Intervention Programs

	On this page: Self-Management Education Arthritis Foundation Self-Help Program Chronic Disease Self-Management Program Tomando Control de su Salud Physical Activity Programs Arthritis Foundation Exercise Program Active Living Everyday Arthritis Foundation Aquatic Program EnhanceFitness Communications Campaign Physical Activity. The Arthritis Pain Reliever Buenos Días, Artritis

The CDC Arthritis Program recommends evidence-based programs that are proven to improve the quality of life of people with arthritis. The programs currently being promoted are: 

• Three self-management education programs.
• Four physical activity programs.
• Two health communications campaigns promoting physical activity.

A description of these programs is summarized below along with information about how to locate these programs in your state. Self-management education programs like the Arthritis Foundation Self-Help Course (AFSHC) and Chronic Disease Self-Management (CDSMP) help teach people with arthritis learn techniques to manage arthritis on a day-to-day basis. Research has shown that appropriate physical activity offers substantial benefits to people with arthritis and can decrease arthritis pain and disability. Preliminary studies have shown Arthritis Foundation Exercise Program (formerly People with Arthritis Can Exercise or PACE), the Arthritis Foundation Aquatic Program, and EnhanceFitness to be both safe and effective for people with arthritis.

There are currently two physical activity interventions on our “Watch List” for possible recommendation that are pending health outcome data from evaluations underway. The CDC’s Arthritis Program is currently working to identify additional evidence-based interventions that are safe and beneficial for people with arthritis. There is a self-management education and two physical activity interventions with promising preliminary data and that are developing the infrastructure to support wide-spread dissemination.  We consider these interventions to be “Promising Practices”. The list of criteria used to screen each intervention is available. Use of these new programs will be promoted through state arthritis programs and other partners.

Self-Management Education

Arthritis Foundation Self-Help Program (AFSHP) is an effective self-management education intervention for people with arthritis. Developed by Dr. Kate Lorig of Stanford University, the course helps people learn and practice the different techniques needed to build an individualized self-management program and gain the confidence to carry it out. The 6-week course consists of weekly 2-hour sessions guided by two trained instructors who follow a detailed protocol. There is a robust science base that demonstrates the positive impacts of participation in the Arthritis Foundation Self-Help Program: participants report a 20% decrease in pain, and a 40% decrease in physician visits, even 4 years after course participation. To find out about availability in your area you can check with the Arthritis Foundation* or view this map to locate your state arthritis program.

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Chronic Disease Self-Management Program (CDSMP) is an effective self-management education program for people with chronic health problems. The program specifically addresses arthritis, diabetes, lung and heart disease, but teaches skills useful for managing a variety of chronic diseases. This program was developed at Stanford University. CDSMP workshops are held in community settings and meet 2 1/2 hours per week for 6 weeks. Workshops are facilitated by two trained leaders, one or both of whom are non-health professionals with a chronic diseases themselves. This program covers topic such as: techniques to deal with problems associated with chronic disease, appropriate exercise, appropriate use of medications, communicating effectively with family, friends, and health professionals, nutrition, and, how to evaluate new treatments. Participants who took CDSMP demonstrated significant improvements in exercise, communication with physicians, self-reported general health, health distress, fatigue, disability, and social/role activities limitations. To find out about availability in your state, you can check with your state arthritis program. Use this map to locate your state arthritis program. More information about the program is available.*

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Tomando Control de su Salud
(Spanish Chronic Disease Self-Management Program)

Tomando Control de su Salud is a self-management education program developed for Spanish-speaking people with a variety of chronic health problems. Workshops for this program are given two and a half hours, once a week, for six weeks, in a community setting. Workshops are facilitated by two trained leaders, one or both of whom are non-health professionals with a chronic diseases themselves. All workshops are given in Spanish without translators. This program is similar in content and process to the English language version of CDSMP, but Tomando Control de su Salud was developed in Spanish to address the health topics in culturally appropriate manner. Topics covered in the program include: appropriate use of the health care system, how to evaluate new treatments, communicating effectively with family, friends, and health professionals, healthy eating, appropriate use of medications, techniques to deal with problems, and appropriate exercises for maintaining and improving strength, flexibility, and endurance. Use this map to locate your state arthritis program. More information about the program is available.*

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Physical Activity Programs

Arthritis Foundation Exercise Program (AFEP) (formerly People with Arthritis Can exercise or PACE) is a community-based recreational exercise program developed by the Arthritis Foundation. Trained AFEP instructors cover a variety of range-of-motion and endurance-building activities, relaxation techniques, and health education topics. All of the exercises can be modified to meet participant needs. The program's demonstrated benefits include improved functional ability, decreased depression, and increased confidence in one's ability to exercise. Classes typically meet two or three times per week. To find about availability in your area you can check with the Arthritis Foundation* or view this map to locate your state arthritis program. More information about the program is available.*

Active Living Everyday (ALED) is a group-based program developed at the Cooper Institute focused on helping sedentary people become and stay physically active. Participants (~20/grp) come together for 1 hour weekly sessions for 20 weeks of classroom instruction to learn behavioral skills (identifying and overcoming barriers, setting goals, creating an action plan) needed to become more physically active. A variety of moderate and vigorous physical activities are discussed in the program, giving the background for individuals to make their personal decisions about type, form, frequency, intensity and dose. Participants do their actual activity outside of the group setting. Facilitators (instructors) that teach the course are trained and certified. A participant book is used in conjunction with the course. http://www.activeliving.info/.*

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Arthritis Foundation Aquatic Program (AFAP) is a water exercise program created by the Arthritis Foundation for people with arthritis and related conditions. The classes are conducted by a trained instructor and are designed to improve flexibility, joint range of motion, endurance, strength, and daily function and to decrease pain. The aquatics classes include joint range of motion, stretching, breathing, and light aerobic activities. The classes typically meet two or three times per week for one hour. To find out about availability in your area you can check with the Arthritis Foundation* or view this map to locate your state arthritis program. More information about the program is available.*

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EnhanceFitness (EF) EnhanceFitness (formerly Lifetime Fitness) is an evidence-based, community-delivered exercise program proven to increase strength, boost activity levels and elevate mood. Certified EF instructors offer a program that focuses on stretching, flexibility, balance, low impact aerobics, and strength training exercises. Typically classes meet three times a week for one hour. To find out about availability in your area you can check with your state arthritis program. Use this map* to locate your state arthritis program. More information about the program is available.*

Communication Campaigns

Media campaigns to promote health messages are useful in reaching broad segments of the population. Currently, we are promoting physical activity to relieve the pain and disability associated with arthritis. The details for this campaign are summarized below.

Physical Activity. The Arthritis Pain Reliever
A health communications campaign promoting physical activity to Caucasians and African-Americans with arthritis between the age of 45-70. This campaign is intended for general use by state health departments, their partners, and other community organizations and is designed to achieve the following goals:

• Raise awareness of physical activity as a way to manage arthritis pain and increase function.
• Increase understanding of how to use physical activity (types and duration) to ease arthritis symptoms and prevent further disability.
• Enhance the confidence of persons with arthritis in their ability to be physically active.
• Increase trial physical activity behaviors.

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Buenos Días, Artritis
This health communications campaign is designed to reach Spanish-speaking Hispanics with arthritis between the ages of 45–64, with an annual income of $35,000 or less. This campaign is targeted primarily to persons within the audience whose symptoms have advanced to the point where arthritis is perceived as interfering with one or more life activities, such as work or family obligations. This campaign is designed to do the following:

• Raise awareness of exercise as a way to manage arthritis pain and increase mobility.
• Increase understanding of how to use exercise (which types and for how long/duration) to ease arthritis symptoms and prevent further disability.
• Enhance the confidence or belief of persons with arthritis that they can engage in moderate exercise.
• Increase trial of moderate exercise behaviors.

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