Ester Manuel, Zafar Saania, Dhiman Kiran, Graveline Christine, McKinnon Annette, Hoens Alison, Barber Claire
McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada
O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada.
BMJ Open. 2025 Feb 20;15(2):e094220. doi: 10.1136/bmjopen-2024-094220.
OBJECTIVES: To review publicly available physical activity (PA) resources for individuals with rheumatoid arthritis (RA). Aims were to find online print and audiovisual resources, review their characteristics and critically examine their quality from medical, exercise and behavioural science perspectives. DESIGN: An environmental scan was completed using the Google search engine, following a pragmatic approach to reviewing patient-facing self-care resources. DATA SOURCES: We used combinations of common search terms for RA and PA. The first five pages of results were reviewed for patient-facing resources. ELIGIBILITY CRITERIA: Resources were included if they were (1) included RA-specific content, (2) provided specific PA recommendations, (3) written in English and (4) freely available. DATA EXTRACTION AND SYNTHESIS: Two independent experts completed a medical review of resources to ensure appropriateness for RA. Data were then extracted by two reviewers using a standardised template to record resource characteristics. Two research team members and two patient partners independently evaluated resources for readability, understandability and actionability. Finally, the quality of exercise recommendations and behaviour change technique use was evaluated by an expert reviewer. RESULTS: The search yielded 23 RA-specific PA resources, 17 of which passed the medical review. All 10 print resources and 7 audiovisual resources were created in English-speaking countries. The mean reading grade was 9.0±1.5. Print resources had mean understandability of 80.0±9.8% and actionability of 60.0±27.7%. Audiovisual materials had mean understandability of 86.0±9.2% and actionability of 86.9±22.9%. The quality of exercise recommendations was low. Only one resource provided comprehensive cardiovascular exercise advice, and two resources provided comprehensive strength exercise advice. 3-14 behaviour change technique groups were featured in each resource. The most common groups were 'shaping knowledge' and 'natural consequences'. CONCLUSIONS: The quality of RA-specific PA resources is variable. Some high-quality resources exist that provide actionable PA behaviour change advice. Healthcare teams may refer patients to these resources. However, more work is needed to improve the overall quality of resources. Codevelopment with patients, providers and exercise behaviour change experts is recommended, ensuring resources are actionable, contain clear exercise recommendations and promote behaviour change.
目的:回顾类风湿关节炎(RA)患者可公开获取的身体活动(PA)资源。目标是查找在线印刷品和视听资源,回顾其特点,并从医学、运动和行为科学角度严格审查其质量。 设计:采用实用方法审查面向患者的自我护理资源,使用谷歌搜索引擎完成环境扫描。 数据来源:我们使用了RA和PA的常见搜索词组合。对结果的前五页进行审查,查找面向患者的资源。 纳入标准:符合以下条件的资源纳入研究:(1)包含RA特定内容;(2)提供具体的PA建议;(3)用英文撰写;(4)免费获取。 数据提取与综合:两名独立专家对资源进行医学审查,以确保其适用于RA。然后由两名审阅者使用标准化模板提取数据,记录资源特征。两名研究团队成员和两名患者伙伴独立评估资源的可读性、可理解性和可操作性。最后,由一名专家审阅者评估运动建议的质量和行为改变技术的使用情况。 结果:搜索得到23个RA特定的PA资源,其中17个通过医学审查。所有10个印刷资源和7个视听资源均在英语国家创建。平均阅读年级为9.0±1.5。印刷资源的平均可理解性为80.0±9.8%,可操作性为60.0±27.7%。视听材料的平均可理解性为86.0±9.2%,可操作性为86.9±22.9%。运动建议的质量较低。只有一个资源提供了全面的心血管运动建议,两个资源提供了全面的力量训练建议。每个资源中包含3 - 14个行为改变技术组。最常见的组是“塑造知识”和“自然结果”。 结论:RA特定的PA资源质量参差不齐。存在一些高质量资源,提供了可操作的PA行为改变建议。医疗团队可将患者推荐至这些资源。然而,需要开展更多工作来提高资源的整体质量。建议与患者、提供者和运动行为改变专家共同开发资源,确保资源具有可操作性,包含明确的运动建议并促进行为改变。
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