title: Online self-management in rheumatoid arthritis: a patient-centered model application.
abstract: OBJECTIVE
  The aim of this study was to describe the online transformation of an empirically validated, clinic-based, self-management (SM) program for rheumatoid arthritis.
  
  
  METHODS
  A cognitive-behavioral framework served as the theoretical basis for the intervention. As with the clinic-based approach, the psychoeducational program included educational modules, weekly homework assignments, and self-evaluation. The dynamic online environment included secure communication tools to support a virtual community for the participants to garner peer support. In addition to peer support, weekly follow-up support was provided by a trained clinician via telephone. We describe the process and structure of the online self-management (OSM) intervention. Administrative issues including clinical monitoring and management, data collection, and security safeguards are considered. Utilization and management data are provided and explored for 33 initial subjects.
  
  
  RESULTS
  Individuals who volunteer to participate in an online modality are eager to receive this home-based programming. They readily engaged with all aspects of the OSM program and experienced few difficulties navigating the environment.
  
  
  CONCLUSIONS
  An OSM site provides a convenient, effective, and securely maintained health service, once restricted to clinic settings. The OSM application can be used to extend the benefits of SM programs to broad target audiences and serves as a model for the emerging generation of Internet-based clinical management/delivery systems.
authors.affiliation: Harry S. Truman Memorial Veterans Hospital , Columbia, Missouri, USA.
authors.forename: Karen L
authors.initials: KL
authors.lastname: Smarr
authors.forename: Dale R
authors.initials: DR
authors.lastname: Musser
authors.forename: Cheryl L
authors.initials: CL
authors.lastname: Shigaki
authors.forename: Rebecca
authors.initials: R
authors.lastname: Johnson
authors.forename: Kathleen Donovan
authors.initials: KD
authors.lastname: Hanson
authors.forename: Chokkalingam
authors.initials: C
authors.lastname: Siva
mesh_terms: D015928:Cognitive Behavioral Therapy; D004521:Educational Measurement; D004522:Educational Status; D006801:Humans; D020407:Internet; D007858:Learning; D008960:Models, Psychological; D008962:Models, Theoretical; D010353:Patient Education as Topic; D018802:Patient-Centered Care / Q000379:methods*; D012213:Rheumatic Fever / Q000517:prevention & control* / Q000523:psychology; D012648:Self Care; D011795:Surveys and Questionnaires