title: An internet-based self-management program with telephone support for adolescents with arthritis: a pilot randomized controlled trial.
abstract: OBJECTIVE
  To determine the feasibility of a 12-week Internet-based self-management program of disease-specific information, self-management strategies, and social support with telephone support for youth with juvenile idiopathic arthritis (JIA) and their parents, aimed at reducing physical and emotional symptoms and improving health-related quality of life (HRQOL).
  
  
  METHODS
  A nonblind pilot randomized controlled trial (NCT01011179) was conducted to test the feasibility of the "Teens Taking Charge: Managing Arthritis Online" Internet intervention across 4 tertiary-level centers in Canada. Participants were 46 adolescents with JIA, ages 12 to 18 years, and 1 parent for each participant, who were randomized to the control arm (n = 24) or the Internet intervention (n = 22).
  
  
  RESULTS
  The 2 groups were comparable on demographic and disease-related variables and treatment expectation at baseline. Attrition rates were 18.1% and 20.8%, respectively, from experimental and control groups. Ninety-one percent of participants randomized to the experimental group completed all 12 online modules and weekly phone calls with a coach in an average of 14.7 weeks (SD 2.1). The control group completed 90% of weekly attention-control phone calls. The Internet treatment was rated as acceptable by all youth and their parents. In posttreatment the experimental group had significantly higher knowledge (p < 0.001, effect size 1.32) and lower average weekly pain intensity (p = 0.03, effect size 0.78). There were no significant group differences in HRQOL, self-efficacy, adherence, and stress posttreatment.
  
  
  CONCLUSIONS
  Findings support the feasibility (acceptability, compliance, and user satisfaction) and initial efficacy of Internet delivery of a self-management program for improving disease-specific knowledge and reducing pain in youth with JIA.
authors.affiliation: Child Health Evaluative Sciences, Chronic Pain Program, Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada. jennifer.stinson@sickkids.ca
authors.forename: Jennifer N
authors.initials: JN
authors.lastname: Stinson
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: McGrath
authors.forename: Ellen D
authors.initials: ED
authors.lastname: Hodnett
authors.forename: Brian M
authors.initials: BM
authors.lastname: Feldman
authors.forename: Ciaran M
authors.initials: CM
authors.lastname: Duffy
authors.forename: Adam M
authors.initials: AM
authors.lastname: Huber
authors.forename: Lori B
authors.initials: LB
authors.lastname: Tucker
authors.forename: C Ross
authors.initials: CR
authors.lastname: Hetherington
authors.forename: Shirley M L
authors.initials: SM
authors.lastname: Tse
authors.forename: Lynn R
authors.initials: LR
authors.lastname: Spiegel
authors.forename: Sarah
authors.initials: S
authors.lastname: Campillo
authors.forename: Navreet K
authors.initials: NK
authors.lastname: Gill
authors.forename: Meghan E
authors.initials: ME
authors.lastname: White
mesh_terms: D000293:Adolescent; D001168:Arthritis / Q000523:psychology / Q000628:therapy; D002170:Canada; D002648:Child; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D010349:Patient Compliance; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D010865:Pilot Projects; D011788:Quality of Life; D012648:Self Care; D012944:Social Support; D013689:Telephone