Table 3.
Proposed Arthritis-Specific Modifications to the ALED Program, With Associated Comments by Participants and Instructors, North Carolina, 2004
| Topic Area of Proposed Modification | Comments by Participants and Instructors | Proposed Modification |
|---|---|---|
| Instructor training, handbook, and support | ||
| Arthritis | "A lot of people started asking…specifically why exercise is good for people with arthritis." (Instructor) "I didn't know a lot about arthritis, but all of the information that…[we received]…helped me understand a little bit more…[about the needs of]…people with arthritis." (Instructor) |
Include a short section in the instructor handbook that discusses a basic overview of arthritis and the impact of physical activity on joints. |
| "[For] people with arthritis, the number one reason [not to exercise] is pain. And I really didn't have an answer for what to do if you have too much pain….I don't want to tell…[class participants to push themselves if they]…have pain." (Instructor) | Include a short section in the instructor handbook that addresses pain management for people with arthritis. Instructors should have the information they need to appropriately tailor exercise goals and activities for the participants. | |
| Access to arthritis resources | "It is extremely comfortable to have this partnership with the university…[T]hey had the 1-800 number…[that class participants] could call with…specific questions [about arthritis that]…we weren't equipped to answer…." (Instructor) | Provide handouts from the National Institute of Arthritis and Musculoskeletal Skin Diseases and the Arthritis Foundation to instructors during training and during the course. If possible, have a contact from a state public health agency available for questions by phone or e-mail. |
| Program content | ||
| Pain management | "You know a lot of concerns were the pain. 'I can't do this.' But the techniques that were given in the book allowed…[course participants] to feel OK that if they had a lot of pain one week or one day, that they could reset their goals for the next week." (Instructor) | Instructors should emphasize concrete pain management techniques during the course, such as working at your own pace and exercising "bit by bit." |
| Information on diet, nutrition, and complementary strategies for arthritis management | "You always hear these advertisements about natural foods that are supposed to stop the pain. I would have liked to learn more…[about] that." (Participant) | Incorporate a lesson on diet and nutrition into the ALED program. |
| Arthritis-specific content in ALED textbook | "I think the book was very good, but it might have helped if…[it] had suggested different things for people with arthritis.…I think that some of the stuff in the book was a little too hard for us to do." (Participant) "A lot of people don't know too much about their body…. I think there needs to be some diagrams and something to show the knee and the hip and what…[they do]." (Participant) |
Add a short section to the textbook that addresses pain as a barrier to physical activity. This section should also address how to protect against injury, monitor and manage symptoms, and accommodate exercise according to symptoms. |