The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.
Self-management education for persons with arthritis: Managing comorbidity and eliminating health disparities†
Article first published online: 30 JUL 2007
Copyright © 2007 by the American College of Rheumatology
Arthritis Care & Research
Volume 57, Issue 6, pages 1081–1088, 15 August 2007
How to Cite
Goeppinger, J., Armstrong, B., Schwartz, T., Ensley, D. and Brady, T. J. (2007), Self-management education for persons with arthritis: Managing comorbidity and eliminating health disparities. Arthritis & Rheumatism, 57: 1081–1088. doi: 10.1002/art.22896
- Issue published online: 30 JUL 2007
- Article first published online: 30 JUL 2007
- Manuscript Accepted: 6 FEB 2007
- Manuscript Received: 25 AUG 2006
- Cooperative Agreement from the Centers for Disease Control and Prevention. Grant Number: CDC 52233-22/22
- NIH to the Research Center on Minority Aging, University of North Carolina at Chapel Hill
- NIH to the Center for Research on Chronic Illness, University of North Carolina at Chapel Hill
- Health disparity;
- Community-based patient education;
- Disease self-management
To compare short-term and long-term effectiveness of the Arthritis Self-Help Course (ASHC) and the Chronic Disease Self-Management Program (CDSMP) for persons with arthritis concerning health care use, health-related quality of life, health behaviors, and arthritis self-efficacy.
Forty-eight workshops were randomized to the ASHC (n = 26) or CDSMP (n = 22). A total of 416 individuals, including 365 African Americans, participated. The mean age for each group was 64 years, mean years of education was 11.7, mean number of chronic conditions was 4, and 75–80% of participants in each group were female. Multivariate statistical tests were used to assess effectiveness within and between programs for all workshop participants and African Americans.
At 4 months all ASHC participants including African Americans, had significant improvements (P ≤ 0.05) in self-efficacy, stretching and strengthening exercises, aerobic exercises, and general health. All CDSMP participants had statistically significant improvements in self-efficacy, disability, pain, and general health. African American CDSMP participants showed statistically significant improvements in general health. Trends toward improvement (P = 0.051–0.100) were shown in 5 variables among African American CDSMP participants and in 4 variables among all CDSMP participants. Statistically significant differences between the 2 programs at 4 months were seen in pain and disability in both groups. The CDSMP produced stronger results. Significant results at 1 year within and between programs were minimal for both groups.
When populations with arthritis and multiple comorbid conditions are targeted, the CDSMP may be most cost effective.