Bet(t)er in balance with rheumatic arthritis

Rheumatic arthritis (RA) is a chronic disease that has a major impact on daily life. Recent evidence shows that healthy nutrition and physical activity can have a positive influence on well-being and functioning. Despite this evidence, people with RA struggle with changing their lifestyle habits.
Further, research on lifestyle interventions which aim to support lifestyle changes, show inconsistent results. One reason for these findings might be that RA is a very heterogeneous health condition and therefore personalized interventions might increase success rate. One way to personalize interventions/programs is using subtypes according to system biology. In preparation of this study the characteristics of these subtypes were translated to specific recommendations for nutrition, physical exercise and support for behavioural change. In an applied practical programme called “BETER” (English “BETTER”, a Dutch acronym for move, eat and change (Beweeg, Eet, verandER in Dutch)) these recommendations were used to tailor a lifestyle program to the characteristics and needs of the subtypes. The aim of this pilot study is to explore participant’s experiences with and use of the programme and describe pre-limerary results of changes in vitality, lifestyle and symptoms.

Twenty-30 adults with RA will be recruited. The BETER program consits of five digital sessions related to excercise, nutrition and mindset during a period of nine weeks. Particpants will also be supported by a personal coach. In between the sessions the personal coach will be available for questions and support. Further, participants can use a two supporting tools: 1) an app which contains information on their subtypes and monitors their aims and 2) an online platform with recipes and online cooking classes.
Measures will be performed before the start of the program (baseline T0), in the middle of the program (T1), immediately after completion of the program (T2) and a month later (follow-up T3). Demographical information of the participants will be collected as wells as RA specific information. Experiences with and use of the program by the participants will be investigated using questionnaires and a focus group discussion. In additional adherence to the program sessions will be monitored. Lifestyle, experienced vitality and symptoms will be measured using self-developed questionnaires. A visual analogue scale will be used to measure pain and the Health Assessment Questionnaire-Disability Index will be used to measure functional status.

The program will be experienced as feasible and satisfying by the participants
A positive change in vitality and life style as well as a decrease in symptoms will be observed.

T0: Before start of the intervention, T1: after two weeks, T2: end of the intervention, T3: after one month follow-up

A 9-week tailored life style program