title: Internet Versus DVD Decision Aids for Hip and Knee Osteoarthritis.
abstract: Decision aids (DAs) can improve multiple decision-making outcomes, but it is not known whether different formats of delivery differ in their effectiveness or acceptability. The present study compared the effectiveness and acceptability of internet and DVD formats of DAs for osteoarthritis (OA).
  
  
  
  Patients with hip or knee OA were randomized to view an internet or DVD format DA, which provided information on OA treatments. Measures were collected at baseline, immediately after viewing the DA and then 30 days later. Outcomes included: Hip/Knee OA Decision Quality Instrument - Knowledge Subscale (HK-DQI Knowledge), Decisional Conflict Scale (DCS), Preparation for Decision Making Scale (PDMS), Stage of Decision Making, and Acceptability of DAs. Generalized estimating equations (GEE) were used to examine changes in HK-DQI Knowledge and DCS scores over time, between decision aid groups and within the sample overall. Group differences in the PDMS scale (assessed once, immediately after DA viewing) were estimated using a Wilcoxon rank sums test.
  
  
  
  Among 155 participants in the study, the mean age was 61.8 years, 60.6% were women and 58.1% were Caucasian. HK-DQI Knowledge scores improved over time (p < 0.001), although there was some attenuation by the 30-day follow-up; there was no difference between the two DA groups (p = 0.448). DCS scores decreased markedly for both groups (p < 0.001) and improvements were maintained by the 30-day follow-up (means: internet: baseline = 25.0, 30-day = 6.9; DVD: baseline = 25.0, 30-day = 6.2); there was no difference between the two DA groups (p = 0.808). PDMS scores were higher for the DVD group than the internet group (85.2 versus 74.9, p = 0.005). Stage of Decision Making became more certain after viewing the DA for both groups, with even more certainty indicated at 30-day follow-up. Acceptability items indicated positive perceptions of both DAs.
  
  
  
  Internet and DVD DAs were associated with meaningful, comparable improvements in decision-making outcomes in patients with knee and hip OA. DAs are inexpensive to disseminate and could be valuable tools for enhancing care for OA. Copyright © 2015 John Wiley & Sons, Ltd.
authors.affiliation: Health Services Research and Development Service, Durham VA Medical Center, Durham, NC, USA.|Department of Medicine and Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Kelli D
authors.initials: KD
authors.lastname: Allen
authors.affiliation: Health Services Research and Development Service, Durham VA Medical Center, Durham, NC, USA.|Department of Medicine, Duke University Medical Center, Durham, NC, USA.
authors.forename: Linda L
authors.initials: LL
authors.lastname: Sanders
authors.affiliation: Health Services Research and Development Service, Durham VA Medical Center, Durham, NC, USA.|Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA.
authors.forename: Maren K
authors.initials: MK
authors.lastname: Olsen
authors.affiliation: Department of Medicine, Duke University Medical Center, Durham, NC, USA.
authors.forename: Lynn
authors.initials: L
authors.lastname: Bowlby
authors.affiliation: Departments of Orthopedic Surgery and Medicine (Rheumatology, Immunology and Allergy), Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Jeffrey N
authors.initials: JN
authors.lastname: Katz
authors.affiliation: Department of Orthopaedic Surgery, Duke University, Durham, NC, USA.
authors.forename: Richard C
authors.initials: RC
authors.lastname: Mather
authors.affiliation: Health Services Research and Development Service, Durham VA Medical Center, Durham, NC, USA.|Department of Medicine, Duke University Medical Center, Durham, NC, USA.
authors.forename: John W
authors.initials: JW
authors.lastname: Williams
mesh_terms: D000368:Aged; D003661:Decision Support Techniques; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000628:therapy*; D020370:Osteoarthritis, Knee / Q000628:therapy*; D014742:Videodisc Recording
keywords: Osteoarthritis; decision making; patient education