Clinical studies have shown that arthritis patient education interventions are an effective adjunct to medical treatment in improving patients' ability to cope with pain, reducing perceived symptom severity, improving patients' self-efficacy, and providing them with skills and strategies for dealing with limitations on daily activities. Little, however, is known about the generalizability of the effects of such programs to cultural minority groups, such as urban African Americans. Even less is known about the longevity of any benefits of patient education nor about effective reinforcement and maintenance techniques. In an effort to examine these issues, the proposed research will recruit subjects through a faith-based community network to pursue the following aims: 1) Evaluate the impact of arthritis patient education on arthritis symptoms and pain levels, functional status, self-care knowledge and behaviors, self-efficacy, emotional status, and health care resource utilization through a randomized controlled trial.(Study 1) 2) Test the impact of focused reinforcement of the concepts in the Arthritis Self Help Course (ASHC) over a 12 month period through a randomized controlled trial. (Study 2) 3) Examine the detailed educational dynamics of the ASHC, identify aspects of the course that are less effective with or relevant to African Americans, and identify modes of communication and presentations used in the course that require adaptation for an African American Audience. (Study 3) 4) Assess the personal and cultural belief system underlying African Americans' understanding of arthritis and their use of conventional and non-conventional arthritis treatments (Study 4). These studies will provide valuable information regarding culturally relevant methods of reaching urban African Americans with arthritis and providing patient education that addresses arthritis care needs of the African American community. This study will also clarify the longevity of educational benefits and the effectiveness of alternative methods of educational reinforcement in this population. The exploratory studies of individual beliefs and knowledge of arthritis and its treatment, and the formal evaluation of a patient education program, will provide a better understanding of the ways in which cultural groups differ and how these differences should influence the design and delivery of culturally appropriate patient education.
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