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Measuring the Value of Program Adaptation: A Comparative Effectiveness Study of the Standard and a Culturally Adapted Version of the Arthritis Self-Help Program

HSS Journal: Volume 10, Issue 1



Arthritis remains an important public health problem.


This study aims to determine the effects of an adapted (vs. the original) Arthritis Self-Help Program (ASHP) among older adults. Specifically, this study sought to determine (1) whether the adapted ASHP improved attendance, retention, and adherence with the use of self-management exercises, and (2) if the original ASHP’s beneficial outcomes were maintained following program adaptation.

Patient and Methods

Individuals age ≥60 with self-reported arthritis were recruited from eight New York City senior centers. Participants were assessed at baseline to assess their demographic and clinical status and at 6 and 24 weeks to ascertain study outcomes using validated measures.


Two-hundred-one participants (64 non-Hispanic African Americans, 86 Hispanics, and 51 non-Hispanic Whites) enrolled. Participants in the adapted (vs. original) ASHP had better average attendance in the six session program (4.7 vs. 3.2 classes attended, p < 0.01) and program retention (93% vs. 74%, p < 0.01). Adherence with use of the self-management exercises (number of days using endurance, stretching, and relaxation exercises) was similar in both groups. Significant positive physical/psychosocial outcomes were documented in both the adapted and original program.


The adapted ASHP improved program attendance and retention while maintaining improvements in physical and psychosocial functions. These results support future efforts to employ controlled designs to quantify the benefits of adapted evidence-based programs to ensure that adaptation maintains program effectiveness.

Level of Evidence: Therapeutic Study Level II.

This article appears in HSS Journal: Volume 10, Issue 1.
View the full article at springerlink.com.

About the HSS Journal

HSS Journal, an academic peer-reviewed journal published three times a year, February, July and October. The Journal accepts and publishes peer reviewed articles from around the world that contribute to the advancement of the knowledge of musculoskeletal diseases and disorders.


M. Carrington Reid, MD, PhD

Division of Geriatrics and Gerontology, Weill Cornell Medical College, New York, NY
Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College, New York, NY

Emily K. Chen, MA

Department of Human Development, Cornell University, Ithaca, NY

Samantha J. Parker, AB

Tulane University School of Medicine, New Orleans, LA

Charles R. Henderson, Jr., MS

Department of Human Development, Cornell University, Ithaca, NY

Karl Pillemer, PhD

Department of Human Development, Cornell University, Ithaca, NY


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