Measuring the value of program adaptation: a comparative effectiveness study of the standard and a culturally adapted version of the arthritis self-help program.
BACKGROUND
Arthritis remains an important public health problem.


OBJECTIVE
This study aims to determine the effects of an adapted (vs. the original) Arthritis Self-Help Program (ASHP) among older adults. Specifically, this study sought to determine (1) whether the adapted ASHP improved attendance, retention, and adherence with the use of self-management exercises, and (2) if the original ASHP's beneficial outcomes were maintained following program adaptation.


METHODS
Individuals age ≥60 with self-reported arthritis were recruited from eight New York City senior centers. Participants were assessed at baseline to assess their demographic and clinical status and at 6 and 24 weeks to ascertain study outcomes using validated measures.


RESULTS
Two-hundred-one participants (64 non-Hispanic African Americans, 86 Hispanics, and 51 non-Hispanic Whites) enrolled. Participants in the adapted (vs. original) ASHP had better average attendance in the six session program (4.7 vs. 3.2 classes attended, p < 0.01) and program retention (93% vs. 74%, p < 0.01). Adherence with use of the self-management exercises (number of days using endurance, stretching, and relaxation exercises) was similar in both groups. Significant positive physical/psychosocial outcomes were documented in both the adapted and original program.


CONCLUSIONS
The adapted ASHP improved program attendance and retention while maintaining improvements in physical and psychosocial functions. These results support future efforts to employ controlled designs to quantify the benefits of adapted evidence-based programs to ensure that adaptation maintains program effectiveness.
Division of Geriatrics and Gerontology, Weill Cornell Medical College, 525 E 68th Street, Box 39, New York, NY 10065 USA ; Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College, New York, NY 10065 USA.
M Carrington
MC
Reid
Department of Human Development, Cornell University, MVR Hall, Ithaca, NY 14853 USA.
Emily K
EK
Chen
Tulane University School of Medicine, New Orleans, LA 70112 USA.
Samantha J
SJ
Parker
Department of Human Development, Cornell University, MVR Hall, Ithaca, NY 14853 USA.
Charles R
CR
Henderson
Department of Human Development, Cornell University, MVR Hall, Ithaca, NY 14853 USA.
Karl
K
Pillemer
arthritis; health promotion; self-management