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Evidence-based programs that are proven to improve the quality of life for adults with arthritis.

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Arthritis-Appropriate, Evidence-Based Interventions (AAEBIs) are programs that have been shown to improve arthritis symptoms, such as pain or limitations in function. These programs have to meet a list of criteria and can include but are not limited to community-based settings, clinical settings, and virtual settings. The criteria were initially created by the Centers for Disease Control and Prevention’s Arthritis Program and are now adapted and upheld by the Osteoarthritis Action Alliance (OAAA). An AAEBI review process ensures that programs are supported scientifically, address arthritis-related symptoms, and can be reasonably implemented. The list of fully reviewed and approved AAEBIs will continue to grow as more programs apply to be considered.

The current list of approved Arthritis-Appropriate Evidence-Based Interventions highlights two types of programs: Physical Activity programs and Self-Management Education programs. Physical Activity programs are designed to help increase physical activity safely and comfortably. Self-Management Education programs are designed to teach individuals how to cope with arthritis-related symptoms and how to adopt healthy behaviors to maintain active and fulfilling lives. Both types of interventions reflect effective prevention and management strategies for addressing arthritis.

Did you know that some AAEBIs are also considered Evidence-Based Falls-Prevention Programs by The National Council on Aging? Learn more about these programs in this short flyer!

 

This year, the OAAA has expanded the menu of AAEBI programs to 23 by adding two programs to the list of recognized AAEBIs.

These newly recognized programs expand the current list of recognized Lifestyle Management Programs for arthritis. All programs – existing and newly recognized – are described below.

If you are interested in having your program considered as an AAEBI, our application cycle will re-open in 2025. You can learn more about the process HERE!

 

 

Physical Activity Programs

  • AEA Arthritis Foundation Exercise Program        
  • Active Living Everyday                                
  • Arthritis Foundation Aquatic Program
  • Camine Con Gusto
  • Enhance®Fitness
  • Fit & Strong!
  • Fit & Strong! Plus
  • Otago Exercise Program 
  • Stay Active and Independent for Life
  • Tai Chi for Arthritis
  • Tai Ji Quan: Moving for Better Balance
  • Walk With Ease – Self-Directed & Group

Newly Recognized Programs

  • My Knee Exercise Program
  • GLA:D®

 

Self-Management Education Programs

  • Better Choices, Better Health®
  • Chronic Disease Self-Management Program
  • Chronic Pain Self-Management Program
  • Enhance®Wellness
  • Program to Encourage Active, Rewarding Lives (PEARLS)
  • Tomando Control de su Salud
  • Toolkit for Active Living with Chronic Pain 
  • Toolkit for Active Living with Chronic Conditions
  • Workplace Chronic Disease Self-Management Program

 

Click here to compare the details of the Physical Activity AAEBIs in a cross-sectional table

Physical Activity Cross-Sectional Table

CLICK HERE TO DOWNLOAD A PDF VERSION OF THIS TABLE!
Active Living Every DayAEA Arthritis Foundation Exercise Program AEA Arthritis Aquatic ProgramEnhance Fitness
Fit and Strong!Good Life with osteoArthritis: Denmark (GLA:D)My Knee Exercise Program Otago Exercise ProgramTai Chi for Arthritis Tai Ji Quan: Moving for Better BalanceWalk With Ease + Camine Con Gusto (Spanish version of WWE)
Priority Audience Adults of all ages are referred by a variety of organizations such as worksites, hospitals, community health programs, colleges, fitness centers, older adult programs and residences, and grant-funded initiatives.Adults suffering from arthritis and similar conditions, seniors, active and sedentary adultsAdults with arthritis, related rheumatic diseases or musculoskeletal conditions, ranging from people who are older, sedentary and very limited by impaired joint mobility to those who are relatively active with only mild joint involvementOlder adults from frail to fit and people aging with disabilityOlder adults with osteoarthritis in lower extremitiesPeople with symptoms of knee and hip osteoarthritis (regardless of stage of osteoarthritis)People with knee osteoarthritisAlmost anyone can use this program with appropriate adaptations, from frail to fit and people aging with disability.Almost anyone can use this program with appropriate adaptation for individual conditions, especially people with arthritis or other chronic conditions, who are sedentary, and would like to improve their activities levels, physical function and wellness of body and mind.Older adults with leg muscles weakness, abnormal gait, walking difficulty, or at risk of falling. Also people with movement or balance disorders People with arthritis and people who seek to improve physical activity levels
Program ContentActive Living Every Day is an evidence-based behavior change program. The approach is unique because it addresses the root causes of inactivity rather than simply prescribing exercise. Using facilitated group-based problem-solving methods to integrate physical activity into everyday living, participants learn the skills they need to become and stay physically active.• Exercise planning
• Low impact exercises
• Stretching
• Balance exercises
• Strengthening exercises
• Sitting, staning, or lying exercises
• Daily living skills
A recreational group exercise program conducted in warm water that consists of two levels, Basic and Plus. Exercises in the Basic level:
• Improve range of motion
• Increase Muscle strength and endurance
• Reduce pain and stiffness
• Maintain or improve mobility, muscle strength and functional ability.

Also includes Endurance-building routines, relaxation exercises and health education topics.
• Fitness Assessment
• Cardiovascular Exercise
• Dynamic/Static Balance Work
• Strength Training with Weights as Appropriate
• Flexibility exercises
• Socialization
• Stretching
• Balance exercises
• Range of motion exercises
• Resistance exercises
• Exercises that mimic daily activities
• Problem-solving and self-management skill building
• Plan ongoing personal exercise programs
Neuromuscular exercise program:
• Aerobic warm-up
• 10 exercises (4 levels of difficulty) for core and lower body
• Cool-down (stretch and gait training)

Self-management educational sessions:
• Knowledge about osteoarthritis and evidence-based treatment
• Exercise and self-management strategies
• Osteoarthritis education information
• A recommended 6 month leg strengthening exercise program
• guidance to increase general physical activity levels
17 exercises in total:
• 5 strengthening
• 12 balance
Gentle tai chi exercises that can be adapted by almost anyone to improve control of:
• Arthritis symptoms
• Balance
• Reduce falls
• Improve flexibility, strength, and cardiovascular fitness.
• Improve immunity
• Reduce stress to gain more tranquility
An evidence-based fall prevention program derived from a contemporary routine known as Simplified 24-Form Tai Ji Quan (pronounced tye gee chuwan). TJQMBB consists of an 8-form core with built-in Tai Ji Quan - Mini Therapeutic Movements®.• Health education
• Stretching and strengthening
• Warm-up and cool-down exercises
• 10-35 minute walk
Program Benefits/Goals/OutcomesThis program allows participants to:
• Identify and address barriers to physical activity
• Increase self-confidence about becoming physically active
• Create realistic goals and rewards for physical activity
• Develop Social Support
• Recover from lapses in physical activity
• Improved range of motion
• Improved stability
• Better health
• Increased motor skills
• Overall sense of well-being
• Better quality of life
• Reduce pain/inflammation
• Increase social interaction
• Fun, safe and effective way to promote better health
• Improved joint function
• Increased Muscular Strength
• Maintains or improves physical function
• Protects against falls and fall injury
• Decreases depression
• Provides a social benefit
• Promotes a physically active lifestyle
• Reduces medical-care utilization costs (~$945/participant annually)
• Saves healthcare costs for managed care plans
• Decreases skilled nursing costs
• Decreases unplanned hospitalizations
• Improve exercise frequency
• Reduce arthritis-related joint pain and stiffness
• Increase strength
• Improve confidence in ability to exercise
Results from more thank 75,000 participants show:
• Decreased pain
• Reduced intake of pain killers
• Improved chair stands capacity
• Increased walking speed
• Improved quality of life
• Cost-effective
• Reduced knee pain
• Improved physical function
• Improved quality of life
• Improved pain self-efficacy
The Otago program is a structured and progressive exercise program with the goal of improving:
• Lower extremity strength
• Balance
• Mobility.

These exercises can be progressed, and when ready, the participants is prescribed a walking program
• Relief of arthritis pain
• Improve balance
• Feel better with oneself
• Improve self-efficacy
• Reduce falls
• Improve physical function and health in general
• Improving postural stability
• Awareness and mindful control of body positioning in space
• Functional walking
• Movement symmetry and coordination
• Range of motion around the ankle and hip joints
• Lower-extremity muscle strength
• Global cognitive function.
• Improved balance
• Improved physical performance
• Preventing falls and injurious falls
The overall goals of the Walk With Ease Program are:
• To promote education about successful physical activity for people with arthritis
• To promote education about arthritis self-management and walking safely and comfortably
• To encourage participants to continue their walking program and explore other exercise and self-management programs that deliver proven benefits for people with arthritis.
Program Format• In-person class/group
• 1-on-1in-person
• Remote delivery by phone, email, or video conferencing
• In-person class/group
• Virtual self-directed
• In-person group • Instructor Led In-person class/group sessions
• Virtual class/group sessions
• Instructor-led in-person group sessions• In-person, group based supervised sessions
• Virtual format available in some countries
• Virtual self-directed/self paced• In-person 1-on-1
• In-person class/group
• Remote delivery by phone, email or video conference
• Virtual class/group
• At home/self-directed
• In-person class/group sessions
• At home/self directed with video
• In-person class/group
• In-person at home
• Online group
• Self-Directed
• Group format with Instructor
Class Size8-15 participants (maximum of 20)5-25 participantsNo greater than 20 participants 10-25 participants20-25 participants • Commonly 5-8 participants
(recommended no more than 12)
N/A, self-directed • N/A for self-directed
• 1-on-1
• 10-20 for group session
1 to 20 participants for in-person session• N/A for Self-Directed
• For Group ideal class size is 12 - 15 participants per leader.
Active Living Every DayAEA Arthritis Foundation Exercise Program AEA Arthritis Aquatic ProgramEnhance Fitness
Fit & Strong!Good Life with osteoArthritis: Denmark (GLA:D) My Knee Exercise Program Otago Exercise Program Tai Chi for Arthritis Tai Ji Quan: Moving for Better BalanceWalk With Ease + Camine Con Gusto (Spanish version of WWE)
Program Sessions/Duration1-hour, 1 time per week30 to 60 minutes, 2-3 times per week1 hour, 2-3 times a week1 hour, 3 times per week90 minutes, 3 times per weekSelf-management education sessions:
• 60-90 minutes, once weekly for 2 weeks ( some clinics offer a third session lead by former participant)
Neuromuscular exercise sessions:
• 60 minutes, 2 times per week for 6 weeks
• 30 minutes recommended per each session, 3 times a week• 30-60 minutes, 2-3 times per week• 1 hour, 1-2 times a week

• Encouraged to practice most days for 15-30 minutes
• 1 hour, 1-2 times a week

• Encouraged 1 hour per week
1 hour, 3 times per week (group)
Total Program Length12 weeksOngoing• 11 weeks

• Ongoing if desired
• Most are ongoing.

• 16 weeks for pre & post measurement
8 weeks6-8 weeks3, 8-week recommended regimens totalling 24 weeks (6-months)• Best results are seen when participation exceeds 17 weeks

• Group sessions often offered in 8-week segments
• 8 to 16 weeks

• Ongoing if desired
• 12-24 weeks

• Encouraged 24 weeks
6 weeks
Instructor Qualifications• A trained facilitator who may have a background as a wellness coach, certified fitness instructor, nurse, teacher, public health professional, or a lay leader.
• At least 1 trained facilitator is needed per class.
• AFEP trained
• CPR/AED
• AFAP Certification
• CPR/AED
• Must have either lifeguard or water safety certification
• 12 hours of specialized EnhanceFitness Master training
• Nationally recognized fitness certification or equivalent strongly recommended
Certified exercise instructor or Master Trainers for A Matter of Balance or Chronic Disease Self-Management Program.• Certified health care practitioner (most commonly physiotherapist)
• GLA:D certified (2-day course on osteoarthritis, evidence-based treatment, registry-based effect evaluation, practical training on delivery of the neuromuscular exercise program and self-management education)
N/A• Instructors need to be trained in the Otago program

Online training (directed to physical therapists)
Instructor certified by the Tai Chi for Health Institute and CRP• Preferred trained lay leader/facilitator, fitness instructor, physical therapist, occupational therapist, nurse, certified fitness instructor

• Individuals who are interested in teaching this community-based fall prevention program must receive training through authorized TJQMBB trainers.

• Online WWE Leader training.
• At least one trained leader per group.
• Current certification in CPR is required. (Live skills training required; online-only courses are not acceptable.) First aid certification is strongly recommended.
• Professional liability insurance coverage with an aggregate/single occurrence limit not less than one million dollars ($1,000,000.00) for personal injury or property damage, unless covered by the host facility’s comprehensive or professional liability insurance policy.
Active Living Every DayAEA Arthritis Foundation Exercise Program AEA Arthritis Aquatic ProgramEnhance Fitness
Fit & Strong!Good Life with osteoArthritis: Denmark (GLA:D)My Knee Exercise Program Otago Exercise Program Tai Chi for Arthritis Tai Ji Quan: Moving for Better BalanceWalk With Ease + Camine Con Gusto (Spanish version of WWE)
Program LicensingYesNoNoNoYesYesNoYesYesNo
Language Offerings• English • English
• Korean
• Spanish
• Spanish • Classes offered at sites in 16 languages. (Languages noted are spoken by participants & instructors in class, not language of class materials).
• Class and instructor training materials are available in English and Mandarin
• English
• Spanish
• English (Canada, Australia, New Zealand, Ireland)
• Danish (Denmark)
• German (Switzerland, Austria, Germany)
• Chinese (China)
• French (Switzerland)
• Italian (Switzerland)
• Dutch (The Netherlands)
• English • English
• Chinese
• Spanish
• English
• Spanish - Camine Con Gusto
Approximate Costs• The Active Living Every Day, Third Edition text is required and costs $49.95 per book. Bulk discounts apply on quantities of 25 or more.

• The Active Living Every Day Facilitator Training Course/Facilitator package is $399 per facilitator. Bulk discounts for 5 or more facilitator training packages are available.
$109• Participant cost varies, participant manuals are $2.30 per person

• $99-129 training for prospective AFAP
See website for details:
Enhance Fitness Cost
• Participant costs: Varies. Around $35 to cover cost of participant manuals.
• Leader/ Host Costs: License at $2,000 for the main site and $400 for each satellite site for the first year or $1,000 if only offered at one site.
• Manuals for each participant at $35 each.
• GLA:D is a not-for profit initiative based at University of Southern Denmark
• Instructor cost vary between countries, typically similar to 2-day courses for physiotherapists
• Participants cost is at most similar to the cost of a used bicycle
No CostDependent on format and location.Around $10 per class per participant• $89 training for prospective instructors

• $11.95 per participant book (required).

Discounted books for community based organizations are available.
Research/Journal ArticleALED Intervention EvaluationAEA Exercise Program researchAquatic Exercise Program research

Additional research
Enhance Fitness ResearchSee Fit & Strong website page on research evidenceSee GLA:D website page on research evidence My Knee Exercise Program research

My Knee Exercise Program research summary
Otago Program research

Otago Modality Research
See Tai Chi for Arthritis website page on research evidence See Tai Ji Quan: Moving for Better Balance website page on research evidenceWWE Self-Directed research

Click here to compare the details of the Self-Management Education AAEBIs in a cross-sectional table

Self-Management Education Cross-Sectional Table

CLICK HERE TO DOWNLOAD A PDF VERSION OF THIS TABLE!
Better Choices, Better Health (Online CDSMP) Chronic Disease Self-Management ProgramTomando Control De Su Salud (Spanish Version of Chronic Disease Self Management Program) Chronic Pain Self-ManagementWorkplace Chronic Disease Self-Management Program
Enhance Wellness

Program to Encourage Active, Rewarding Lives (PEARLS)
Priority Audience
Anyone living with one or more chronic health conditions or ongoing symptoms

People with any physical or mental chronic condition or multiple chronic conditionsSpanish-speakers with any physical or mental chronic condition or multiple chronic conditionsPeople with chronic pain conditions such as back pain, arthritis, or headachesEmployees of the hosting workplace with any physical or mental chronic conditions or multiple chronic conditionsOlder adults and people aging with disabilityOlder adults living in poverty with multiple chronic conditions who are reached through social services and underserved by clinical care (e.g. people of color, homebound, limited English proficiency)
Program Content• Goal Setting
• Action Planning
• Decision Making
• Problem Solving
• Communication
• Symptom Management
• Exercise
• Healthy Eating
• Managing Medications
• Stress Management
• Managing Emotions
• Navigating Resources
• Working with Your Healthcare Team
• Planning for the Future
• An interactive workshop where participants learn skills to manage their chronic conditions on a day to day including:
• exercise
• healthy eating
• symptom management (pain, fatigue, sleep, shortness of breath, stress and depression)
• weight loss
• communication skills.

Core self-management skills taught include:
• action planning
• problem solving
• decision making
• An interactive workshop where participants learn techniques to deal with symptoms of chronic conditions such as:
• fatigue
• pain
• sleeplessness
• shortness of breath
• stress
• emotional problems such as depression, anger, fear and frustration.

Core self-management techniques that are taught include:
• topics to help with healthy eating
• appropriate use of medications
• managing depression
• decision making
• appropriate exercises for maintaining and improving strength, flexibility and endurance
• For those living with chronic pain, participants can learn the skills to manage their pain on a day to day basis including:
• exercise
• healthy eating
• cognitive pain management

Participants will also learn how to deal with such concerns as:
• fatigue
• sleep problems
• difficult emotions
• weight loss
• communicating with family, friends, and coworkers

Core self-management skills taught include:
• action planning
• problem solving
• decision making
• An interactive group workshop where participants learn self-management skills to manage their conditions on a day-to-day basis including:

• balancing work and home life
• exercise
• healthy eating
• pain
• fatigue
• sleep
• shortness of breath
• stress
• depression
• weight loss
• communication skills

Self-management skills taught include:
• action planning
• problem solving
• decision making
• Connects participants with a personal health coach to improve physical, emotional and social well-being.

• based on the Chronic Care Model,
• EW’s participant- centered approach uses motivational interviewing techniques and validated assessment tools in 10+ domains to guide Health Action Plan creation and accountability.

• Through the use of problem-solving strategies participants can clarify goals, responsibilities, and activities as they work toward health-related behavioral change.
• Brief behavioral interventions for depression including:
• problem-solving and
• pleasant physical and social activity planning (behavioral activation)
• teaching about what depression is and isn't (psychoeducation)
• social support
• connection to other social and health services
Program Benefits/Goals/Outcomes• Improved Health Status
• Increased Health Behaviors
• Improved A1-c
• Increased Self-Efficacy
• Reduced Pain and Fatigue
• Improved Health Behaviors: (exercise, medication adherence, communication with health professionals)

• Reduced Symptoms: (pain, fatigue, shortness of breath, depression)

• Reduced health care utilization (ED visits, physician visits, hospital days)
• Improved Health Behaviors: (exercise, medication adherence, communication with health professionals)

• Reduced Symptoms: (pain, fatigue, shortness of breath, depression)

• Reduced health care utilization (ED visits, physician visits, hospital days)
• Less pain: (Improved quality, problem, severity)

• Other outcomes: (Less depression, less dependency, increased self-efficacy, improved role behaviors and life satisfaction)
• Improved exercise and eating behaviors
• Reduced fatigue
• 72% decrease in hospital days
• 35% decrease in psychoactive medication use
• 11% decrease in depression
• Significant reduction in rehospitalizations and HMO utilization – overall increased health
• Lower depression, social isolation and loneliness
• Improved well-being
Program Format• Virtual Self-Directed/Self-
Paced for 6 weeks
• In-person Group Workshop
• Virtual Group Workshop
• Mailed Toolkit with or without Phone Call Check-in
• In-person Group Workshop
• Virtual Group Workshop
• Mailed Toolkit with or without Phone Call Check-in
• In-person Group Workshop
• Virtual Group Workshop
• Mailed Toolkit with or without Phone Call Check-in
• In-person Group Workshop
• Mailed Toolkit with or without Phone Call Check-in
• In-person 1-on-1 format• 1-on-1 In person
• Virtual Remote Format
• Over-The-Phone Remote Format
Class Size• 20-30 participants• 12-14 participants for face-to-face workshop
• 8-12 for virtual workshop
• 3-5 participants per Toolkit with scripted phone call workshop
• 12-14 participants for face-to-face workshop
• 8-12 for virtual workshop
• 3-5 participants per Toolkit with scripted phone call workshop
• 12-14 participants for face-to-face workshop
• 8-12 for virtual workshop
• 3-5 participants per Toolkit with scripted phone call workshop
• 12-14 participants for face-to-face workshop
• 3-5 participants per Tool Kit with scripted phone call workshop
• N/A, 1-on-1 format• N/A, 1-on-1 format
Better Choices, Better Health (Online CDSMP) Chronic Disease Self-Management ProgramTomando Control De Su Salud (Spanish Version of Chronic Disease Self Management Program)Chronic Pain Self-ManagementWorkplace Chronic Disease Self-Management Program
Enhance Wellness
Program to Encourage Active, Rewarding Lives (PEARLS)
Program Sessions/Duration • 30 min sessions 3 times a week• In-Person and Virtual Workshop: 2 and ½ hours per session

• Mailed Toolkit with phone calls: 45-60 minute small group phone calls per session

• Mailed Toolkit without phone calls: Self-Directed
• In-Person and Virtual Workshop: 2 and ½ hours per session

• Mailed Toolkit with phone calls: 45-60 minute small group phone calls per session

• Mailed Toolkit without phone calls: Self-Directed
• In-Person and Virtual Workshop: 2 and ½ hours per session

• Mailed Toolkit with phone calls: 45-60 minute small group phone calls per session

• Mailed Toolkit without phone calls: Self-Directed
• In-Person Workshop:
50-55 minutes per session

• Mailed Toolkit with phone calls: 25-30 minute small group phone calls per session

• Mailed Toolkit without phone calls: Self-Directed
• In-Person Workshop:
50-55 minutes per session

• Mailed Toolkit with phone calls: 25-30 minute small group phone calls per session

• Mailed Toolkit without phone calls: Self-Directed
• Variable, dependent on need.
• 6 to 8 one hour sessions tapered weekly to monthly
Total Program Length• 6 weeks plus ongoing alumni community group • In-person workshop:
1 session per week for 6 weeks

• Virtual workshop:
1 session per week for 6 weeks

• Mailed Toolkit with phone calls:
1 session per week for 6 weeks

• Mailed Toolkit without weekly phone calls is self-directed.
• In-person workshop:
1 session per week for 6 weeks

• Virtual workshop:
1 session per week for 6 weeks

• Mailed Toolkit with phone calls:
1 session per week for 6 weeks

• Mailed Toolkit without weekly phone calls is self-directed.
• In-person workshop:
1 session per week for 6 weeks

• Virtual workshop:
1 session per week for 6 weeks

• Mailed Toolkit with phone calls:
1 session per week for 6 weeks

• Mailed Toolkit without weekly phone calls is self-directed.
• In-person workshop:
2 sessions per week for 6 weeks

• Mailed Toolkit with phone calls: 2 sessions per week for 6 weeks

• Mailed Toolkit without weekly phone calls is self-directed
• 6 months• 6-8 months
Instructor Qualifications• Canary Peers certified online facilitator (complete 6-week facilitator training)• Trained by SMRC-certified Master Trainers, 2 trained Leaders, one or both of whom are non-health professionals with a chronic condition themselves, for both in person and virtual workshops

For Phone-led workshops, only 1 leader is needed.
• Trained by SMRC-certified Master Trainers, 2 trained Leaders, one or both of whom are non-health professionals with a chronic condition themselves, for both in person and virtual workshops

For Phone-led workshops, only 1 leader is needed.
• Trained by SMRC-certified Master Trainers, 2 trained Leaders, one or both of whom are non-health professionals with a chronic condition themselves, for both in person and virtual workshops

For Phone-led workshops, only 1 leader is needed.
• Trained by SMRC-certified Master Trainers, 2 trained Leaders, one or both of whom are non-health professionals with a chronic condition themselves, for both in person and virtual workshops

For Phone-led workshops, only 1 leader is needed.
• Social Workers, Registered Nurses, Community Health Workers, Registered Dietitians, others with Motivational Interviewing Experience
• See website for more details.
Enhance Wellness - Become a Coach
• PEARLS Coach training (distance): an online, self-paced training course and an additional 90-minute, live-over-Zoom practice session.
Program LicensingYesYesYesYesYesYesNo
Language OfferingsEnglishEnglish, French Canadian
Chinese, French, Italian, Hmong, Hindi, Russian, Vietnamese, Arabic, Creole-Haitian, Finnish, Danish, Samoan, Tongan. For Spanish and Portuguese see Tomando Control de Su Salud
English, See: Chronic Disease Self-Management Program, PortugueseEnglish, Spanish, French, CanadianEnglish, Spanish 1:1 program, materials are in English but program offered in variety of languages by bilingual coaches• We have community-translated PEARLS forms available in English, Spanish, Chinese, Somali and Russian.

• In addition, organizations have delivered PEARLS in Cantonese, Ilocano, Korean, Khmer, Mandarin, Ukrainian, Vietnamese, Tagalog.

The training and toolkit are currently only in English.
Better Choices, Better Health (Online CDSMP) Chronic Disease Self-Management ProgramTomando Control De Su Salud (Spanish Version of Chronic Disease Self Management Program)Chronic Pain Self-ManagementWorkplace Chronic Disease Self-Management Program
Enhance Wellness
Program to Encourage Active, Rewarding Lives (PEARLS)
Approximate CostCanary offers a turn key service and provides facilitators, workshop administration, book fulfillment, access to platform with 6 week workshop and ongoing alumni community. Organizations purchase workshop slots at approximately $275 per workshop participant that shows up to the program• License Cost $550: lasts three years and includes 20 workshops.

• Participants books cost: 15 to 20 dollars a person depending on volume ordered.
• License Cost $550: lasts three years and includes 20 workshops.

• Participants books cost: 15 to 20 dollars a person depending on volume ordered.
• License Cost $550: lasts three years and includes 20 workshops.

• Participants books cost: 15 to 20 dollars a person depending on volume ordered.
• License Cost $550: lasts three years and includes 20 workshops.

• Participants books cost: 15 to 20 dollars a person depending on volume ordered.
See website for details: Enhance Wellness Program Cost$500/person for PEARLS Coach Training. Other costs for in-person delivery include staff outreach, screening, and session time-associated costs, mileage reimbursement, and clinical supervision time-associated costs (~1-2 hrs/mo)
Research/Journal Article Better Choices Better Health Research Article 1

Article 2

Article 3
CDSMP Research Articles (Virtual and In-Person)

CDSMP Related Research Articles (Toolkit)
Tomando Control De Su Salud Research ArticlesCPSMP Research Articles (Virtual and In-Person)

CPSMP Related Research Articles (Toolkit)
wCDSMP Research ArticlesCitations - Project EnhancePEARLS Research Article

 

Program Descriptions

Newly Recognized Programs

GLA:D®

https://gladinternational.org

GLA:D is a combined self-management education and physical activity program led by a GLA:D® certified therapist.

The GLA:D® neuromuscular exercise component is a structured and progressive exercise program aimed at enhancing confidence in knees and hips, functional strength, balance, and movement control during everyday activities.

The program is typically conducted in groups of 5-8 participants and includes a warm-up (aerobic component), 10 exercises, each with four levels of difficulty for both the core and lower body, as well as a cool-down phase (stretching and gait training). An initial assessment by a certified GLA:D® therapist helps determine your individual starting level. Progression occurs when exercises are performed with good movement quality and without experiencing more than acceptable pain. Participants are encouraged to maintain a record of their progression and pain levels in an exercise diary.

Each session lasts for 1 hour and is conducted twice a week for 6 weeks. Chair stand capacity and walking speed are assessed before and after the program. During the final sessions, the therapist and participant discusses ongoing exercise options for the future including how to retain improvements through daily physical activity.

The GLA:D® self-management education component comprises two group-based educational sessions, each lasting 60-90 minutes, led by a certified GLA:D® therapist. In some clinics, there is also an optional third session led by a former GLA:D® participant. The first session primarily delves into understanding osteoarthritis and evidence-based treatments, including exercise, dietary recommendations, pharmacological pain relievers, and surgical options. The second session is centered around exercise and self-management strategies. The sessions are interactive with participant engagement and discussions encouraged.

 

My Knee Exercise Program

https://mykneeexercise.org.au

My Knee Exercise is a freely available website that contains a 6-month leg strengthening exercise program for people with knee osteoarthritis or persistent knee pain. The exercise program is fully self-directed and designed to improve knee symptoms. Instructional videos are provided for each recommended exercise as well as details of how each exercise can be made more, or less, challenging, depending on your abilities.  In addition to the exercise program, the website includes educational information about knee osteoarthritis and exercise as well as guidance to increase overall physical activity levels.

 

List of Recognized Physical Activity Programs

AEA Arthritis Foundation Exercise Program

https://aeawave.org/Arthritis/Arthritis-Foundation-Programs

The Arthritis Foundation Exercise Program is a community-based, recreational exercise program developed by the Arthritis Foundation. Trained AFEP instructors cover a variety of range-of-motion and endurance-building activities, relaxation techniques and health education topics. All the exercises can be modified to meet participants needs. The program’s demonstrated benefits include improved functional ability, decreased depression and increased confidence in one’s ability to exercise. Classes typically meet two or three times per week for an hour. 

 

Active Living Everyday

http://www.activeliving.info

Active Living Everyday (ALED) is a group-based program developed at the Cooper Institute that focuses on helping sedentary people become and stay physically active. Participants learn skills needed to become more physically active, such as identifying and overcoming barriers, setting goals, and creating an action plan. The program addresses a variety of moderate and vigorous physical activities and provides background information that can be used to make personal decisions about the type and amount of exercise to pursue. Participants do their actual physical activity outside of the group setting. Classes meet once a week for 12 to 20 weeks. Trained and certified facilitators (instructors) teach the course in conjunction with a participant book.

 

Arthritis Foundation Aquatic Program

https://aeawave.org/Arthritis/Arthritis-Foundation-Programs

The Arthritis Foundation Aquatic Program (AFAP) is a water exercise program created by the Arthritis Foundation and the Y-USA for people with arthritis and related conditions. The classes are conducted by a trained instructor and include joint range of motion, stretching, breathing, and light aerobic activities. The classes typically meet two or three times per week for one hour for six to 10 weeks.

 

Camine Con Gusto (Spanish version of the Walk With Ease Self-Directed Program)

https://www.afstore.org/shopping_product_detail.asp?pid=53408

Camine Con Gusto (CCG) Self-Directed arthritis physical activity program was developed by researchers at the Thurston Arthritis Research Center, UNC-Chapel Hill and is owned by the Arthritis Foundation. The primary audience is adults who have been either self or medically diagnosed with arthritis or have other chronic conditions and wish to be more physically active.   The CCG guidebook leads participants through the program, including setting goals, identifying barriers, conducting self-assessments, stretching exercises, strengthening exercises, and – of course – walking.  Participants are encouraged to walk at least three times per week, working up to 30 min per session or more.

CCG addresses four primary goals: (1) to provide education about safe and effective physical activity for people with arthritis; (2) to provide basic information about arthritis and arthritis symptom management; (3) to guide participants through key behavior change steps to increase physical activity; and (4) to provide participants with a step-by-step approach to increasing and maintaining physical activity levels based on the latest research and recommendations.

 

Enhance®Fitness

https://projectenhance.org/enhancefitness/

Enhance®Fitness is an arthritis friendly low-cost, evidence-based group exercise and falls prevention program that helps older adults at all levels of fitness become more active, energized, and empowered. Classes meet for one hour three times a week in person, online, or in hybrid mode. Over 99% of participants say they would recommend Enhance Fitness to a friend. 

This program is proven to:

  • Improve physical function
  • Decrease depression
  • Protect against falls and fall injury
  • Provide a social benefit
  • Promote a physically active lifestyle
  • Reduce medical care utilization costs
  • Decrease unplanned hospitalizations
  • Decrease mortality rates

 

Fit & Strong!

https://fitandstrong.uic.edu

Fit & Strong! is a community-based physical activity and behavior change intervention offering stretching, balance, aerobic, and endurance exercises. Health education, problem-solving, and goal setting also are important components of Fit & Strong!. The program was designed to target sedentary older adults who are experiencing lower-extremity joint pain and stiffness and adults with osteoarthritis. Fit & Strong! classes are 90 minutes 3 times per week for 8 weeks and are delivered by a certified exercise instructor.

 

Fit & Strong! Plus

https://fitandstrong.uic.edu/about-fit-strong/versions/plus/

Fit & Strong! Plus is the physical activity plus weight loss version of the Fit & Strong! program, a recognized physical activity AAEBI. Fit & Strong! Plus has the same structure (twenty-four 90-minute classes consisting of 60 minutes of physical activity and 30 minutes of health education, goal setting, and group problem solving). The physical activity routine (warm-up, low-impact aerobics, lower extremity strength training, and cool down) is the same as the traditional program, but the health education has been modified to include a systematic participant-engaged curriculum on healthy eating and weight loss. Participants are also regularly weighed in class and perform homework activities like keeping food diaries, reading labels, healthy shopping, and food preparation. The goals of Fit & Strong! Plus are to help adults with lower extremity arthritis adopt healthy eating habits in addition to physical activity to manage their weight and osteoarthritis. Workshops are led by certified fitness instructors trained in Fit & Strong! Plus.

 

Otago Exercise Program

https://www.med.unc.edu/aging/cgwep/courses/exercise-program/

The Otago Exercise Program (OEP) is a structured and progressive exercise program with the goal of improving lower extremity strength, balance, and mobility. The program consists of 17 exercises that can be progressed either by intensity or by balance challenge. Participants perform their exercises 2-3 times a week, for 30-60 minutes. They are prescribed progressively challenging exercises over the course of the program. In addition, when ready the participant is prescribed a walking program 3 times a week for 30 minutes.

 

Stay Active & Independent for Life (SAIL)

https://www.sailfitness.org

Stay Active & Independent for Life (SAIL)  is a strength, balance, and fitness program for adults 65 and older. Performing exercises that improve strength, balance, and fitness is the single most important activity that adults can do to stay active and reduce their chance of falling. The entire curriculum of activities in the SAIL Program can help improve strength and balance if done regularly. SAIL Fitness Classes may be offered at senior centers, community centers, YMCAs, parks and recreation facilities, trauma centers, hospital community outreach centers, churches, indoor malls, and community colleges.

The SAIL program is suitable for diverse participants (e.g., age, gender, ethnicity, functional status) and targets community-dwelling adults aged 65 and older, who are in need of a strength and balance program to remain active and independent and to reduce the risks of falling. 

 

Tai Chi for Arthritis

https://taichiforhealthinstitute.org/

Tai Chi for Arthritis (TCA) was developed to improve health with an emphasis on evidence-based efficacy and safety. Tai Chi’s Sun style was used for its ability to improve health, relieve arthritis pain, function, and its ease of use for older adults. Movements are performed at a higher stance to make it easier for older participants and those with arthritis and disability. Movements can be modified to accommodate mobility issues for any participant and can be done seated as a starting exercise. TCA, also known as Tai Chi for Arthritis and Fall Prevention, is led by a Tai Chi for Health Institute (TCHI) Board certified instructor. Participants should attend a minimum of one hour per week for 16 weeks or two hours per week for eight weeks.

TCA incorporates tai chi principles.  It has three components: warmup and cooldown exercises, six basic core movements, and six advanced extension movements. Another nine movements may be added to maintain participant interest and enhance program sustainability.

 

Tai Ji Quan: Moving for Better Balance

https://tjqmbb.org/

Tai Ji Quan: Moving for Better Balance® (TJQMBB) is an evidence-based balance training regimen designed for older adults at risk of falling and people with balance disorders. TJQMBB represents a substantive enhancement of traditional Tai Ji Quan training and performance as it transforms martial arts movements into a therapeutic regimen aimed at improving postural stability, awareness and mindful control of body positioning in space, functional walking, movement symmetry and coordination, range of motion around the ankle and hip joints, lower-extremity muscle strength, and global cognitive function. The program is delivered by a trained lay leader/facilitator, fitness instructor, physical therapist, occupational therapist, nurse,  or certified fitness instructor during two one-hour sessions each week for 24 weeks. Each session consists of warm-up exercises; core practices, which include a mix of practice of forms, variations of forms, and mini-therapeutic movements; and brief cool-down exercises.

 

Walk With Ease – Self-Directed

https://www.arthritis.org/health-wellness/healthy-living/physical-activity/walking/walk-with-ease/wwe-about-the-program

https://www.arthritis.org/getmedia/0d445dd7-ff2c-4956-82a1-d4843bb487f2/WWE-Self-Directed_1-2-3-FINAL.pdf

www.walkwitharthritis.org

The Arthritis Foundation’s Walk With Ease (WWE) Self-Directed arthritis physical activity program was developed by researchers at the Thurston Arthritis Research Center, UNC-Chapel Hill. The primary audience is adults who may be either self- or medically diagnosed with arthritis, or who have other chronic conditions and wish to be more physically active. The CCG guidebook leads participants through the program, including setting goals, identifying barriers, conducting self-assessments, stretching exercises, strengthening exercises, and – of course – walking.  Participants are encouraged to walk at least three times per week, working up to 30 min per session or more.

The self-directed program addresses four primary goals: (1) to provide education about safe and effective physical activity for people with arthritis; (2) to provide basic information about arthritis and arthritis symptom management; (3) to guide participants through key behavior change steps to increase physical activity; and (4) to provide participants with a step-by-step approach to increasing and maintaining physical activity levels based on the latest research and recommendations.

 

Walk with Ease – Group

https://www.arthritis.org/health-wellness/healthy-living/physical-activity/walking/walk-with-ease

Walk with Ease (WWE)–Group is a community-based walking program developed by the Arthritis Foundation. WWE group sessions meet three times per week for 6 weeks.  Trained group exercise leaders begin each session with a pre-walk discussion covering a specified topic related to exercise and arthritis, followed by a 10- to 40-minute walk that includes a warm-up and a cool-down period.

 

List of Recognized Self-Management Education Programs

Better Choices, Better Health®

https://canarypeers.com/bcbh-better-choices-better-health/

Better Choices, Better Health® (BCBH) is an internet-based group workshop that uses content from the Chronic Disease Self-Management Program. It focuses on chronic disease management, decision-making, problem-solving, and action-planning. Participants log on at their convenience 2-3 times per week for a total of approximately two hours; participants do not need to log on at the same time. Trained peer coaches facilitate the group dynamic and provide additional support to workshop participants. All the interactions occur through the secure web application and are designed to leverage both self-discovery and peer interactions to increase participants’ self-efficacy.

 

Chronic Disease Self-Management Program

https://www.selfmanagementresource.com/

The Chronic Diseases Self-Management Program (CDSMP) is an effective self-management education workshop for people with chronic health problems including arthritis, diabetes, lung and heart disease. This program covers topics such as techniques to deal with problems associated with chronic disease, appropriate exercise, appropriate use of medications, communicating effectively with family, friends, and health professionals, nutrition, and, how to evaluate new treatments. Participants demonstrated significant improvements in exercise, ability to do social and household activities, less depression, fear and frustration or worry about their health, reduction in symptoms like pain, and increased confidence in their ability to manage their condition.

 

Chronic Pain Self-Management Program

https://www.selfmanagementresource.com/

The Chronic Pain Self-Management Program (CPSMP), was developed for people who have a primary or secondary diagnosis of chronic pain. Pain is defined as being chronic or long-term when it lasts for longer than 3 to 6 months (such as pain from arthritis), or beyond the normal healing time of an injury. The CPSMP may also benefit those who have conditions such as persistent headache, Crohn’s disease, irritable bowel syndrome, diabetic neuropathy, or those who experience severe muscular pain due to conditions such as multiple sclerosis. The CPSMP is held during a 2.5-hour session once a week over a six-week period. Classes are highly participative, where mutual support and success build the participants’ confidence in their ability to manage their health and maintain active and fulfilling lives. Classes are led by two trained leaders, one or both of whom are non-health professionals with chronic pain themselves. All leaders must be certified in the CPSMP.  The CPSMP can be offered by telephone, video platform, or in person.   It is available in English and Spanish.

 

Enhance®Wellness

https://projectenhance.org/enhancewellness/

Enhance®Wellness (EW) is an evidence-based program that connects participants with a trained personal health and wellness coach to improve physical, emotional, and social well-being. Based on the Chronic Care Model, EW’s participant-centered approach uses motivational interviewing techniques and validated assessment tools in ten+ domains to guide Health Action Plan creation and accountability. Through the use of problem-solving strategies, participants clarify goals, responsibilities, and activities as they work toward health-related behavioral change. The goal of the program is to maintain or increase the health and functional status of older adults with chronic conditions and people aging with disability.

 

Program to Encourage Active, Rewarding Lives (PEARLS)

www.pearlsprogram.org

 The Program to Encourage Active, Rewarding Lives (PEARLS), an intervention for adults and older adults with depression, aims to reduce symptoms of depression and suicidal ideation and improve quality of life.

 

PEARLS is delivered in six to eight 1-hour sessions by a trained health or social service professional (e.g., social worker, case manager, community health worker) in the client’s home or other community-based setting. Sessions are initially held weekly and become less frequent over a four- to five-month period. During sessions, clients choose the problems they would like to discuss; and the trained coach guides, teaches, and supports them in developing action plans that are implemented by the client between sessions to address these problems. Clients also plan meaningful and accessible physical, social, and pleasant activities to improve mood and energy.

 

Tomando Control de su Salud

(Spanish Chronic Disease Self-Management Program)

https://www.selfmanagementresource.com/

Tomando Control de su Salud is a self-management education program developed for Spanish-speaking people with chronic health problems. Tomando Control de su Salud was developed to address the health content and topics in a culturally appropriate manner. Topics covered in the program include appropriate use of the health care system, how to evaluate new treatments, communicating effectively with family, friends, and health professionals, healthy eating, appropriate use of medications, techniques to deal with problems, and appropriate exercises for maintaining and improving strength, flexibility, and endurance.

Toolkit for Active Living with Chronic Conditions

https://selfmanagementresource.com/programs/mail-program/

https://selfmanagementresource.com/programs/small-group/chronic-disease-self-management-small-group/

The Tool Kit for Active Living with Chronic Conditions is a mailed program based on the Chronic Disease Self-Management Program, or CDSMP. (Note: Original CDSMP program is already an AAEBI). The program has all the same components as CDSMP in a mailed pack. Each tool kit includes a book, relaxation and exercise CDs, and tip sheets for self-management. It also includes a self-test that participants can use to decide how they should use the materials. It can be used by itself or with small group (3-5 people) weekly scripted phone calls.

 

Toolkit for Active Living with Chronic Pain 

https://selfmanagementresource.com/programs/mail-program/

https://selfmanagementresource.com/programs/small-group/chronic-pain-self-management-small-group/

The Tool Kit for Active Living with Chronic Pain is a mailed program based on the Chronic Pain Self-Management Program, or CPSMP. (Note: Original CPSMP program is already an AAEBI). The program has all the same components as CPSMP in a mailed pack. Each tool kit includes a book, relaxation and exercise CDs, and tip sheets for self-management. It also includes a self-test that participants can use to decide how they should use the materials. It can be used by itself or with small group (3-5 people) weekly scripted phone calls.

 

Workplace Chronic Disease Self-Management Program

https://www.selfmanagementresource.com/

The Workplace Chronic Disease Self-Management Program (wCDSMP) is an adapted version of the Chronic Disease Self-Management Program (CDSMP, originally developed at Stanford) for use in the workplace. The primary goals and objectives for the program are to: 1. Improve self-management skills of employees with one or more chronic conditions; 2. Improve physical and mental health indicators of employees who participate in the program; and 3. Improve work performance and productivity indicators of employees who participate in the program. The program is conducted in a small group workshop during a 50-55 minute session, with two sessions held per week for six weeks. Classes are led by two trained CDSMP leaders, who have also attended the wCDSMP update, one or both of whom are non-health professionals with chronic disease, themselves. The classes are available in person or by video platform in both English and Spanish.


AAEBI Evaluation Overview

The purpose of the Arthritis-Appropriate, Evidence-Based Intervention (AAEBI) Evaluation Process is to review the Centers for Disease Control and Prevention’s published process for program evaluation, update the process as needed, and employ the process to screen promising intervention programs for elevation to recognized interventions that are proven to improve the quality of life of people with arthritis. Learn more about the AAEBI program review process and criteria here.

Programs were evaluated by a national group of reviewers with extensive expertise in arthritis research, AAEBIs, program evaluation, and program implementation. This activity was supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $461,914 with 100 percent funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, CDC/HHS, or the U.S. Government.