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How Was Our Model Developed

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The PREVAIL model of care, as well as this exercise resource website, was developed using input from adults with RA and a review of existing evidence to guide our collection of resources. We will be using additional feedback from adults with RA and updating information with health literacy in mind to ensure this resource remains relevant, updated, and easy to understand.

Adults with rheumatoid arthritis from the UNC Health System were selected to participate in an interview about their experience with RA as part of the PREVAIL study (IRB 21-2200, 22-3194). These individuals had a range of symptoms, personal characteristics, and experience with rehabilitation. Participants were invited to discuss their lived experiences with RA and exercise. They were asked to identify their personal barriers and facilitators to exercise and provide insights and suggestions regarding tools or resources to promote exercise.

Participants expressed interest in a resource that provides:

  • Evidence that exercise is safe, beneficial, and can be modified for RA,
  • Information on incorporating physical therapy into a care plan, particularly early after diagnosis,
  • Resources for finding physical therapists and expectations on what to expect with physical therapy,
  • Information on general wellness and educational resources,
  • Digital exercises/videos that are short, easy, and tailored to RA.

The PREVAIL model of care exercise resource aims to provide individuals will enough information to make informed choices on what is best for their needs and encourages adults with RA to explore exercise as a way to manage symptoms in their day-to-day lives.

This website was created following exercise prescription and patient education guidelines from the American College of Rheumatology (ACR), American College of Sports Medicine (ACSM), European Alliance of Associations for Rheumatology (EULAR), and the Royal Dutch Society for Physical Therapy, to name a few. We also reviewed literature focused on clinical practice guidelines and rehabilitation utilization for adults with RA. The Cochrane Database was used for the systematic review process.
We collected a wide array of resources through our review of existing evidence based on the needs, wants, and concerns expressed by our interview participants. This includes not only exercise videos, but informative websites, community resources, and testimonials. Each source is reviewed by one physical therapist and determined to be consistent with evidence-based practices. We hope to continue expanding our content as the study progresses.
Health information can be confusing or difficult to understand for many people, which can lead to health inequity. One way to combat this is by increasing health literacy, one’s “ability to find, understand, and use information and services to inform health-related decision and actions for themselves and others,” (for more information on this topic, visit the NIH Health Literacy page).

The UNC Health Science Library Language Guide and Readability Calculators were used during the development of this website to make it inclusive and easier to understand. The “Exercise Terminology” page is included to improve health literacy and increase understanding of exercise and medical terms that may appear during care for RA.