Identifying RA Risk Factors: Efficacy of Web-Based Educational Interventions

woman sitting on computer at desk
woman sitting on computer at desk
Personalized web-based education tools may lead to an increase in knowledge of RA risk factors.

A web-based educational intervention can effectively educate first-degree relatives of individuals with rheumatoid arthritis (RA) about modifiable risk factors for the disease, according to research published in Arthritis Care & Research.

Researchers from Brigham and Women’s Hospital Division of Rheumatology, Immunology, and Allergy in Boston, Massachusetts, conducted a randomized, controlled trial of first-degree relatives of people with RA. Using a web-based tool (Personalized Risk Estimator for RA [PRE-RA]), researchers sought to examine the efficacy of educational interventions on knowledge of RA risk factors.

The intervention was assessed in 238 first-degree relatives who were randomly assigned to 1 of 3 arms: 80 were assigned to the comparison arm, which received standard education; 78 were assigned to the PRE-RA arm, which used the web-based tool alone; and 80 were assigned to the PRE-RA Plus arm, which used the web-based tool plus a one-on-one session with a health educator. All participants received one additional “booster” education session according to their original study arm.

Primary study outcome was participants’ RA Knowledge Score (RAKS), calculated at baseline and then again immediately, 6 weeks, 6 months, and 12 months post-education.

RAKS were low across all study arms at baseline, with a statistically significant improvement noted in the PRE-RA and PRE-RA Plus groups following the educational intervention (mean RAKS: 7.0 and 7.2, respectively, vs 5.3 in the comparison group). Although RAKS score decreased over time, the researchers noted that it “remained higher than at baseline in all arms.” The additional benefit of a one-on-one education session in the PRE-RA Plus group was statistically significant only at 6 weeks and 12 months post-intervention (P <.05).

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Following the intervention, more participants in the PRE-RA arm vs the comparison arm were able to identify individual risk factors for RA correctly.

“Our results suggest that a web-based tool using personalized RA risk disclosure may be effective in educating unaffected [first-degree relatives] about RA risk factors,” the researchers concluded. “Since we found similar results when comparing the PRE-RA Plus and PRE-RA arms, this suggests that even without in-person facilitation, the PRE-RA tool could be widely implemented to educate about RA risk factors and motivate healthy behavior change.”


Prado MG, Iversen MD, Yu Z, et al. Effectiveness of a web-based personalized rheumatoid arthritis risk tool with or without a health educator for knowledge of RA risk factors [published online January 5, 2018]. Arthritis Care Res. doi:10.1002/acr.23510