title: Modifications to the Active Living Every Day (ALED) course for adults with arthritis.
abstract: BACKGROUND
  Active Living Every Day (ALED) is a 20-week behavioral theory-based physical activity program originally developed for the general population; the purpose of our qualitative evaluation was to investigate whether the existing program is also appropriate (regarding safety, content, and instructor training) for sedentary adults with arthritis.
  
  
  METHODS
  We conducted telephone interviews with 30 of 355 participants in a randomized control trial of the ALED program for sedentary adults with arthritis within 6 months after they completed the program. Interviewees, who attended at least 50% of program classes, were asked about the safety of program activities, the knowledge they gained from the program, how they felt about their program instructors, and any recommendations they had for how the program could be modified to better serve people with arthritis. We used NUD*IST (N6) (QSR International, Melbourne, Australia) software for the qualitative data analysis. We also conducted a conference call with program instructors to elicit their opinion of the course and how it might be improved to better meet the needs of people with arthritis.
  
  
  RESULTS
  Twenty seven (90%) of the program participants we interviewed were female, and their average age was 69 years. Components of the course that they reported finding particularly helpful were being encouraged to exercise "bit by bit" and receiving social support from other adults with arthritis. Program instructors and program participants both generally felt that the program was appropriate for people with arthritis but could be enhanced with the following modifications: 1) incorporating arthritis-specific information in the textbook, 2) providing information on pain management, 3) and providing dietary and nutritional information for arthritis management. Instructors also reported a need for more information on pain management and arthritis during their training.
  
  
  CONCLUSIONS
  Although instructors and participants felt the ALED program as designed for the general population was useful for people with arthritis, they suggested minor modifications that would make the program even more beneficial. Some of these modifications may be applicable to other community-based activity programs not designed specifically for people with arthritis.
authors.affiliation: 3300 Thurston Building CB7280, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599. E-mail: Leigh_Callahan@med.unc.edu.
authors.forename: Leigh F
authors.initials: LF
authors.lastname: Callahan
authors.forename: Britta
authors.initials: B
authors.lastname: Schoster
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hootman
authors.forename: Teresa
authors.initials: T
authors.lastname: Brady
authors.forename: Laura
authors.initials: L
authors.lastname: Sally
authors.forename: Katrina
authors.initials: K
authors.lastname: Donahue
authors.forename: Thelma
authors.initials: T
authors.lastname: Mielenz
authors.forename: Katherine
authors.initials: K
authors.lastname: Buysse
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis; D001521:Behavior Therapy / Q000379:methods*; D005260:Female; D006293:Health Promotion; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D010146:Pain; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic; D015397:Program Evaluation; D011634:Public Health