SAN FRANCISCO—When it comes to key public health messages about the management of arthritis, patients may not get the message, interpret messages differently than their providers do, or ignore those messages altogether.
“We need to make sure that we’re describing the programs in terms that resonate with patients, and we need to increase awareness of the programs—that they exist and how they would benefit you,” said Teresa J. Brady, PhD, senior behavioral scientist in the Arthritis Program at the Centers for Disease Control and Prevention (CDC) in Atlanta. During her presentation at the 2008 ACR/ARHP Annual Scientific Meeting, Dr. Brady outlined some of the recent initiatives undertaken by the CDC to help shape public health messages to motivate patients to actively manage their condition.
Action and Perception Gaps
“In general, most people are not doing the activities that we know can make a difference in managing their arthritis,” Dr. Brady began. For example, research has validated that people with arthritis can benefit from engaging in physical activity, watching their weight, and participating in self-management education. And yet, 67% of people with arthritis are overweight or obese, 44% are physically inactive, and only 11% have completed self-management education (SME) courses. “We haven’t really done a good job of selling tertiary prevention,” she said.
Dr. Brady synthesized results from a series of audience research projects conducted by the CDC’s Arthritis Program since 1999. To date, the CDC has conducted 81 focus groups with a total of more than 700 participants from communities across the nation. The topic-specific projects have revealed important information regarding patients’ perceptions of and motivations towards SME, physical activity, and weight control.
SME: A “Stealth” Intervention?
During initial research projects in 1999 and 2000 and a second round of focus groups conducted in 2006, CDC Arthritis Program researchers explored awareness of and receptiveness to the notion of learning techniques to manage arthritis. Round 1 projects in 1999 and 2000 recruited Caucasian and African-American males and females, ages 25–72, from a mix of income and educational levels. Round 2, conducted in 2006, included eight groups of participants in Chicago; Fresno, Calif.; and Norfolk, Va., with some limitations from their arthritis (i.e., the condition was beginning to threaten valued activities). Two major themes were revealed during the course of this work: 1) Most participants hadn’t heard of any self-help course; and 2) Patients may interpret health recommendations differently than health professionals intend.