Interventions to reduce the impact of chronic disease: community-based arthritis patient education

Systematic development and testing of the efficacy of educational interventions to improve functioning, prevent disability, and reduce the impact of chronic disease has been limited, perhaps because many chronic diseases disable, do not kill, and because they are managed largely within home, work, and community environments and not within the medical care system. Until recently, these factors contributed to a paucity of arthritis educational interventions. But since the impetus provided by the establishment of the Multipurpose Arthritis Centers Program of the NIH (1977), a number of arthritis patient education programs have been established and evaluated. This chapter summarizes findings from community-based arthritis patient education studies conducted between 1980 and 1995, critiques the methods of these studies, and provides guidance for state-of-the-art community-based intervention research aimed at reducing the individual and social impact of arthritis and other chronic diseases.