Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Walk with Ease Program: One-Year Follow-Up.

Callahan2,  Leigh F., Shreffler4,  Jack H., Altpeter4,  Mary, Houenou4,  Laura O., Schoster4,  Britta, Martin3,  Kathryn Remmes, Hootman1,  Jennifer M.

Centers for Disease Control, Kennesaw, GA
Univ of North Carolina, Chapel Hill, NC
University of North Carolina at Chapel Hill, Chapel Hill, NC
University of North Carolina, Chapel Hill

Purpose:

One year after completing the Arthritis Foundation's 6-week Walk with Ease (WWE) group or self-directed mode of intervention, participants were evaluated to determine their adherence to the WWE program and to see what improvements in physical function, symptoms and psychosocial variables were noted

Methods:

403 individuals who completed the 6 week follow-up assessment (178 group, 225 self-directed) were mailed a self-report questionnaire designed to assess physical function, arthritis symptoms, psychosocial variables, and continuation of the WWE program at one year after the intervention completion. Repeated measures regression models were used to fit the data from baseline, 6-weeks, and 1-year. Responses were required at all time points for inclusion in the model. An indicator was included for mode of intervention (self-directed or group). Results were adjusted for age, education, gender, race, and BMI.

Results:

158 (89%) group and 204 (91%) self-directed participants completed the 1 year follow-up questionnaire. At 6-weeks, there were significant improvements in nearly all self-report measures and physical performance measures (not included in 1 year follow-up) regardless of the mode of intervention (presented previously). For both the group and self directed intervention modes, 2 measures show significant improvements at one year from baseline: PROMIS satisfaction with social roles (effect sizes ES=0.33/0.27); arthritis self-efficacy (ASE) for handling pain (ES=0.17/0.17). There were 7 outcomes where self-directed participants showed significant improvement from baseline, while the group participants did not: Health Assessment Questionnaire (HAQ) (ES =0.21); pain (ES=0.38) and stiffness (ES=0.31) Visual Analog Scales (VAS); general health (ES=0.17); Rheumatology Attitudes Index (RAI, helplessness) (ES=0.28); PROMIS depression (ES=0.17); and ASE for dealing with symptoms (ES=0.22). The follow-up rate at 1-yr was similar for both modes, but 60% of group participants continued walking versus 70% of the self-directed participants. The most frequently cited reason for stopping walking for both modes was "pain, stiffness, or fatigue" (42%/36%). The group participants also cited "other health problems" more frequently (33%) than the self-directed (17%).

Conclusions:

Both group and self-directed participants maintained some benefits 1 year after the WWE intervention. However, self-directed participants were more likely to continue walking and retained improvement in more self-reported physical function, symptoms, and psychosocial outcomes. Two factors could influence this finding. First, the self-directed participants were on average about 5.7 years younger than those in the group sessions. Second, the self-directed have chosen a mode of intervention that suited their proclivity to act alone, while the group participants may be stimulated by group instruction but have less inclination to continue after the course ended.

To cite this abstract, please use the following information:
Callahan, Leigh F., Shreffler, Jack H., Altpeter, Mary, Houenou, Laura O., Schoster, Britta, Martin, Kathryn Remmes, et al; Walk with Ease Program: One-Year Follow-Up. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :691
DOI: 10.1002/art.28459

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