Evaluating/Reinforcing Arthritis Patient Education for Urban African Americans

Clinical studies have shown that arthritis patient education interventions are an effective addition to medical treatment in improving patients' ability to cope with pain, thereby reducing perceived symptom severity, improving patients' ability to help themselves, and providing them with skills and strategies for dealing with limits on daily activities. We know little, however, about generalizing the effects of such programs to cultural minority groups, such as urban African Americans. We know even less about the longevity of any benefits of patient education or about effective reinforcement and maintenance techniques. To examine these issues, we will recruit participants for this project through a faith-based community network to pursue the following aims:

1. Evaluate the impact of arthritis patient education on arthritis symptoms and pain levels, functional status, self-care knowledge and behaviors, self-efficacy, emotional status, and health care resource use through a randomized controlled trial (Study 1).
2. Test the impact of focused reinforcement of the concepts in the Arthritis Self-Help Course (ASHC) over a 12-month period through a randomized controlled trial (Study 2).
3. Examine the detailed educational dynamics of the ASHC, identify aspects of the course that are less effective with or relevant to African Americans, and identify modes of communication and presentation used in the course that require adaptation for an African American audience (Study 3).
4. Assess the personal and cultural belief systems underlying African Americans' understanding of arthritis and their use of conventional and unconventional arthritis treatments (Study 4).

These studies will provide valuable information regarding culturally relevant methods of reaching urban African Americans with arthritis and providing patient education that addresses arthritis care needs of the African American community. This study will also clarify the longevity of educational benefits and the effectiveness of alternative methods of educational reinforcement in this population. The exploratory studies of individual beliefs and knowledge of arthritis and its treatment, and the formal evaluation of a patient education program, will provide a better understanding of the ways in which cultural groups differ and how these differences should influence the design and delivery of culturally appropriate patient education.