Public health interventions for arthritis: expanding the toolbox of evidence-based interventions.
BACKGROUND
Since 1999, the Centers for Disease Control and Prevention's (CDC) Arthritis Program has worked to improve the quality of life for people with arthritis, in part by funding state health departments to disseminate physical activity (PA) and self-management education (SME) interventions. Initially, only one SME and two PA interventions were considered evidence-based and appropriate for people with arthritis. The purposes of this article are to describe the processes and criteria used to screen new or existing intervention programs and report the results of that screening, including an updated list of recommended intervention programs.


METHODS
A series of three sets of screening criteria was created in consultation with subject matter experts: arthritis appropriateness, adequacy of the evidence base, and implementability as a public health intervention. Screening interventions were categorized as Recommended, Promising Practices, Watch List, Future Possibility, or Unlikely to Meet criteria based on how well the intervention met the screening criteria.


RESULTS
A total of 15 packaged PA interventions and six SME interventions were screened. Three PA and three SME interventions met all three sets of criteria and were added to the list of recommended public health interventions for use by CDC-funded state arthritis programs. An additional two SME interventions are developing the infrastructure for public health dissemination and were categorized as Promising Practices, and six PA interventions have evaluations underway and are on the Watch List.


CONCLUSIONS
The CDC Arthritis Program identified arthritis-appropriate interventions that can be used effectively and efficiently in public health settings to improve the quality of life of people with arthritis. The screening criteria used offer a guide to intervention developers on necessary characteristics of interventions for use in public health settings. The expanded menu of interventions is beneficial to clinical care and public health professionals and, ultimately, to people with arthritis.
Brady
Teresa J
TJ
Arthritis Program, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA. tob9@cdc.gov
Jernick
Susan L
SL
Hootman
Jennifer M
JM
Sniezek
Joseph E
JE
D001168:Arthritis / Q000534:rehabilitation*; D001172:Arthritis, Rheumatoid / Q000534:rehabilitation; D002487:Centers for Disease Control and Prevention, U.S.; D018672:Community Health Planning / Q000458:organization & administration*; D019317:Evidence-Based Medicine / Q000379:methods*; D015444:Exercise; D006266:Health Education / Q000458:organization & administration; D006801:Humans; D010043:Outcome and Process Assessment, Health Care; D010353:Patient Education as Topic / Q000458:organization & administration*; D011322:Primary Prevention / Q000458:organization & administration*; D011634:Public Health; D011788:Quality of Life; D012648:Self Care / Q000379:methods; D014481:United States