title: Mail-delivered arthritis self-management tool kit: a randomized trial and longitudinal followup.
abstract: OBJECTIVE
  To determine the effectiveness of an intervention Tool Kit of arthritis self-management materials to be sent once through the mail, and to describe the populations reached.
  
  
  METHODS
  Spanish speakers (n = 335), non-Hispanic English-speaking African Americans (n = 156), and other non-Hispanic English speakers (n = 404) were recruited separately and randomized within each of the 3 ethnic/racial categories to immediately receive the intervention Tool Kit (n = 458) or to a 4-month wait-list control status (n = 463). At the end of 4 months, controls were sent the Tool Kit. All subjects were followed in a longitudinal study for 9 months. Self-administered measures included health status, health behavior, arthritis self-efficacy, medical care utilization, and demographic variables. Using analyses of covariance and t-tests, analyses were conducted for all participants and for Spanish- and English-language groups.
  
  
  RESULTS
  At 4 months, comparing all intervention subjects with randomized wait-list controls, there were significant (P < 0.01) benefits in all outcomes except medical care utilization and self-rated health. The results were maintained at 9 months compared with baseline. On average, the Tool Kit reached persons ages 50-56 years with 12-15 years of schooling. There were few differences between English- and Spanish-language participants in either the effectiveness or reach variables.
  
  
  CONCLUSIONS
  A mailed Arthritis Self-Management Tool Kit proved effective in improving health status, health behavior, and self-efficacy variables for up to 9 months. It also reached younger persons in both English- and Spanish-language groups and Spanish speakers with higher education levels than previous studies of the small-group Arthritis Self-Management Program.
authors: University of North Carolina, Chapel Hill, NC 27599-7460, USA. jgoeppin@email.unc.edu
authors: Jean
authors: J
authors: Goeppinger
authors: Kate R
authors: KR
authors: Lorig
authors: Philip L
authors: PL
authors: Ritter
authors: Sonal
authors: S
authors: Mutatkar
authors: Frank
authors: F
authors: Villa
authors: Ziya
authors: Z
authors: Gizlice
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000208:ethnology; D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis / Q000208:ethnology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006630:Hispanic or Latino / Q000208:ethnology; D006801:Humans; D007802:Language; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D011177:Postal Service; D012648:Self Care / Q000379:methods*; D016896:Treatment Outcome; D014481:United States; D044465:White People / Q000208:ethnology; D055815:Young Adult