Abstract
BackgroundA web-based self-management intervention guided by peer-trainers was developed to support young adults’ self-management in coping with Juvenile Idiopathic Arthritis (JIA). To investigate its effectiveness, a randomized controlled trial (RCT) was conducted. In addition, the content of the chat and participants’ goals were studied to identify underlying processes.MethodsAn RCT with a six-month follow up period was conducted among 72 young adults with JIA, aged between 16 and 25 years old, randomly assigned to the intervention or to the usual care control group. After 24 weeks, in both groups 24 participants completed all measurements. Intentions to treat analyses were carried out by means of linear mixed models for longitudinal measurements. With self-efficacy as primary outcome, self-management, disease activity, quality of life, absenteeism of school/work, health care medication use and adherence to the intervention were studied. The participants’ goals, personal achievements, interactions on the chat, and their appreciation of the intervention were analyzed using thematic analyses.ResultsNo significant differences were found on self-efficacy, quality of life, and self-management between the participants of the control group and the intervention group. In the intervention group, modeling and sharing experiences were the most recognized themes. Fifty-five goals were formulated and divided into the following categories: improvement and maintaining balance, setting and recognizing boundaries, communicating and coping with incomprehension. Adherence, appreciation of the own learning experience, and personal achievements were rated positively.ConclusionThe web-based intervention did not lead to an improvement of self-efficacy. However, additional qualitative analyses showed that the intervention was appreciated and valuable for the participants. More research is needed on how to measure the added value of this intervention compared to the usual care.Trial registrationTrial registration number NTR4679.
Highlights
A web-based self-management intervention guided by peer-trainers was developed to support young adults’ self-management in coping with Juvenile Idiopathic Arthritis (JIA)
A group of 224 young adults with JIA were found to be eligible to participate in this study and were invited. 152 were excluded of which the largest group (55/152) was Baseline characteristics Intervention versus Control Characteristic Gender – female n (%) Age, mean years (SD) Education level completed n (%)
F statistic, T Time, T *group interaction time and group, Sig significance technical problems, not every video led to the outcome that was hoped for. In this randomized controlled trial (RCT) on the effectiveness of the web-based selfmanagement intervention Challenge your arthritis among young adults with JIA, no significant differences were found between the intervention group and the control group on self-efficacy, quality of life (QoL), and selfmanagement
Summary
A web-based self-management intervention guided by peer-trainers was developed to support young adults’ self-management in coping with Juvenile Idiopathic Arthritis (JIA). The disease and its treatment put extensive demands on children and young adults as well as on their parents, due to precisely-scheduled daily medication requirements, regular physical exercise regimes and regular visits to the pediatrician or rheumatologist [14, 15]. Most of these young adults still experience problems well into their adult years with on-going medical treatment and significant disability [12,13,14].
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