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

Child Health Evaluative Sciences, Chronic Pain Program, Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada.
The Journal of Rheumatology (Impact Factor: 3.19). 09/2010; 37(9):1944-52. DOI: 10.3899/jrheum.091327
Source: PubMed


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.

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    • "+ + Guendelman et al. (2002) +/= b = Holden et al. (2000) + Homer et al. (2000) + = = Horan et al. (1990) = = Huss et al. (2003) = = NR Iafusco et al. (2011) + Jan et al. (2007) = = Johnson et al. (2001) - + Jones et al. (2010) = +/= c = Joshi et al. (2009) + Krishna et al. (2003) + = + = McPherson et al. (2006) + + = + Mosnaim et al. (2008) + Mulvaney et al. (2010) + Palermo et al. (2009) + Rubin et al. (1986) + + = = Shegog et al. (2001) = + Stinson et al. (2010) + = = Whittemore et al. (2010) "
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    ABSTRACT: Advances in technology have offered health professionals alternative mediums of providing support to patients with long-term conditions. This critical review evaluated and assessed the benefit of electronic media technologies in supporting children and young people with long-term conditions. Of 664 references identified, 40 met the inclusion criteria. Supportive technology tended to increase disease-related knowledge and improve aspects of psychosocial function. Supportive technology did not improve quality of life, reduce health service use or decrease school absences. The poor methodological quality of current evidence and lack of involvement of users in product development contribute to the uncertainty that supportive technology is beneficial.
    Journal of Pediatric Nursing 10/2014; 30(1). DOI:10.1016/j.pedn.2014.09.014 · 1.01 Impact Factor
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    • "To broaden access to effective cognitive-behavioral treatment in children, CD-ROM and internet-based pain management programs have been developed and tested with children and adolescents with migraine [12-14] and other recurrent or persistent pain conditions [15-17]. In general, these studies have found positive outcomes forreducing pain relative to control conditions and the results are similar to those found in traditional biobehavioral interventions delivered in face-to-face contacts. "
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    The Journal of Headache and Pain 02/2014; 15(1):12. DOI:10.1186/1129-2377-15-12 · 2.80 Impact Factor
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    • "In regard to delivery of the program, three involved a trained interventionist [67–69], two were clinician-led [70,71] and one by a program co-ordinator [72]. Two interventions had telephone support for participants [69,71]. "
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