Patient Education In the Department of Medicine
Steps to Healthier Living trademark

Better Choice, Better Health ®- Arthritis
or Healthier Living With Arthritis
(Internet Arthritis Self-Management Program)


Launch your Digital Self-Management Program! Canary Health can deliver digital health self-management programs to your populations. To learn more, email Canary Health has licensed all online Stanford Self-Management Programs.

The Better Choices, Better Health®- Arthritis program, formerly named the Self-Management @ Stanford Healthier Living with Arthritis program is the online version of the Arthritis Self-Management Program. Groups of about 24 people with osteoarthritis, rheumatoid arthritis, fibromyalgia, or other rheumatic diseases participate together. Workshops are facilitated by two trained facilitators, one or both of whom are peers with a rheumatic condition. Topics covered include: 1) techniques to deal with problems such as pain, fatigue, frustration and isolation, 2) appropriate exercise for maintaining and improving strength, flexibility, and endurance, 3) appropriate use of medications, 4) communicating effectively with family, friends, and health professionals, 5) healthy eating, and, 6) making informed treatment decisions, 7) disease related problem solving, 8) getting a good night's sleep.

It is the process in which the online workshop is presented that makes it unique. Sessions are highly participative through email and online discussion boards, where mutual support and success builds the participants' confidence in their ability to manage their health and maintain active and fulfilling lives.

Each workshop is 6 weeks with new lessons each week. Participants are asked to log on at their convenience 2-3 times each week for a total of 1-2 hours. There are no requirements that participants log in at the same time. Each participant in the workshop receives a copy of the companion book, The Arthritis Helpbook, 6th Edition.

How was the Program developed?

The Healthier Living With Arthritis workshop is the online version of the community-based Arthritis Self-Management Program (ASMP), also known as the Arthritis Self-Help Course, which was developed and evaluated during several randomized, controlled research projects since 1979. The the development and evaluation of the online program was funded by the National Institutes of Health.

The process of both the online and community-based workshops are based on the experience of the investigators and others with self-efficacy, the confidence one has that he or she can master a new skill or affect one's own health. The content of the workshop was the result of focus groups with people with arthritis, in which the participants discussed which content areas were the most important to them.

How was the online program evaluated?

We recruited 700 adult study participants in 2003-2004. All participants had a diagnosis of osteoarthritis, rheumatoid arthritis, or fibromyalgia and lived in the United States. Qualified participants were randomly assigned to either participate immediately in the workshop or to a control group. The control group waited to take the workshop for 12 months. Both groups completed 5 online questionnaires about their health status, health care utilization, self-efficacy and self-management behaviors over a 2-year period.

What were the results?

Participants at six months compared to controls demonstrated improvements in pain, disability, health distress, role function, self-reported health, and self-efficacy to deal with the consequences of arthritis. There were no changes in exercise or health care utilization. These outcomes remained the same at 12 months. At that time, participants compared to controls also demonstrated a decrease in hospitalizations.

Is the program being offered?

The National Council on Aging (NCOA) has licensed the Arthritis Online program. See the NCOA website for more information. If you are a participant and would like to take part in a workshop, please email


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