Online Self-management Program Research Articles

A randomized controlled trial of an online self-management program for adults with arthritis pain.

The objective of this RCT was to assess the efficacy of an online pain self-management program with adults who had a self-reported doctor diagnosis of arthritis pain (N = 228). Participants were recruited via flyers and online postings then randomized to the experimental condition or the wait-list control condition. Individuals in the experimental condition reported significantly (1) increased arthritis self-efficacy and (2) reduced pain catastrophizing from baseline to follow up compared to those in the control condition. High user engagement (>204.5 min on the website) was also significantly associated with improved self-management outcomes. These findings suggest that use of an online self-management program may positively impact self-efficacy and catastrophizing among adults with arthritis pain at 6 month follow up. Nonsignificant findings for hypothesized variables such as pain intensity and health behaviors are also discussed. Future longitudinal research is needed to assess if cognitive changes associated with participation in an online self-management program leads to reduced pain.

An Overactive Bladder Online Self-management Program With Embedded Avatars: A Randomized Controlled Trial of Efficacy

To determine whether an avatar-based, online, self-management program is an effective therapeutic approach for women with overactive bladder (OAB). OAB is a highly prevalent symptom complex that significantly impacts health-related quality of life (HRQOL). Behavioral interventions can produce substantial improvement in symptoms and HRQOL. Online education programs offer patients with OAB an alternative to face-to-face self-management instruction. Evidence suggests that avatars (digital humans) embedded into online programs may help persuade and motivate patients to adopt healthy behaviors. In a 12-week, randomized, controlled trial, women (aged >55 years) with symptoms of OAB for at least 3 months were randomized to 2 versions of a 3-part, online, self-management program. After collecting the baseline metrics, the intervention group viewed a generic avatar coach with a self-avatar peer mentor designed to resemble the participant, and the control group viewed the identical online program with voice only. Participants viewed part 1 at week 1 and parts 2 and 3 at week 6. Participants completed daily bladder diaries throughout the 12-week period and OAB-related outcome measures at weeks 1, 6, and 12. Forty-one women completed the study (mean age = 61 years, standard deviation = 6). The analysis of covariance of week-12 outcome measures with the baseline as covariates demonstrated significant improvements in the intervention group in OAB questionnaire HRQOL (P = .02; large effect), 24-hour frequency (P <.001; large effect), night-time urination (P <.001; large effect), urgency (P <.001; large effect), and urge incontinence (P <.001; large effect). An avatar-based intervention embedded into an online self-management program improved OAB HRQOL and symptoms in women.

Online self-management for gay men living with HIV: a pilot study.

Background The aim of this pilot study was to assess the feasibility, acceptability and effectiveness of Positive Outlook, an online self-management program for gay men living with HIV in Australia. Two pilot studies were conducted, a small feasibility study (Pilot 1) followed by a pilot randomised controlled study (Pilot 2). Pilot 1 employed a pre and post-test design and included 10 men. Within- and between-group differences were evaluated in Pilot 2, which involved 37 participants randomly assigned to receive the Positive Outlook Program or usual care. We report on feasibility, acceptability and a range of preliminary efficacy outcomes, including health education impact, HIV-related quality of life and HIV-related self-efficacy. The program was well accepted by participants with some decline in engagement with the discussion boards witnessed over the duration of the program. Overall, intervention group participants demonstrated improvements in the majority of efficacy outcome measures, including HIV-related quality of life, self-efficacy, self-management skills, social support and adjustment to HIV. These pilot studies demonstrated that an online program to facilitate self-management among gay men living with HIV is both feasible and well accepted by participants who persisted with the program per protocol. Preliminary data suggest that the Positive Outlook program has the potential to enhance participants' quality of life, self-efficacy and health related outcomes, and demonstrates the need for further study with a larger sample.

Informing the development of an online self-management program for men living with HIV: a needs assessment.

BackgroundThe aim of this mixed methods study was to conduct a multifaceted needs assessment to inform the development of an online self-management program for men living with HIV. The objectives were to describe the health-related quality of life for men living with HIV, the impact of living with HIV, and the perceived problem areas and service and support needs of these men. The needs assessment was conducted in accordance with the PRECEDE model for health promotion program planning.MethodsA survey assessing the quality of life of men living with HIV (n = 72) was conducted and results were compared to Australian normative data. Focus groups were also undertaken with men living with HIV (n = 11) and a multidisciplinary team of service providers working in the area of HIV (n = 11). Focus groups enabled an in-depth description of the impact of HIV on quality of life and perceived problem areas in daily life.ResultsHIV-positive men experience significantly lower quality of life when compared with Australian normative data, particularly in those domains concerned with social and emotional aspects of quality of life. Qualitative focus groups yielded an overarching theme ‘The psychosocial impact of HIV’ which contained three sub-themes; (1) Life before and after HIV – a changed identity and its repercussions; (2) Resilience and the importance of social support; (3) Negotiating the practicalities – intimate relationships and disclosure.ConclusionsThe findings from this needs assessment highlight the need to target socio-emotional contexts of HIV positive men’s daily lives to improve quality of life and well-being. Intervention priorities for the proposed online self-management program include: (1) managing the emotional impact of HIV; (2) disclosing HIV status to family and friends; (3) maintaining social connectedness; (4) managing HIV within intimate relationships; and (5) disclosure of HIV status to intimate partners.

Integrative oncology and wellness considerations in cancer survivorship.

The American Cancer Society (ACS) is pleased to contribute to this issue of JNCI Monographs on integrative oncology in the care of cancer survivors. The ACS includes integrative methods in our work to help people “stay well, get well, find cures, and fight back” through prevention and early detection initiatives; programs and services that support those diagnosed with cancer; intramural and extramural research; and advocacy at national, state, and local levels. In the context of survivorship, “staying well” includes facilitating positive personal health behaviors and evidence-based health care by providing information about nutrition, physical activity, tobacco cessation, and integrative health practices to survivors, caregivers, and health care providers (1). The Society’s Nutrition and Physical Activity Guidelines for Cancer Survivors (2) are the foundation of communication, programmatic, and advocacy efforts designed to support survivors in their ability to make healthy lifestyle choices. Resources such as the What to Eat During Cancer Treatment cookbook, The Complete Guide to Nutrition For Cancer Survivors, and the online I Can Cope— Nutrition During Treatment help survivors manage nutrition-related side effects of treatment and maintain good nutritional status. The Society’s collaboration with the American College of Sports Medicine to create the Cancer Exercise Trainer certification helps survivors identify qualified exercise professionals to assist with setting and achieving physical activity goals, and our collaboration with the LiveSTRONG at the Y program provides local expertize to support survivors in being physically active. ACS recognizes that “getting well” is not over when active treatment is completed, and that wellness includes emotional, physical, social, and spiritual domains. The Cancer Survivors Network (csn.cancer.org) provides a web-based forum for peer support among cancer patients, survivors, and their caregivers. Sharing experiences with the use of complementary and alternative methods (CAM) is among the most popular (and challenging) topics in this forum. The ACS is pilot testing Cancer: Thriving and Surviving, an online self-management program developed by Stanford University to help empower posttreatment survivors to manage their health and quality of life (QOL). The Society’s Intramural Research program is not limited to “finding cures,” but also includes a broad portfolio of observational studies of survivors’ QOL and health behaviors, including the use of integrative methods. The ACS Studies of Cancer Survivors (3) have documented the prevalence and correlates of CAM use in a large population-based sample of cancer survivors (4–6). The longitudinal component of these studies will address the prevalence, pattern, predictors, and impact of continued CAM use among long-term cancer survivors and will assess where survivors obtained information about CAM, perceived benefits of CAM use, and survivors’ self-reported reasons for using CAM. The ACS Extramural Grants department funds innovative research to advance the field of palliative care and symptom management, including integrative oncology. In addition to investigator-initiated mechanisms, the Society is also developing Requests For Applications to address how nutrition and physical activity influence survivors’ treatment, symptoms, weight, and QOL. Through Health Professional Training Grants, the Society funds clinicians and clinician-researchers working in the area of integrative oncology and has funded health professionals studying Reiki, mindfulness, acupuncture to treat hot flashes, and other integrative methods. Finally, “fighting back” includes advocacy and policy work to support survivor wellness and QoL. Specifically, the American Cancer Society Cancer Action Network (ACS CAN), our advocacy affiliate, has championed two federal bills and many state bills focused on addressing QOL issues of people affected by cancer. Via these efforts, ACS CAN is working to build legislative campaigns that include increasing public research funding to find better curative and palliative treatments, access to prescription drugs, and insurance coverage of treatment services including integrative methods.

Technology applications to improve health outcomes and self-management in patients with arthritis

Mobile technologies are proliferating rapidly in medicine and provide opportunities for patient education and behavior change interventions. Technology-based interventions have the potential to overcome barriers to adherence, are accessible and entertaining thereby increasing interest in participation. This article provides an overview of new technology-based educational and behavioral interventions used to manage arthritis symptoms and promote healthy behaviors such as online education and self-management programs, mobile applications, and virtual reality-based rehabilitation. We also highlight a new area for technology applications in arthritis, exergaming, based on evidence from other chronic illnesses. Given the limited controlled studies in this area, data will be summarized by topic area highlighting the effectiveness of various interventions, their challenges, opportunities and areas for future research.

Optimizing delivery of recovery-oriented online self-management strategies for bipolar disorder: a review.

Self-management is emerging as a viable alternative to difficult-to-access psychosocial treatments for bipolar disorder (BD), and has particular relevance to recovery-related goals around empowerment and personal meaning. This review examines data and theory on BD self-management from a recovery-oriented perspective, with a particular focus on optimizing low-intensity delivery of self-management tools via the web. A critical evaluation of various literatures was undertaken. Literatures on recovery, online platforms, and self-management in mental health and BD are reviewed. The literature suggests that the self-management approach aligns with the recovery framework. However, studies have identified a number of potential barriers to the utilization of self-management programs for BD and it has been suggested that utilizing an online environment may be an effective way to surmount many of these barriers. Online self-management programs for BD are rapidly developing, and in parallel the recovery perspective is becoming the dominant paradigm for mental health services worldwide, so research is urgently required to assess the efficacy and safety of optimization methods such as professional and/or peer support, tailoring and the development of 'online communities'.

Activation to self-management and exercise in overweight and obese older women with knee osteoarthritis.

Knee osteoarthritis (OA) affects approximately 1 in 10 adults in the United States, with higher prevalence in women, aggravated by increased weight. This quasi-experimental pilot study implemented an online self-management (SM) program for older overweight and obese women with knee OA combined with a two-arm progressive exercise trial (walking and stepping groups). After the 10-week intervention using an interprofessional approach, activation to SM scores were significantly higher in all participants (N = 16) and between groups, with a higher increase in the stepping group. Those with higher activation scores pre-intervention obtained higher scores post-intervention. Activation levels also increased significantly among all participants with majority at the highest activation level. Follow-up data at 6 weeks and 6 months showed sustained SM and health-directed behaviors. These findings, although preliminary, highlight the value of combined SM and progressive exercise intervention using an interprofessional approach. Further investigations are essential toward potential practice and policy changes.

Usability testing of an online self-management program for adolescents with cancer.

The objective of this study was to explore the usability of a bilingual (English and French) Internet-based self-management program for adolescents with cancer and their parents and refine the Internet program. A qualitative study design with semistructured, audio-taped interviews and observation was undertaken with 4 iterative cycles. A purposive sample of English-speaking and French-speaking adolescents with cancer and one of their parents/caregivers was recruited. Adolescents and parents provided similar feedback on how to improve the usability of the Internet program. Most changes to the website were completed after the initial cycles of English and French testing. Both groups also found information presented on the website to be appropriate, credible, and relevant to their experiences of going through cancer. Participants reported the program would have been extremely helpful when they were first diagnosed with cancer. Usability testing uncovered some issues that affected the usability of the website that led to refinements in the online program.

(525) Factors associated with goal achievement for patients with persistent pain who engage in an online self-management program: Secondary analysis of a randomized-controlled study

(525) Factors associated with goal achievement for patients with persistent pain who engage in an online self-management program: Secondary analysis of a randomized-controlled study

The positive outlook study- a randomised controlled trial evaluating the effectiveness of an online self-management program targeting psychosocial issues for men living with HIV: a study protocol

BackgroundThe emergence of HIV as a chronic condition means that people living with HIV are required to take more responsibility for the self-management of their condition, including making physical, emotional and social adjustments. This paper describes the design and evaluation of Positive Outlook, an online program aiming to enhance the self-management skills of gay men living with HIV.Methods/designThis study is designed as a randomised controlled trial in which men living with HIV in Australia will be assigned to either an intervention group or usual care control group. The intervention group will participate in the online group program ‘Positive Outlook’. The program is based on self-efficacy theory and uses a self-management approach to enhance skills, confidence and abilities to manage the psychosocial issues associated with HIV in daily life. Participants will access the program for a minimum of 90 minutes per week over seven weeks. Primary outcomes are domain specific self-efficacy, HIV related quality of life, and outcomes of health education. Secondary outcomes include: depression, anxiety and stress; general health and quality of life; adjustment to HIV; and social support. Data collection will take place at baseline, completion of the intervention (or eight weeks post randomisation) and at 12 week follow-up.DiscussionResults of the Positive Outlook study will provide information regarding the effectiveness of online group programs improving health related outcomes for men living with HIV.Trial registrationACTRN12612000642886.

Web-based self-management with and without coaching for type 2 diabetes patients in primary care: design of a randomized controlled trial.

BackgroundSelf-management is recognized as the cornerstone of overall diabetes management. Web-based self-management programs have the potential of supporting type 2 diabetes patients with managing their diabetes and reducing the workload for the care provider, where the addition of online coaching could improve patient motivation and reduce program attrition. This study aims to test the hypothesis that a web-based self-management program with coaching will prove more effective on improving patient self-management behavior and clinical outcome measures than a web-based self-management program without coaching.MethodsThe effects of a web-based self-management program with and without coaching will be tested with a nested randomized controlled trial within a healthcare group in the Netherlands. In one year 220 type 2 diabetes patients will be randomized into an intervention group (n = 110) or a control group (n = 110). The control group will receive only the online self-management program. The intervention group will receive the online self-management program and additional online coaching. Participants will be followed for one year, with follow-up measurements at 6 and 12 months.DiscussionThe intervention being tested is set to support type 2 diabetes patients with their diabetes self-management and is expected to have beneficial effects on self-care activities, well being and clinical outcomes. When proven effective this self-management support program could be offered to other health care groups and their type 2 diabetes patients in the Netherlands.Trial registrationNederlands Trial Register NTR4064

Feasibility Study Of a Randomized Control Trial To Evaluate An Internet-Based Self-Management Program For Adolescents With Hemophilia

IntroductionAs adolescents with hemophilia approach adulthood, they must assume responsibility for their health and management of their disease. An online self-management program was developed to support adolescents during this transition. AimTo determine the feasibility of studying the online educational program using a non-blind, randomized control trial(RCT) design in terms of 1)Study accrual and attrition rates, 2) willingness to be randomized 3) compliance with the program and completion of the outcome measures, and 4) satisfaction with the program. MethodsAdolescents, ages 13-18, were enrolled from three tertiary care centres in Canada in a pilot RCT (NCT01477437). After providing informed consent, adolescents were randomized to the intervention (8 week program with telephone coaching) or the control arm (no access, weekly telephone call as attention-strategy). Adolescents in both arms of the study were asked to complete pre- and post- outcome measures. Following completion of the program, quantitative analysis addressed the feasilibity measures and qualitative interviews were conducted to assess satisfaction. Results29 teens participated (intervention group, n=16, control group, n=13).Participants in the intervention arm spent an average of 50 minutes on the website per week completed the 8 modules in an average of 14 weeks (SD= 4.9). Among those randomized to the intervention, 2 participants dropped out of the study and 2 were lost to follow-up, resulting in an attrition rate of 25% (4/16). The control arm had a higher attrition rate of 54% (7/13) with 5 participants being lost to follow-up and 2 participants dropping out. For participants who completed the program, 17/18 (94%) completed the post-study outcome measures. Despite the study not being powered to assess efficacy, teens on the intervention arm showed significant improvement in disease-specific knowledge (p=0.004), self-efficacy (p=0.007) and transition preparedness (p=0.046) over time. There was a statistically significant improvement in the knowledge measure in the intervention group when compared to the control group (p=0.01). Overall, the teens found the website to be informative, comprehensive and easy to use and were satisfied with the program. ConclusionsThis feasibility study suggests benefit to the program and indicates a full scale RCT to be a reasonable next step with minor adjustments to the protocol. The higher than expected attrition rate in the control group, suggests the need to improve the strategies for maintaining participant engagement using a more active attention control group (static educational materials) in the design of this web-based intervention prior to a larger study to assess efficacy. Disclosures:Breakey:Baxter Bioscience: Research Funding.

Internet Self-Management Uniform Reporting Framework

A review of the literature was conducted to identify the "active ingredients" needed to produce successful Internet interventions that support older adults in self-management of chronic disease. The term "Internet intervention" was used as an umbrella term to include all online self-management programs. Thirteen articles were found to meet the inclusion criteria from the initial 204 articles identified. Ritterband's Model of Internet Interventions was used as a framework to classify the intervention components reported. It was found that online self-management interventions can improve outcomes for some older adults. However, the wide diversity of interventions and the measures reported, coupled with the complex nature of the studies, made it difficult to identify the "active ingredients." To overcome this problem, the authors propose a minimum reporting set, the Internet Self-Management Uniform Reporting Framework, which can be used in the reporting of all interventions. Internet Self-Management Uniform Reporting Framework proposes the collection of specific data from six domains: Web site design, support, study design, Web site use, user characteristics and reporting outcomes. The adoption of Internet Self-Management Uniform Reporting Framework would enable easy comparison of online interventions targeting chronic diseases.

Usability Testing of AsthmaWise With Older Adults

There are many reasons why online self-management education is attractive to both patients and providers. AsthmaWise, an online self-management program, was developed using a Moodle platform, to enable older adults to learn asthma self-management skills. This study aimed to improve AsthmaWise through conducting: usability testing with a sample of end users; a cognitive walk-through undertaken by an independent health researcher; and assessment of content readability. A Perceived Health Web Site Usability Questionnaire score of 67% was achieved, indicating that there were usability issues that needed to be addressed. The cognitive walk-through and readability assessment identified unique issues that were not identified through usability testing with end users. The testing process allowed issues to be identified and rectified before piloting AsthmaWise, creating a more accessible and refined end product. The involvement of the site designer in the testing process was valuable and is highly recommended. This study shows that usability testing involving both end users and experts is an essential part of the design process that is relatively easy and inexpensive to undertake and can be effectively conducted by a nonexpert.

Evaluating a web-based self-management program for employees with hypertension and prehypertension: A randomized clinical trial

Web-based self-management programs offer a novel approach for self-insured employers seeking to improve and maintain employee health. We conducted a 6-month prospective, cluster-randomized controlled trial designed to evaluate whether worksite access to an automated, web-based, self-management program resulted in better blood pressure control. The trial was conducted at 6 EMC Corporation worksites in Massachusetts, each of which had at least 600 employees; 404 EMC employees with pre-hypertension or hypertension participated. Participants at 3 worksites received a home blood pressure cuff that uploaded readings to a Web site where they could view trends and read automated rules-based messages. Participants at 3 worksites received access to an onsite blood pressure cuff. Primary outcome measure was change in systolic blood pressure. Secondary outcome measures were change in diastolic blood pressure, proportion of participants achieving significant changes in systolic and diastolic blood pressure, and subject satisfaction. Although the mean change in systolic blood pressure was not significantly different between intervention and control groups (-1.69 vs. -0.86 mm HG, respectively, P = .49) the change in diastolic blood pressure between groups was significant. (-1.08 vs. = 1.47 mm HG, respectively, P < .001). Significantly more intervention participants experienced a >10-mm Hg decrease in systolic blood pressure or >5-mm Hg decrease in diastolic blood pressure compared to controls (22% vs 17%, P = .02 and 29% vs 16%, P = .03, respectively). Intervention participants were twice as likely to report starting a new medication (P = .02) and more likely to report improved communication with their doctor (P = .02). Participation in an automated online self-management program resulted in improved blood pressure among employees with prehypertension or hypertension.

News from the CDC: translating epilepsy self-management research to practice

Epilepsy, which affects about two million persons in the USA, is characterized by recurrent, unprovoked seizures [1]. Many with the condition face significant challenges related to managing treatment, symptoms, disability, lifestyle limitations, depression, and stigma. The Centers for Disease Control and Prevention’s (CDC) Epilepsy Program supports activities related to epidemiologic and prevention research, improving care, combating stigma, promoting patient self-management, increasing public awareness and knowledge, and strengthening partnerships. In 2002, promising research on epilepsy self-management began to emerge from CDC’s Prevention Research Centers, which led to the development of the Managing Epilepsy Well (MEW) Network (http://www.sph.emory.edu/ManagingEpilepsyWell/) [2]. Since 2007, the MEW Network has successfully developed and evaluated several theory-based interventions through telehealth and traditional formats [3]. MEW programs currently available to the public include Epilepsy Awareness Support and Education (WebEase), an on-line self-management program, Using Practice and Learning to Increase Favorable Thoughts (UPLIFT), a telehealth depression treatment program, and Program to Encourage Active Rewarding Lives (PEARLS), a collaborative care home-based depression treatment intervention [3].

What arthritis pain practitioners and patients want in an online self‐management programme

Self-management of pain is a critical component of arthritis care; however, limited mobility can restrict access to resources. Although the internet has become a primary source of health information, few studies address what patients want and need from a self-management website. Thirty-two people diagnosed with arthritis and 12 practitioners a) participated in individual one-hour interviews and b) sorted and rated a list of 88 unique statements that were derived from the interviews. Qualitative data were analysed using concept mapping procedures. The six-cluster map provided the best discrimination between statements. Follow-up analyses suggested that although patients with arthritis and practitioners generally agree on the categories of content on a self-management website about arthritis, they appear to disagree on the importance of each category. These findings about patient and provider desired content can be used by health educators to develop a curriculum for health education of patients with arthritis pain.

The Impact of an Online Disease Management Program on Medical Costs among Health Plan Members

This study evaluated the economic impact of an online disease management program within a broader population health management strategy. A retrospective, quasi-experimental, cohort design evaluated program participants and a matched cohort of nonparticipants on 2003-2007 claims data in a mixed model. The study was conducted through Highmark Inc, Blue Cross Blue Shield, covering 4.8 million members in five regions of Pennsylvania. Overall, 413 online self-management program participants were compared with a matched cohort of 360 nonparticipants. The costs and claims data were measured per person per calendar year. Total payments were aggregated from inpatient, outpatient, professional services, and pharmacy payments. The costs of the online program were estimated on a per-participant basis. All dollars were adjusted to 2008 values. The online intervention, implemented in 2006, was a commercially available, tailored program for chronic condition self management, nested within the Blues on Call(SM) condition management strategy. General linear modeling (with covariate adjustment) was used. Data trends were also explored using second-order polynomial regressions. Health care costs per person per year were $757 less than predicted for participants relative to matched nonparticipants, yielding a return on investment of $9.89 for every dollar spent on the program. This online intervention showed a favorable and cost-effective impact on health care cost.

Usability Testing of an Online Self-management Program for Adolescents With Juvenile Idiopathic Arthritis

BackgroundA new bilingual (English and French) Internet-based self-management program, Teens Taking Charge: Managing Arthritis Online, for adolescents with arthritis and their parents was developed following a needs assessment.ObjectivesThis study explored the usability (user performance and satisfaction) of the self-management program for youth with juvenile idiopathic arthritis (JIA) and their parents to refine the health portal prototype.MethodsA qualitative study design with semi-structured, audio taped interviews and observation by a trained observer was undertaken with two iterative cycles to determine the usability (ease of use, efficiency, errors, and user satisfaction) of the user interface and content areas of the intervention. A purposive sample of English-speaking (n = 11; mean age = 15.4, standard deviation [SD] 1.7) and French-speaking (n = 8; mean age = 16.0, SD 1.2) adolescents with JIA and one of their respective parents/caregivers were recruited from 2 Canadian tertiary care centers. Descriptive statistics and simple content analyses were used to organize data into categories that reflected the emerging usability themes.ResultsAll of the participants had access to a computer/Internet at home; however, adolescents were more comfortable using the computer/Internet than their parents. Adolescents and parents provided similar as well as differing suggestions on how the website user interface could be improved in terms of its usability (navigation; presentation and control usage errors; format and layout; as well as areas for further content development). There were no major differences in usability issues between English- and French-speaking participants. Minor changes to the website user interface were made and tested in a second cycle of participants. No further usability problems were identified in the second iterative cycle of testing. Teens and parents responded positively to the appearance and theme of the website (ie, promoting self-management) and felt that it was easy to navigate, use, and understand. Participants felt that the content was appropriate and geared to meet the unique needs of adolescents with JIA and their parents as well as English- and French-speaking families. Many participants responded that the interactive features (discussion board, stories of hope, and video clips of youth with JIA) made them feel supported and “not alone” in their illness.ConclusionsWe describe the usability testing of a self-management health portal designed for English- and French-speaking youth with arthritis and their parents, which uncovered several usability issues. Usability testing is a crucial step in the development of self-management health portals to ensure that the various end users (youth and parents) have the ability to access, understand, and use health-related information and services that are delivered via the Internet and that they are delivered in an efficient, effective, satisfying, and culturally competent manner.