title: Internet-based implementation of non-pharmacological interventions of the "people getting a grip on arthritis" educational program: an international online knowledge translation randomized controlled trial design protocol.
abstract: BACKGROUND
  Rheumatoid arthritis (RA) affects 2.1% of the Australian population (1.5% males; 2.6% females), with the highest prevalence from ages 55 to over 75 years (4.4-6.1%). In Canada, RA affects approximately 0.9% of adults, and within 30 years that is expected to increase to 1.3%. With an aging population and a greater number of individuals with modifiable risk factors for chronic diseases, such as arthritis, there is an urgent need for co-care management of arthritic conditions. The increasing trend and present shifts in the health services and policy sectors suggest that digital information delivery is becoming more prominent. Therefore, it is necessary to further investigate the use of online resources for RA information delivery.
  
  
  OBJECTIVE
  The objective is to examine the effect of implementing an online program provided to patients with RA, the People Getting a Grip on Arthritis for RA (PGrip-RA) program, using information communication technologies (ie, Facebook and emails) in combination with arthritis health care professional support and electronic educational pamphlets. We believe this can serve as a useful and economical method of knowledge translation (KT).
  
  
  METHODS
  This KT randomized controlled trial will use a prospective randomized open-label blinded-endpoint design to compare four different intervention approaches of the PGrip-RA program to a control group receiving general electronic educational pamphlets self-management in RA via email. Depending on group allocation, links to the Arthritis Society PGrip-RA material will be provided either through Facebook or by email. One group will receive feedback online from trained health care professionals. The intervention period is 6 weeks. Participants will have access to the Internet-based material after the completion of the baseline questionnaires until the final follow-up questionnaire at 6 months. We will invite 396 patients from Canadian and Australian Arthritis Consumers' Associations to participate using online recruitment.
  
  
  RESULTS
  This study will build on a pilot study using Facebook, which revealed promising effects of knowledge acquisition/integration of the evidence-based self-management PGrip educational program.
  
  
  CONCLUSIONS
  The use of online techniques to disseminate knowledge provides an opportunity to reduce health care costs by facilitating self-management of people with arthritis. Study design strengths include the incorporation of randomization and allocation concealment to ensure internal validity. To avoid intergroup contamination, the Facebook group page security settings will be set to "closed", thus allowing only invited participants to access it. Study limitations include the lack of participant blinding due to the characteristics of this KT randomized controlled trial and a potential bias of recruiting patients only online, though this was proven effective in the previous pilot study.
  
  
  BACKGROUND
  Australian New Zealand Clinical Trials Registry ACTRN12614000397617; http://www.anzctr.org.au/TrialSearch.aspx (Archived by WebCite at http://www.webcitation.org/6PrP0kQf8).
authors: School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada. Lucie.Brosseau@uottawa.ca.
authors: Lucie
authors: http://orcid.org/0000-0002-9587-7504
authors: L
authors: Brosseau
authors: George
authors: http://orcid.org/0000-0002-2289-9139
authors: G
authors: Wells
authors: Sydney
authors: http://orcid.org/0000-0003-1673-0916
authors: S
authors: Brooks-Lineker
authors: Kim
authors: K
authors: Bennell
authors: Cathie
authors: http://orcid.org/0000-0001-8934-4368
authors: C
authors: Sherrington
authors: Andrew
authors: http://orcid.org/0000-0002-6736-3098
authors: A
authors: Briggs
authors: Daina
authors: http://orcid.org/0000-0002-4602-7685
authors: D
authors: Sturnieks
authors: Judy
authors: http://orcid.org/0000-0003-4530-9987
authors: J
authors: King
authors: Roanne
authors: http://orcid.org/0000-0001-5495-4772
authors: R
authors: Thomas
authors: Mary
authors: http://orcid.org/0000-0003-0149-958X
authors: M
authors: Egan
authors: Laurianne
authors: http://orcid.org/0000-0002-7059-8859
authors: L
authors: Loew
authors: Gino
authors: http://orcid.org/0000-0003-2099-9870
authors: G
authors: De Angelis
authors: Lynn
authors: http://orcid.org/0000-0002-5184-3257
authors: L
authors: Casimiro
authors: Karine
authors: http://orcid.org/0000-0003-0141-7193
authors: K
authors: Toupin April
authors: Sabrina
authors: http://orcid.org/0000-0003-0484-1205
authors: S
authors: Cavallo
authors: Mary
authors: http://orcid.org/0000-0002-3003-5760
authors: M
authors: Bell
authors: Rukhsana
authors: http://orcid.org/0000-0003-2458-6811
authors: R
authors: Ahmed
authors: Doug
authors: http://orcid.org/0000-0003-3492-2268
authors: D
authors: Coyle
authors: Stéphane
authors: http://orcid.org/0000-0002-8049-958X
authors: S
authors: Poitras
authors: Christine
authors: http://orcid.org/0000-0002-1025-6005
authors: C
authors: Smith
authors: Arlanna
authors: http://orcid.org/0000-0002-1184-5821
authors: A
authors: Pugh
authors: Prinon
authors: http://orcid.org/0000-0002-4673-0055
authors: P
authors: Rahman
keywords: clinical trial; knowledge translation; rheumatoid arthritis; social media; technology
references: BMJ. 2007 Jul 7;335(7609):24-7
references: 17615222
references: Acad Med. 2013 Sep;88(9):1376-83
references: 23887004
references: Health Promot Pract. 2005 Apr;6(2):148-56
references: 15855284
references: Int J Behav Nutr Phys Act. 2009 Jun 03;6:30
references: 19490649
references: J Aging Health. 2013 Oct;25(7):1258-74
references: 24029414
references: Dermatol Clin. 2009 Apr;27(2):133-6, vi
references: 19254656
references: BMJ. 2014 Mar 07;348:g1687
references: 24609605
references: Int J Behav Nutr Phys Act. 2012 Apr 30;9:52
references: 22546283
references: Ambul Pediatr. 2005 Mar-Apr;5(2):117-21
references: 15780014
references: J Cancer Surviv. 2013 Sep;7(3):355-68
references: 23532799
references: Cochrane Database Syst Rev. 2005 Oct 19;(4):CD004274
references: 16235356
references: Epidemiology. 2012 May;23(3):500
references: 22475832
references: BMJ Open. 2014 Jan 21;4(1):e004089
references: 24448847
references: Best Pract Res Clin Rheumatol. 2012 Oct;26(5):611-25
references: 23218426
references: PLoS One. 2014 Jan 10;9(1):e82986
references: 24427268
references: Am J Pharm Educ. 2011 Dec 15;75(10):207
references: 22345726
references: BMC Med Inform Decis Mak. 2013 May 28;13:61
references: 23714120
references: J Am Geriatr Soc. 1992 Jun;40(6):574-8
references: 1587973
references: BMJ Open. 2013 May 09;3(5):
references: 23667163
references: J Med Internet Res. 2014 Feb 14;16(2):e40
references: 24550083
references: Stat Med. 1996 Jul 15;15(13):1447-58
references: 8841654
references: J Med Internet Res. 2013 Oct 16;15(10):e223
references: 24132044
references: Cochrane Database Syst Rev. 2003;(2):CD003688
references: 12804484
references: Am J Prev Med. 2012 Nov;43(5):527-32
references: 23079176
references: Phys Ther. 2004 Nov;84(11):1016-43
references: 15509188
references: Am J Prev Med. 2007 Jul;33(1):54-64
references: 17572313
references: Int J Nurs Stud. 2013 May;50(5):587-92
references: 23159157
references: Can Fam Physician. 1999 Apr;45:992, 995, 1004-5
references: 10216799
references: Health Educ Behav. 2013 Feb;40(1):67-77
references: 22491008
references: Am J Phys Med Rehabil. 1990 Feb;69(1):6-10
references: 2137345
references: Am J Prev Med. 2007 Oct;33(4):336-345
references: 17888860
references: Ann Med. 2001 Jul;33(5):337-43
references: 11491192
references: J Med Internet Res. 2004 Sep 29;6(3):e34
references: 15471760
references: Am J Epidemiol. 1985 Jan;121(1):91-106
references: 3964995
references: Health Econ. 2005 May;14(5):487-96
references: 15497198
references: Arthritis Rheum. 1989 Jan;32(1):37-44
references: 2912463
references: J Med Internet Res. 2013 Nov 22;15(11):e257
references: 24269911
references: Postgrad Med J. 2009 Sep;85(1007):455-9
references: 19734511
references: Med Sci Sports Exerc. 2003 May;35(5):801-9
references: 12750590
references: BMC Public Health. 2012 Oct 13;12:871
references: 23061875
references: Arthritis Rheum. 2008 Jul 15;59(7):1009-17
references: 18576310
references: J Rheumatol. 2001 Sep;28(9):1944-51
references: 11550958
references: Ann Rheum Dis. 2004 Apr;63(4):395-401
references: 15020333
references: Contemp Clin Trials. 2014 Jan;37(1):10-8
references: 24215774
references: J Med Internet Res. 2001 Apr-Jun;3(2):E20
references: 11720962
references: Trials. 2012 Oct 05;13:187
references: 23039306
references: J Hypertens. 2003 Jul;21(7):1291-8
references: 12817175
references: Disabil Rehabil. 2008;30(19):1429-38
references: 18923976
references: Obesity (Silver Spring). 2013 Jan;21(1):25-31
references: 23505165
references: J Med Internet Res. 2011 Dec 31;13(4):e126
references: 22209829
references: Arthritis Rheum. 2009 Jul 15;61(7):867-75
references: 19565554
references: Best Pract Res Clin Rheumatol. 2012 Oct;26(5):599-609
references: 23218425
references: Circulation. 2013 Jan 15;127(2):260-7
references: 23212719
references: Qual Life Res. 2014 Feb;23(1):195-203
references: 23852096
references: Am J Prev Med. 2012 Nov;43(5):467-74
references: 23079168
references: Arthritis Care Res (Hoboken). 2013 Oct;65(10):1573-81
references: 23666599
references: Phys Ther. 2004 Oct;84(10):934-72
references: 15449978
references: Rural Remote Health. 2011;11(4):1798
references: 21995854
references: PLoS One. 2014 May 19;9(5):e95369
references: 24840205