The proposed research focuses on adapting tailored message intervention methods for patients with systemic lupus erythematosus (SLE) and their spouses. Tailored message interventions have increased the success of indivually focused behavioral interventions, but have not been used previously with couples managing chronic illness. SLE is a disease that is marked by unpredictable periods of flares and remissions, involves treatment with medications that can cause serious side effects, requires strict adherence to a variety of health behaviors, and can cause secondary symptoms. Because of this many patients and their family members find it a difficult condition to cope with or manage. Explicitly targeting the patient and spouse may increase successful management of the condition. This research proposes to: 1) Identify the determinants that facilitate or hinder chronic illness management in couples coping with SLE; 2) Design and conduct a determinant assessment with couples to identify optimal content for an SLE-management message library; 3) Develop a message library and computer programs; 4) Pretest the intervention messages for credibility, relevance, persuasiveness, importance, and impact, and gather information about format arid timing of intervention delivery. To achieve these aims we will: a) draw on previous information we have already collected with couples coping with SLE and other rheumatic conditions; b) conduct focus groups with patients and spouses, and c) implement a determinant assessment of patient and spouses. The ultimate outcome of this research will be prototype intervention messages that can be subsequently tested in a larger study with couples managing SLE. We will recruit couples who have previously participated in a longitudinal study of couples coping with chronic illness in which one partner has a medically confirmed diagnosis of SLE and from a group of 700 SLE patients from UNC Hospitals and theThurston Arthritis Research Center. ? ? ? ? ? ?
