in: Journal of rheumatology 2010-09, Vol.37 (9), p.1944-1952
• Main Authors: STINSON, Jennifer N, MCGRATH, Patrick J, CAMPILLO, Sarah, GILL, Navreet K, WHITE, Meghan E, HODNETT, Ellen D, FELDMAN, Brian M, DUFFY, Ciaran M, HUBER, Adam M, TUCKER, Lori B, HETHERINGTON, C. Ross, TSE, Shirley M. L, SPIEGEL, Lynn R
• Format: Article
• Language: English
• Subjects: Adolescent; Arthritis - psychology; Arthritis - therapy; Biological and medical sciences; Canada; Child; Diseases of the osteoarticular system; Female; Humans; Inflammatory joint diseases; Internet; Male; Medical sciences; Patient Compliance; Patient Education as Topic; Patient Satisfaction; Pilot Projects; Quality of Life; Self Care; Social Support; Telephone
• ISSN: 0315-162X; 1499-2752
• DOI: 10.3899/jrheum.091327

To determine the feasibility of a 12-week Internet-based self-management program of disease-specific information, self-management strategies, and social support with telephone support for youth with juvenile idiopathic arthritis (JIA) and their parents, aimed at reducing physical and emotional symptoms and improving health-related quality of life (HRQOL). A nonblind pilot randomized controlled trial (NCT01011179) was conducted to test the feasibility of the "Teens Taking Charge: Managing Arthritis Online" Internet intervention across 4 tertiary-level centers in Canada. Participants were 46 adolescents with JIA, ages 12 to 18 years, and 1 parent for each participant, who were randomized to the control arm (n = 24) or the Internet intervention (n = 22). The 2 groups were comparable on demographic and disease-related variables and treatment expectation at baseline. Attrition rates were 18.1% and 20.8%, respectively, from experimental and control groups. Ninety-one percent of participants randomized to the experimental group completed all 12 online modules and weekly phone calls with a coach in an average of 14.7 weeks (SD 2.1). The control group completed 90% of weekly attention-control phone calls. The Internet treatment was rated as acceptable by all youth and their parents. In posttreatment the experimental group had significantly higher knowledge (p < 0.001, effect size 1.32) and lower average weekly pain intensity (p = 0.03, effect size 0.78). There were no significant group differences in HRQOL, self-efficacy, adherence, and stress posttreatment. Findings support the feasibility (acceptability, compliance, and user satisfaction) and initial efficacy of Internet delivery of a self-management program for improving disease-specific knowledge and reducing pain in youth with JIA.