Presentation: Is a Mail-Delivered Arthritis Self-Management Program Effective? A Randomized 4-Month Study (2007)

723 Is a Mail-Delivered Arthritis Self-Management Program Effective? A Randomized 4-Month Study

Purpose: To determine the effectiveness of an Arthritis Self-Management Program (ASMP) delivered through the mail.
Methods: The content of the classic ASMP was packaged in an attractive, user-friendly Tool Kit for mailing. Persons (N=922) with OA (51%), RA (33%) and fibromyalgia (30%) were recruited from across the United States to participate in a randomized controlled trial. After completing a mailed baseline questionnaire they were randomized to receive the mailed Arthritis Self-Management Tool Kit or to usual care. The Tool Kit included: 1) 4 audio CDs: 2 exercise, 1 relaxation, and 1 with vignettes from persons with arthritis; 2) The Arthritis Help Book; 3) a set of Tip Sheets highlighting self-management content and skills; and 4) a self-test which gave participants personalized guidance on the use of the materials. The Tool Kits cost under $50 per person, and were available in English and Spanish. Data were collected by validated self-administered mailed or telephone delivered questionnaires at baseline and four months.
Results: Mean age was 53.8 (SD=12.3). 43.6% were non-Hispanic Caucasian, 37.4% were Hispanic and 16.9% were African American. 13.8% were men, and the mean years of education was13.8 (SD=3.8). 80% of the persons entered into the study completed 4 months of follow-up. At four months participants (N=341) were compared to controls (N=401). Analysis of covariance was used to control for age, gender, education, marital status, race/ethnicity and baseline values of study variables. Findings demonstrated improvements in pain, fatigue, disability, health distress, role function, depression, and self-efficacy to deal with the consequences of arthritis (all p<.001). There were no changes in health care utilization. There were few differences by ethnicity. African Americans had less improvement in role limitation than the overall sample, and both African Americans and Hispanics had less improvement in depression (p>.05).
Conclusion: This mail-based intervention appears to improve health status and self-efficacy similar to the small group and Internet based ASMP. A mailed arthritis self-management program may reach a different and larger group of people with less cost and/or fewer administrative resources than the small group or Internet self-management program.

  K.R. Lorig, Da Capo Press and Bull Publications, 7; J. Goeppinger, None; C. Lum, None; P. Ritter, None; S. Mutatkar, None.