Mail-delivered arthritis self-management tool kit: a randomized trial and longitudinal followup

Arthritis Rheum. 2009 Jul 15;61(7):867-75. doi: 10.1002/art.24587.


Objective: To determine the effectiveness of an intervention Tool Kit of arthritis self-management materials to be sent once through the mail, and to describe the populations reached.

Methods: Spanish speakers (n = 335), non-Hispanic English-speaking African Americans (n = 156), and other non-Hispanic English speakers (n = 404) were recruited separately and randomized within each of the 3 ethnic/racial categories to immediately receive the intervention Tool Kit (n = 458) or to a 4-month wait-list control status (n = 463). At the end of 4 months, controls were sent the Tool Kit. All subjects were followed in a longitudinal study for 9 months. Self-administered measures included health status, health behavior, arthritis self-efficacy, medical care utilization, and demographic variables. Using analyses of covariance and t-tests, analyses were conducted for all participants and for Spanish- and English-language groups.

Results: At 4 months, comparing all intervention subjects with randomized wait-list controls, there were significant (P < 0.01) benefits in all outcomes except medical care utilization and self-rated health. The results were maintained at 9 months compared with baseline. On average, the Tool Kit reached persons ages 50-56 years with 12-15 years of schooling. There were few differences between English- and Spanish-language participants in either the effectiveness or reach variables.

Conclusion: A mailed Arthritis Self-Management Tool Kit proved effective in improving health status, health behavior, and self-efficacy variables for up to 9 months. It also reached younger persons in both English- and Spanish-language groups and Spanish speakers with higher education levels than previous studies of the small-group Arthritis Self-Management Program.

Trial registration: NCT00449474.

Publication types

  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • African Americans / ethnology
  • Aged
  • Aged, 80 and over
  • Arthritis / ethnology
  • Arthritis / therapy*
  • European Continental Ancestry Group / ethnology
  • Female
  • Follow-Up Studies
  • Health Status
  • Hispanic Americans / ethnology
  • Humans
  • Language
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Patient Education as Topic / methods*
  • Postal Service*
  • Self Care / methods*
  • Treatment Outcome
  • United States
  • Young Adult

Associated data