Teens Taking Charge: A Randomized Controlled Trial of a Web-Based Self-Management Program With Telephone Support for Adolescents With Juvenile Idiopathic Arthritis

Background Juvenile idiopathic arthritis (JIA) is a serious and potentially debilitating pediatric illness. Improved disease self-management may help to improve health outcomes. Objective This study aimed to evaluate the effectiveness of the Teens Taking Charge Web-based self-management intervention in reducing symptoms and improving health-related quality of life (HRQL) in adolescents with JIA compared with a Web-based education control condition. Methods Adolescents with JIA aged 12 to 18 years were recruited from 11 Canadian pediatric rheumatology centers. Caregivers were invited to participate along with their child. In addition to standard medical care, participants were randomized to receive either (1) the Teens Taking Charge self-management intervention or (2) a Web-based education control condition for a period of 12 weeks. Adolescents in the intervention group completed website modules addressing cognitive behavioral coping skills, stress management, and other self-management topics, while also receiving monthly telephone calls from a trained health coach. Adolescents in the education control group were instructed to view a series of preselected public JIA educational websites and received monthly calls from a coach who asked about their own best efforts at managing JIA. Caregivers in the intervention group completed website modules related to promoting independence and disease self-management in their child. Caregivers in the education control group were instructed to view a series of preselected public JIA educational websites. Outcome assessment occurred at baseline, 12 weeks (posttreatment), and at 6 and 12 months postrandomization. The primary outcomes were pain intensity, pain interference, and HRQL. Secondary outcomes were emotional symptoms, adherence, coping, knowledge, and self-efficacy. Results In total, 333 adolescents and 306 caregivers were enrolled. Significant overall reductions in pain intensity (P=.02) and pain interference (P=.007) were observed for intervention group participants compared with those in the education control group, after adjusting for baseline levels. There was a significant overall improvement in HRQL related to problems with pain (P=.02) and problems with daily activities (P=.01). There was also a significant difference in the intervention group over time (P=.008) for HRQL related to treatment problems, with the intervention group participants demonstrating improved HRQL by 12 months compared with education control group participants. Both groups showed nonsignificant improvements compared with baseline in other primary outcomes. There were no significant differences between the groups in any secondary outcomes or caregiver-reported outcomes. Conclusions The results of this randomized trial suggest that the Teens Taking Charge Web-based intervention is effective at reducing both pain intensity and pain interference, as well as improving HRQL in adolescents with JIA, compared with education control. These effects are sustained for up to 12 months following program completion. The Teens Taking Charge program is now publicly available at no cost. Trial Registration ClinicalTrials.gov NCT01572896; https://clinicaltrials.gov/ct2/show/NCT01572896

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Teens Taking Charge: A Randomized Controlled Trial of a Web-Based Self-Management Program With Telephone Support for Adolescents With Juvenile Idiopathic Arthritis (Preprint)

10.2196/preprints.16234 ◽

2019 ◽

Author(s):

Jennifer N Stinson ◽

Chitra Lalloo ◽

Amos S Hundert ◽

Sarah Campillo ◽

Tania Cellucci ◽

...

Keyword(s):

Pain Intensity ◽

Intervention Group ◽

Pain Interference ◽

Self Management ◽

Control Group ◽

Web Based ◽

Management Intervention ◽

Taking Charge ◽

Secondary Outcomes ◽

Web Based Education

BACKGROUND Juvenile idiopathic arthritis (JIA) is a serious and potentially debilitating pediatric illness. Improved disease self-management may help to improve health outcomes. OBJECTIVE This study aimed to evaluate the effectiveness of the Teens Taking Charge Web-based self-management intervention in reducing symptoms and improving health-related quality of life (HRQL) in adolescents with JIA compared with a Web-based education control condition. METHODS Adolescents with JIA aged 12 to 18 years were recruited from 11 Canadian pediatric rheumatology centers. Caregivers were invited to participate along with their child. In addition to standard medical care, participants were randomized to receive either (1) the Teens Taking Charge self-management intervention or (2) a Web-based education control condition for a period of 12 weeks. Adolescents in the intervention group completed website modules addressing cognitive behavioral coping skills, stress management, and other self-management topics, while also receiving monthly telephone calls from a trained health coach. Adolescents in the education control group were instructed to view a series of preselected public JIA educational websites and received monthly calls from a coach who asked about their own best efforts at managing JIA. Caregivers in the intervention group completed website modules related to promoting independence and disease self-management in their child. Caregivers in the education control group were instructed to view a series of preselected public JIA educational websites. Outcome assessment occurred at baseline, 12 weeks (posttreatment), and at 6 and 12 months postrandomization. The primary outcomes were pain intensity, pain interference, and HRQL. Secondary outcomes were emotional symptoms, adherence, coping, knowledge, and self-efficacy. RESULTS In total, 333 adolescents and 306 caregivers were enrolled. Significant overall reductions in pain intensity (P=.02) and pain interference (P=.007) were observed for intervention group participants compared with those in the education control group, after adjusting for baseline levels. There was a significant overall improvement in HRQL related to problems with pain (P=.02) and problems with daily activities (P=.01). There was also a significant difference in the intervention group over time (P=.008) for HRQL related to treatment problems, with the intervention group participants demonstrating improved HRQL by 12 months compared with education control group participants. Both groups showed nonsignificant improvements compared with baseline in other primary outcomes. There were no significant differences between the groups in any secondary outcomes or caregiver-reported outcomes. CONCLUSIONS The results of this randomized trial suggest that the Teens Taking Charge Web-based intervention is effective at reducing both pain intensity and pain interference, as well as improving HRQL in adolescents with JIA, compared with education control. These effects are sustained for up to 12 months following program completion. The Teens Taking Charge program is now publicly available at no cost. CLINICALTRIAL ClinicalTrials.gov NCT01572896; https://clinicaltrials.gov/ct2/show/NCT01572896

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Healthy eating and lifestyle in pregnancy (HELP): a cluster randomised trial to evaluate the effectiveness of a weight management intervention for pregnant women with obesity on weight at 12 months postpartum

International Journal of Obesity ◽

10.1038/s41366-021-00835-0 ◽

2021 ◽

Author(s):

Sharon A. Simpson ◽

Elinor Coulman ◽

Dunla Gallagher ◽

Karen Jewell ◽

David Cohen ◽

...

Keyword(s):

Weight Management ◽

Healthy Eating ◽

Primary Outcome ◽

Intervention Group ◽

Control Group ◽

Risky Drinking ◽

Management Intervention ◽

Cluster Randomised ◽

Secondary Outcomes ◽

Weight Management Intervention

Abstract Objective To assess whether a weight management intervention for pregnant women with obesity was effective in reducing body mass index (BMI) 12 months after giving birth. Methods Pragmatic, cluster randomised controlled trial (RCT) with embedded cost-effectiveness analysis. 598 women with a BMI of ≥30 kg/m2 (between 12 and 20 weeks gestation) were recruited from 20 secondary care maternity units in England and Wales. BMI at 12 months postpartum was the primary outcome. A range of clinical and behavioural secondary outcomes were examined. Interventions Women attending maternity units randomised to intervention were invited to a weekly weight management group, which combined expertise from a commercial weight loss programme with clinical advice from midwives. Both intervention and control participants received usual care and leaflets on diet and physical activity in pregnancy. Results Mean (SD) BMI at 12 months postpartum was 36.0 kg/m2 (5.2) in the control group, and 37.5 kg/m2 (6.7) in the intervention group. After adjustment for baseline BMI, the intervention effect was −0.02 (95% CI −0.04 to 0.01). The intervention group had an improved healthy eating score (3.08, 95% CI 0.16 to 6.00, p < 0.04), improved fibre score (3.22, 1.07 to 5.37, p < 0.01) and lower levels of risky drinking at 12 months postpartum compared to the control group (OR 0.45, 0.27 to 0.74, p < 0.002). The net incremental monetary benefit was not statistically significantly different between arms, although the probability of the intervention being cost-effective was above 60%, at policy-relevant thresholds. Conclusions There was no significant difference between groups on the primary outcome of BMI at 12 months. Analyses of secondary outcomes indicated improved healthy eating and lower levels of risky drinking. Trial registration: Current Controlled Trials ISRCTN25260464.

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83 A Medication Self-Management Intervention to Improve Medication Adherence For Older People with Multimorbidity: A Pilot Study

Age and Ageing ◽

10.1093/ageing/afab030.44 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

pp. i12-i42

Author(s):

C Yang ◽

Z Hui ◽

S Zhu ◽

X Wang ◽

G Tang ◽

...

Keyword(s):

Medication Adherence ◽

Pilot Study ◽

Older People ◽

Intervention Group ◽

Self Management ◽

Control Group ◽

Medication Knowledge ◽

Management Intervention ◽

Patient Reported

Abstract Introduction Medication self-management support has been recognised as an essential element in primary health care to promote medication adherence and health outcomes for older people with chronic conditions. A patient-centred intervention empowering patients and supporting medication self-management activities could benefit older people. This pilot study tested a newly developed medication self-management intervention for improving medication adherence among older people with multimorbidity. Method This was a two-arm randomised controlled trial. Older people with multimorbidity were recruited from a community healthcare centre in Changsha, China. Participants were randomly allocated to either a control group receiving usual care (n = 14), or to an intervention group receiving three face-to-face medication self-management sessions and two follow-up phone calls over six weeks, targeting behavioural determinants of adherence from the Information-Motivation-Behavioural skills model (n = 14). Feasibility was assessed through recruitment and retention rates, outcome measures collection, and intervention implementation. Follow-up data were measured at six weeks after baseline using patient-reported outcomes including medication adherence, medication self-management capabilities, treatment experiences, and quality of life. Preliminary effectiveness of the intervention was explored using generalised estimating equations. Results Of the 72 approached participants, 28 (38.89%) were eligible for study participation. In the intervention group, 13 participants (92.86%) completed follow-up and 10 (71.42%) completed all intervention sessions. Ten participants (71.42%) in the control group completed follow-up. The intervention was found to be acceptable by participants and the intervention nurse. Comparing with the control group, participants in the intervention group showed significant improvements in medication adherence (β = 0.26, 95%CI 0.12, 0.40, P < 0.001), medication knowledge (β = 4.43, 95%CI 1.11, 7.75, P = 0.009), and perceived necessity of medications (β = −2.84, 95%CI -5.67, −0.01, P = 0.049) at follow-up. Conclusions The nurse-led medication self-management intervention is feasible and acceptable among older people with multimorbidity. Preliminary results showed that the intervention may improve patients’ medication knowledge and beliefs and thus lead to improved adherence.

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The Effect of Self-Management Educational Program on Pain Intensity in Elderly Patients with Knee Osteoarthritis: A Randomized Clinical Trial

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2018.225 ◽

2018 ◽

Vol 6 (6) ◽

pp. 1062-1066 ◽

Cited By ~ 6

Author(s):

Reza Ganji ◽

Azadeh Pakniat ◽

Mohammad Reza Armat ◽

Mahbubeh Tabatabaeichehr ◽

Hamed Mortazavi

Keyword(s):

Elderly Patients ◽

Knee Osteoarthritis ◽

Pain Intensity ◽

Educational Program ◽

Intervention Group ◽

Self Management ◽

Control Group ◽

Control Groups ◽

The Mean ◽

And Control

BACKGROUND: Osteoarthritis is one of the chronic diseases that greatly affect the health and life quality of individuals.AIM: This study aimed to determine the effect of self-management educational program on the pain intensity of the elderly patients with knee osteoarthritis.METHODS: In a randomised clinical trial, a total of 82 elderly patients with knee osteoarthritis were randomly divided into intervention and control groups. The intervention group received six sessions of self-management group education, while the control group received only the routine care during this period. In both groups, patients’ pain intensity, with a visual analogue scale (VAS), were assessed before, immediately after and eight weeks after the start of the study.RESULTS: The mean pain intensity scores of the intervention and control groups were not significantly different before the intervention (P = 0.9), but after the intervention, the mean pain intensity score in the intervention group (3.61 ± 2.36) was significantly lower than that of the control group (4.93 ± 2.00), (P < 0.0001).CONCLUSION: Implementation of a self-management program for the patients with knee osteoarthritis is useful in reducing their pain intensity and can be used as one of the effective methods for their empowerment.

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The Effect of Pre-Consultation Information Videos on Patients Undergoing Carpal Tunnel Surgery: A Randomised Control Trial (Preprint)

10.2196/preprints.23291 ◽

2020 ◽

Author(s):

Reece Tso ◽

Tristan Symonds ◽

Justin Smith ◽

Peter Bovey

Keyword(s):

Patient Satisfaction ◽

Carpal Tunnel ◽

Intervention Group ◽

Randomised Control Trial ◽

Future Research ◽

Control Group ◽

Web Based ◽

Carpal Tunnel Surgery ◽

Consultation Time ◽

Web Based Education

BACKGROUND Preoperative patient education is essential in ensuring patient satisfaction and optimising outcomes. With advances in technology, web-based education for preoperative care has become a useful tool to enhance in person consultations. OBJECTIVE The aim of this study was to determine the effect of web-based pre-consultation education videos on patient satisfaction and consultation time for patients undergoing carpal tunnel surgery (CTS). METHODS A randomised control study was conducted in Townsville. Participants were randomised in a 1:1 ratio to receive either a web-based or no pre-consultation video prior to consultation. After the consultation, patients completed a Likert scale questionnaire on the content of the video and their overall satisfaction with it. Consultation time was measured from the time patients entered the room to when they exited the room. Statistical analysis was performed using Stata V16. RESULTS There were 60 patients included in the analysis, with 30 in the intervention group and 30 in the control group. The results demonstrated a marginally higher satisfaction rate with the intervention group compared to the control group however this was not statistically significant (77% vs 70%, p = 0.559). Additionally, consultation time was found to be lower in the intervention group (6.4 minutes) when compared to the control group (12 minutes), with very strong evidence to suggest an association (p < 0.0001). CONCLUSIONS This study demonstrated that participants undergoing carpal tunnel surgery who engaged in pre consultation web-based education had a decreased consultation time and similar overall satisfaction. This suggests that web-based education may have a beneficial role for both surgeons and patients. Future research should be conducted to determine the optimal web-based education and to consider needs based education as a means of increasing patient satisfaction.

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Short-term effect of a chronic pain self-management intervention delivered by an easily accessible primary healthcare service: a randomised controlled trial

BMJ Open ◽

10.1136/bmjopen-2018-023017 ◽

2018 ◽

Vol 8 (12) ◽

pp. e023017 ◽

Cited By ~ 2

Author(s):

Torunn Hatlen Nøst ◽

Aslak Steinsbekk ◽

Ola Bratås ◽

Kjersti Grønning

Keyword(s):

Chronic Pain ◽

Healthcare Service ◽

Primary Outcome ◽

Controlled Trial ◽

Intervention Group ◽

Patient Activation ◽

Self Management ◽

Control Group ◽

Secondary Outcomes ◽

Randomised Controlled

ObjectivesTo investigate the effects on persons with chronic pain after 3 months of a group-based chronic pain self-management course compared with a drop-in, low-impact outdoor physical group activity on patient activation and a range of secondary outcomes.DesignAn open, pragmatic, parallel group randomised controlled trial. Analyses were performed using a two-level linear mixed model.SettingAn easily accessible healthcare service provided by Norwegian public primary healthcare.ParticipantsA total of 121 participants with self-reported chronic pain for 3 months or more were randomised with 60 participants placed in the intervention group and 61 placed in the control group (mean age 53 years, 88% women, 63% pain for 10 years or more).InterventionsThe intervention group was offered a group-based chronic pain self-management course with 2.5-hour weekly sessions for a period of 6 weeks. The sessions consisted of education, movement exercises and emphasised group discussions. The control group was offered a low-impact outdoor group physical activity in 1-hour weekly sessions that consisted of walking and simple strength exercises for a period of 6 weeks.Main outcomesThe primary outcome was patient activation assessed using the Patient Activation Measure. Secondary outcomes measured included assessments of pain, anxiety and depression, pain self-efficacy, sense of coherence, health-related quality of life, well-being and the 30 s chair to stand test.ResultsThere was no effect after 3 months of the group-based chronic pain self-management course compared with the control group for the primary outcome, patient activation (estimated mean difference: −0.5, 95% CI –4.8 to 3.7, p=0.802).ConclusionsThere was no support for the self-management course having a better effect after 3 months than a low-impact outdoor physical activity offered the control group.Trial registration numberNCT02531282; Results.

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Effect of web-based time-use intervention on occupational balance during the Covid-19 pandemic

Canadian Journal of Occupational Therapy ◽

10.1177/0008417421994967 ◽

2021 ◽

pp. 000841742199496

Author(s):

Serkan Pekçetin ◽

Ayla Günal

Keyword(s):

University Students ◽

Time Use ◽

Time Management ◽

Intervention Group ◽

Control Group ◽

Single Session ◽

Post Intervention ◽

Web Based ◽

Management Intervention ◽

Management Interventions

Background. Restrictions implemented to control the spread of the Covid-19 pandemic may lead to disruptions in occupational balance among university students. Purpose. The aim of this study was to evaluate the effectiveness of a web-based time-use intervention on the occupational balance of university students. Method. A total of 60 participants were randomly assigned to the intervention and control groups. The intervention group received eight sessions of web-based time management intervention, while the control group received a single-session web-based time management intervention. Pre-and post-intervention occupational balance of the participants was evaluated with Occupational Balance Questionnaire (OBQ). Findings. The eight-session intervention was more effective than the single-session intervention in improving OBQ total scores and all individual OBQ item scores except for “Having sufficient things to do during a regular week.” Implications. Occupational therapists can implement web-based time management interventions to promote the occupational balance of university students during the Covid-19 pandemic.

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Work Ability and Vitality in Coach Drivers: An RCT to Study the Effectiveness of a Self-Management Intervention during the Peak Season

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16122214 ◽

2019 ◽

Vol 16 (12) ◽

pp. 2214 ◽

Cited By ~ 1

Author(s):

Art van Schaaijk ◽

Karen Nieuwenhuijsen ◽

Monique Frings-Dresen

Keyword(s):

Work Ability ◽

Controlled Trial ◽

Intervention Group ◽

Self Management ◽

Control Group ◽

Sleep Complaints ◽

Psychosomatic Health ◽

Management Intervention ◽

Work Related ◽

Mental Exertion

Background: This randomized controlled trial (RCT) evaluates the effectiveness of a self-management toolbox designed to maintain work ability and vitality in coach drivers over their peak season. Methods: The intervention group received a self-management intervention providing advice aimed at increasing work ability and vitality. These suggestions targeted three specific domains: work–recovery–rest balance, food and drink intake, and physical activity. At the beginning (March), middle (July), and end (October) of the coach sector peak season, work ability, vitality, work-related fatigue, psychosomatic health, sleep complaints, and perceived mental exertion of coach drivers were assessed through questionnaires. Results: A total of 96 drivers participated in the study. Access to the toolbox did not result in significant differences between groups. Work ability and vitality decreased significantly in both groups, falling from 7.8 ± 1.3 to 7.3 ± 1.6 and from 63 ± 16.7 to 55 ± 18.7, respectively. Work-related fatigue increased from 35 ± 31.9 to 52 ± 35.3. Psychosomatic health complaints, sleep complaints, and perceived mental exertion also increased significantly. Conclusions: The uptake of the intervention was too low to determine if this toolbox can maintain work ability and vitality in coach drivers when compared with a control group. Overall work ability and vitality decrease significantly as the peak season progresses, while work-related fatigue accumulates. Other interventions should be explored to ensure sustainable employability in this population.

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A Digital Self-Management Program (HOPE) for People Living with Cancer During the COVID-19 Pandemic: Findings from a Feasibility Randomized Controlled Trial (Preprint)

10.2196/preprints.28322 ◽

2021 ◽

Author(s):

Hayley Wright ◽

Faith Martin ◽

Wendy Clyne ◽

Cain Clark ◽

Gabriela Matouskova ◽

...

Keyword(s):

Intervention Group ◽

Patient Activation ◽

Management Program ◽

Mental Wellbeing ◽

Self Management ◽

Control Group ◽

Wait List Control ◽

Definitive Trial ◽

Secondary Outcomes

BACKGROUND Trial Design We present the results from a feasibility, randomised wait-list control group parallel design study, with a 1:1 allocation ratio. Participants were randomised to an intervention group or a waitlist control group.The intervention was a six-week digital self-management program (HOPE Program) for people with cancer. OBJECTIVE The aim of this study was to test the feasibility of a digitally delivered self-management program for people with cancer. This will inform the design of a definitive RCT. Additionally, preliminary assessment of the impact of the HOPE Program, via secondary outcomes, will be used to assess signals of efficacy in a trial context. METHODS Participants were drawn from an opportunity sample, referred by Macmillan Cancer Support and were invited via email to take part in the study (N=61). Primary outcomes were rates of recruitment, retention, follow up, completion and adherence, sample size and effect size estimation, and assessment of progression criteria for a definitive trial. Secondary outcomes were self-report measures of participants’ positive mental wellbeing, depression, anxiety and patient activation (i.e. confidence to manage their cancer). The intervention and data collection took place online. RESULTS The recruitment rate was 77% (N=47). Forty one participants (n=41) completed the baseline questionnaires and were randomised to either the intervention group (n=21) or waitlist control group (n=20). The retention rate (attending all program sessions) was over 50% (all n=21, 51.2%; intervention group n=10, 47.6%; control group n=11, 55.0%), the follow up rate (completing all questionnaires) was over 80% (all 80.5%, n=33; intervention group 76.2%, n=16; control group 85.0%, n=17), and completion rate (attending 3 sessions and completing all questionnaires) was over 60% (all n=25, 61.0%; intervention group n=13, 61.9%; control group n=12, 60.0%). Engagement data showed that participants viewed between half (n=5.1, 51.0%) and three quarters (n=12.2, 76.3%) of the pages in each session. CONCLUSIONS All progression criteria for a definitive trial were met, as supported by the primary outcome data. On average, participants showed improved postprogram scores on measures of positive mental wellbeing, depression, anxiety and patient activation. A full scale trial of the digital HOPE Program for people with cancer will allow us to fully evaluate the efficacy of the intervention relative to a control group. CLINICALTRIAL This feasibility randomised wait-list control trial was retrospectively registered with the ISRCTN registry (https://www.isrctn.com/ISRCTN79623250) on Nov 4, 2020. The feasibility trial protocol has been registered and published [International Registered Report Identifier (IRRID): DERR1-10.2196/24264. INTERNATIONAL REGISTERED REPORT RR2-10.2196/24264

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A randomised trial of a web-based physical activity self-management intervention in COPD

ERJ Open Research ◽

10.1183/23120541.00158-2021 ◽

2021 ◽

pp. 00158-2021

Author(s):

Stephanie A. Robinson ◽

J. Allen Cooper ◽

Rebekah L. Goldstein ◽

Madeline Polak ◽

Paola N. Cruz Rivera ◽

...

Keyword(s):

Physical Activity ◽

Social Support ◽

Usual Care ◽

Exercise Capacity ◽

Step Count ◽

Self Management ◽

Web Based ◽

Management Intervention ◽

Management Interventions ◽

Secondary Outcomes

Improving exercise capacity is a primary objective in chronic obstructive pulmonary disease (COPD). Declines in exercise capacity result in reduced physical activity (PA) and health-related quality of life (HRQL). Self-management interventions can teach patients skills and behaviours to manage their disease. Technology-mediated interventions have the potential to provide easily accessible support for disease self-management. We evaluated the effectiveness of a web-based self-management intervention, focused on PA promotion, on exercise capacity in COPD. This 6-month randomised controlled trial (NCT02099799) enrolled 153 persons with COPD at two U.S. sites (VABoston, n=108; VABirmingham, n=45). Participants were allocated (1:1) to the web-based self-management intervention (PA promotion through personalised, progressive step-count goals, feedback, online COPD-related education, and social support via an online community), or usual care. The primary outcome was exercise capacity (6-min walk test distance [6 MWD]). Secondary outcomes included PA (daily steps per day), HRQL (St. George's Respiratory Questionnaire Total Score), dyspnoea, COPD-related knowledge, and social support. Change in step-count goals reflected intervention engagement. Participants were 69±7 years old, mean FEV1% predicted 61±21%. Change in 6 MWD did not differ between groups. Intervention participants improved daily step counts by an average of 1312 more than usual care (p<0.001). Groups did not differ on other secondary outcomes. VABirmingham participants were significantly more engaged with the intervention, although site did not modify the effect of the intervention on 6 MWD or secondary outcomes. The intervention did not improve exercise capacity, but improved PA at 6 months. Additional intervention modifications are needed to optimise its COPD self-management capabilities.

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