Multisite Randomized Clinical Trial Evaluating an Online Self-Management Program for Adolescents With Juvenile Idiopathic Arthritis

作者：Mark Connelly, Laura E. Schanberg, Stacy P. Ardoin, Michael Blakley, Ruy Carrasco, Peter Chira, Kristen Hayward, Maria Ibarra, Yukiko Kimura, D. Kingsbury, Marisa S. Klein‐Gitelman, Erica Lawson, Jennifer Stinson · 发表于：Journal of Pediatric Psychology · 年份：2018 · DOI：10.1093/jpepsy/jsy066 · 被引用次数：38 · 研究领域：Autoimmune and Inflammatory Disorders Research、Adolescent and Pediatric Healthcare、Childhood Cancer Survivors' Quality of Life

OBJECTIVE: To determine the efficacy in improving pain and health-related quality of life (HRQOL) of an online self-management program for adolescents with juvenile idiopathic arthritis (JIA). METHODS: Youth ages 12-18 years with JIA were recruited from 10 rheumatology clinics across the United States and randomized to complete an online self-management program (n = 144) or an online disease education program (n = 145). Participants in the self-management group worked through multimedia-based modules comprising psychoeducation, training in cognitive-behavioral coping skills and stress management, and other self-management topics over a 12-week period. Participants in the control group viewed a series of preselected quality educational websites about JIA over the same interval. Online content for both groups was made available in English and Spanish to facilitate inclusion of Hispanic participants. Blinded assessment of main outcomes (pain intensity, pain interference, and HRQOL) and process outcomes (disease knowledge, self-efficacy, pain coping, and emotional adjustment) occurred at baseline, posttreatment, and at 6- and 12-month postrandomization follow-up visits. RESULTS: Participants on average demonstrated significant improvements over the study period in the main outcomes, with no significant group differences in the degree of improvement. Effect sizes for these improvements were small. The amount of improvement in self-efficacy, emotional avoidance coping, disease know...