In the Journals

Web-based tool increased RA knowledge in patients' relatives

Jeffrey A. Sparks

A web-based educational intervention was effective in raising awareness of increased risk among parents, siblings and children of patients with rheumatoid arthritis, who were largely unaware of the condition’s risk factors, according to findings published in Arthritis Care and Research.

“Much progress has been made in identifying risk factors for RA, but it is unclear whether those at risk for developing RA are aware of them,” Jeffrey A. Sparks, MD, MMSc, of Brigham and Women’s Hospital and Harvard Medical School, in Boston, told Healio Rheumatology. “We enrolled unaffected first-degree relatives of patients with RA into an RA education trial because they are at increased RA risk and are familiar with RA due to their family history.”

To determine the education level of first-degree family members — defined as parents, siblings and children — of patients of RA regarding risk factors, and whether a personalized, web-based tool could help in raising awareness, the researchers conducted a randomized controlled trial of 238 patient relatives. Recruited from families at Brigham and Women’s Hospital, participants were aged less than 70 years, and had not received a diagnosis of RA. Investigators randomly assigned 80 participants to receive standard RA education, 78 to use a web-based RA information tool, and 80 to use the web-based tool and participate in a one-on-one session with a trained health educator.

The web-based tool, called the Personalized Risk Estimator for RA (PRE-RA), was an interactive website adapted from Your Disease Risk — available at www.yourdiseaserisk.wustl.edu — which the researchers modified to take into account personalized genetic and biomarker information, as well as RA-specific material. The tool displayed personalized RA risk factors for each user, including genetics, autoantibodies, demographics and behaviors, and provided additional education and information regarding each. The researchers collected RA knowledge scores from each participant at baseline as well as 6 weeks, 6 months and 1 year following education.

According to the researchers, few patient relatives were familiar with behavioral risk factors for RA, with 15.9% positively identifying dental health, 31.9% identifying smoking, 47.5% recognizing obesity and 54.2% identifying diet. However, following education, knowledge scores increased among participants in all three groups, although improvements in knowledge were more pronounced in both PRE-RA cohorts (P < .05). Among relatives who used PRE-RA plus the one-on-one education session, 83.1% positively identified smoking as a risk factor at 6 weeks. Among those who received only PRE-RA training, that figure was 71.8%, and 43.1% among those who received standard education (P < .05).

“At baseline prior to education, most relatives were unaware of RA risk factors,” Sparks said. “After education, knowledge of RA risk factors improved by all methods, but the group randomized to receive results personalized to genetics, autoantibodies, and behaviors had the greatest improvement in RA risk factor knowledge. These results suggest that personalized RA education may lead to increased knowledge of RA risk factors and subsequent improvements in health behaviors.” – by Jason Laday

Disclosure: Sparks reports funding from the National Institute of Arthritis and

Musculoskeletal and Skin Diseases and the Rheumatology Research Foundation Scientist Development Award. See the full study for additional authors’ disclosures.

Jeffrey A. Sparks

A web-based educational intervention was effective in raising awareness of increased risk among parents, siblings and children of patients with rheumatoid arthritis, who were largely unaware of the condition’s risk factors, according to findings published in Arthritis Care and Research.

“Much progress has been made in identifying risk factors for RA, but it is unclear whether those at risk for developing RA are aware of them,” Jeffrey A. Sparks, MD, MMSc, of Brigham and Women’s Hospital and Harvard Medical School, in Boston, told Healio Rheumatology. “We enrolled unaffected first-degree relatives of patients with RA into an RA education trial because they are at increased RA risk and are familiar with RA due to their family history.”

To determine the education level of first-degree family members — defined as parents, siblings and children — of patients of RA regarding risk factors, and whether a personalized, web-based tool could help in raising awareness, the researchers conducted a randomized controlled trial of 238 patient relatives. Recruited from families at Brigham and Women’s Hospital, participants were aged less than 70 years, and had not received a diagnosis of RA. Investigators randomly assigned 80 participants to receive standard RA education, 78 to use a web-based RA information tool, and 80 to use the web-based tool and participate in a one-on-one session with a trained health educator.

The web-based tool, called the Personalized Risk Estimator for RA (PRE-RA), was an interactive website adapted from Your Disease Risk — available at www.yourdiseaserisk.wustl.edu — which the researchers modified to take into account personalized genetic and biomarker information, as well as RA-specific material. The tool displayed personalized RA risk factors for each user, including genetics, autoantibodies, demographics and behaviors, and provided additional education and information regarding each. The researchers collected RA knowledge scores from each participant at baseline as well as 6 weeks, 6 months and 1 year following education.

According to the researchers, few patient relatives were familiar with behavioral risk factors for RA, with 15.9% positively identifying dental health, 31.9% identifying smoking, 47.5% recognizing obesity and 54.2% identifying diet. However, following education, knowledge scores increased among participants in all three groups, although improvements in knowledge were more pronounced in both PRE-RA cohorts (P < .05). Among relatives who used PRE-RA plus the one-on-one education session, 83.1% positively identified smoking as a risk factor at 6 weeks. Among those who received only PRE-RA training, that figure was 71.8%, and 43.1% among those who received standard education (P < .05).

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“At baseline prior to education, most relatives were unaware of RA risk factors,” Sparks said. “After education, knowledge of RA risk factors improved by all methods, but the group randomized to receive results personalized to genetics, autoantibodies, and behaviors had the greatest improvement in RA risk factor knowledge. These results suggest that personalized RA education may lead to increased knowledge of RA risk factors and subsequent improvements in health behaviors.” – by Jason Laday

Disclosure: Sparks reports funding from the National Institute of Arthritis and

Musculoskeletal and Skin Diseases and the Rheumatology Research Foundation Scientist Development Award. See the full study for additional authors’ disclosures.