The identification of autoantibodies and cytokines in the serum many years prior to the diagnosis of rheumatoid arthritis (RA) suggests opportunities to prevent disease during the pre-clinical phase. Recent research has led to the recognition that RA develops in individuals with genetic risk factors after exposure to environmental factors, including cigarette smoking, periodontitis, and dietary factors. Having a first degree relative (FDR) with RA increases RA risk 3- to 9-fold compared to that in the general population. Despite the expanding knowledge of individual risk factors in the development of RA, there have been no studies of how best to communicate biomarker, genetic and lifestyle risk profiles for a given individual to enable personalized prevention of RA. Given the recent emergence of effective early treatment and the promise of preventive therapies, RA risk prediction now has the potential to avert decades of disability in at-risk patients. In this project, we will build upon our prior discoveries and risk models to develop an online RA risk calculator that combines biomarker, genetic and lifestyle factors. We will then conduct a randomized, controlled trial using this risk calculator in aymptomatic first degree relatives of RA patients in order to test the impact of risk education and counseling upon the readiness to adopt preventive health behaviors. We propose the following specific aims: 1) To develop an online RA risk calculator, a personalized communication tool that includes biomarker, genetic and lifestyle RA risk factors and 2) To conduct a randomized trial of communication of risk factor profiles to first degree relatives of RA patients to test whether use of risk prediction profiles and education will result in change in readiness to undertake behaviors to decrease their RA risk and health behavior change. We will conduct a 3-arm randomized trial, assigning 222 FDRs to receive: (i) a printed pamphlet, (ii) online risk communication or (iii) online risk communication plus health education and counseling. We will follow these groups at 6 weeks, 6 months and 12 months post intervention in order to determine change in behavioral readiness to modify smoking, oral health, or diet behaviors and health behavior change.
This innovative project will develop and validate an online risk calculator that includes biomarker, genetic and lifestyle risk profiles and test communication of personalized education about risk profiles for RA among asymptomatic first degree relatives of RA patients, a population at substantial risk for developing RA.
|Zak, Agnes; Corrigan, Cassandra; Yu, Zhi et al. (2018) Barriers to treatment adjustment within a treat to target strategy in rheumatoid arthritis: a secondary analysis of the TRACTION trial. Rheumatology (Oxford) 57:1933-1937|
|von Heideken, Johan; Iversen, Maura D; Gerdhem, Paul (2018) Rapidly increasing incidence in scoliosis surgery over 14 years in a nationwide sample. Eur Spine J 27:286-292|
|MacFarlane, Lindsey A; Yang, Heidi; Collins, Jamie E et al. (2018) Relationship between patient-reported swelling and MRI-defined effusion-synovitis in patients with meniscus tears and knee osteoarthritis. Arthritis Care Res (Hoboken) :|
|Sparks, Jeffrey A; Lin, Tzu-Chieh; Camargo Jr, Carlos A et al. (2018) Rheumatoid arthritis and risk of chronic obstructive pulmonary disease or asthma among women: A marginal structural model analysis in the Nurses' Health Study. Semin Arthritis Rheum 47:639-648|
|Kreps, David J; Halperin, Florencia; Desai, Sonali P et al. (2018) Association of weight loss with improved disease activity in patients with rheumatoid arthritis: A retrospective analysis using electronic medical record data. Int J Clin Rheumtol 13:1-10|
|Solomon, Daniel H; Lu, Bing; Yu, Zhi et al. (2018) Benefits and Sustainability of a Learning Collaborative for Implementation of Treat-to-Target in Rheumatoid Arthritis: Results of a Cluster-Randomized Controlled Phase II Clinical Trial. Arthritis Care Res (Hoboken) 70:1551-1556|
|Prado, Maria G; Iversen, Maura D; Yu, Zhi et al. (2018) Effectiveness of a Web-Based Personalized Rheumatoid Arthritis Risk Tool With or Without a Health Educator for Knowledge of Rheumatoid Arthritis Risk Factors. Arthritis Care Res (Hoboken) 70:1421-1430|
|Lee, Moa P; Lii, Joyce; Jin, Yinzhu et al. (2018) Patterns of Systemic Treatment for Psoriatic Arthritis in the US: 2004-2015. Arthritis Care Res (Hoboken) 70:791-796|
|Barbhaiya, Medha; Tedeschi, Sara K; Lu, Bing et al. (2018) Cigarette smoking and the risk of systemic lupus erythematosus, overall and by anti-double stranded DNA antibody subtype, in the Nurses' Health Study cohorts. Ann Rheum Dis 77:196-202|
|Sparks, Jeffrey A; Iversen, Maura D; Yu, Zhi et al. (2018) Disclosure of Personalized Rheumatoid Arthritis Risk Using Genetics, Biomarkers, and Lifestyle Factors to Motivate Health Behavior Improvements: A Randomized Controlled Trial. Arthritis Care Res (Hoboken) 70:823-833|
Showing the most recent 10 out of 444 publications