Design and evaluation of a pilot community program for musculoskeletal disability

A pilot community program for arthritis disability was developed for three census tracts in Jamaica Plain. An inexpensive case-finding phone and mail survey carried out by community volunteers identified persons with arthritis disability at a unit cost of $8.46. Persons identified had a variety of problems: undiagnosed and treatable arthritic conditions such as psoriatic arthritis and tophaceous gout. Some were ignorant about the risks and benefits of joint replacement surgery, about rehabilitation intervention, or about existing community resources such as transportation services. Persons with impaired function from arthritis were assessed by a rehabilitation team and were given specific management recommendations. A trained ombudsman assisted the clients in getting health care or community services. An experimental design was used to evaluate the advocacy program in improving function and to document patterns of utilization. The results suggest that persons who received the intervention were more likely to have improved their function status, but the numbers are too small to permit definite conclusions.