title: The Self-Management of OsteoArthritis in Veterans (SeMOA) Study: design and methodology.
abstract: BACKGROUND
  Osteoarthritis (OA) is a leading cause of disability among adults. Although self-management behaviors such as exercise and weight management can improve pain and function, these behaviors are vastly underutilized. There is a need to implement effective self-management programs among the growing number of adults with OA.
  
  
  OBJECTIVE
  The Self-Management of OsteoArthritis (SeMOA) in Veterans Study examines a 12-month telephone-based OA self-management program in the primary care setting. This manuscript details the design, methodology, and advances of the SeMOA trial.
  
  
  METHODS
  Participants (N=519) with hip or knee OA are randomly assigned to one of three groups: OA self-management, health education (attention control), or usual care. The OA self-management group receives written and audio materials regarding OA care (including health behaviors, medical care, and interacting with health care providers). A health educator calls participants monthly to review these materials and provide support for developing individualized goals and action plans related to OA management. The health education group receives written and audio materials and monthly calls from a health educator discussing health issues unrelated to OA. Usual care involves no additional materials or phone calls. The primary outcome is change in the Arthritis Impact Measurement Scales-2 pain subscale from baseline to 12 months. Analysis of covariance models will compare changes in pain across study groups. The cost-effectiveness of the OA self-management program will also be assessed.
  
  
  CONCLUSIONS
  SeMOA is one of the first to examine telephone-based delivery of OA self-management and one of few trials to target the primary care setting. This program has the potential for broad dissemination because it reduces both the costs and barriers that accompany in-person programs. This study will provide important information about its feasibility and effectiveness in a real-world clinical setting.
authors.affiliation: Health Services Research and Development Service, Durham VA Medical Center, Durham, NC 27705P, USA. kelli.allen@duke.edu
authors.forename: Kelli D
authors.initials: KD
authors.lastname: Allen
authors.forename: Eugene Z
authors.initials: EZ
authors.lastname: Oddone
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Stock
authors.forename: Cynthia J
authors.initials: CJ
authors.lastname: Coffman
authors.forename: Jennifer H
authors.initials: JH
authors.lastname: Lindquist
authors.forename: Karen A
authors.initials: KA
authors.lastname: Juntilla
authors.forename: Deborah S
authors.initials: DS
authors.lastname: Lemmerman
authors.forename: Santanu K
authors.initials: SK
authors.lastname: Datta
authors.forename: Mikeal L
authors.initials: ML
authors.lastname: Harrelson
authors.forename: Morris
authors.initials: M
authors.lastname: Weinberger
authors.forename: Hayden B
authors.initials: HB
authors.lastname: Bosworth
mesh_terms: D005081:Exercise Therapy; D006266:Health Education; D006305:Health Status Indicators; D006801:Humans; D010003:Osteoarthritis / Q000628:therapy*; D011320:Primary Health Care; D012107:Research Design; D018401:Sample Size; D012648:Self Care / Q000379:methods*; D013689:Telephone; D016896:Treatment Outcome; D014481:United States; D014728:Veterans