Randomized Controlled Trial of an Educational Intervention Using an Online Risk Calculator for Knee Osteoarthritis: Effect on Risk Perception

Abstract

Objective Young adults, in general, are not aware of their risk of knee osteoarthritis (OA). Understanding risk and risk factors is critical to knee OA prevention. We tested the efficacy of a personalized risk calculator on accuracy of knee OA risk perception and willingness to change behaviors associated with knee OA risk factors. Methods We conducted a randomized controlled trial of 375 subjects recruited using Amazon Mechanical Turk. Subjects were randomized to either a) use a personalized risk calculator based on demographic and risk factor information (intervention) or b) view general OA risk information (control). At baseline and after the intervention, subjects estimated their 10-year and lifetime risk of knee OA and responded to contemplation ladders measuring willingness to change diet, exercise, or weight-control behaviors. Results Subjects in both arms had an estimated 3.6% 10-year and 25.3% lifetime chance of developing symptomatic knee OA. Both arms greatly overestimated knee OA risk at baseline, estimating a 10-year risk of 26.1% and a lifetime risk of 47.8%. After the intervention, risk calculator subjects’ perceived 10-year risk decreased by 12.9 percentage points to 12.5% and perceived lifetime risk decreased by 19.5 percentage points to 28.1%. Control subjects’ perceived risks remained unchanged. Risk calculator subjects were more likely to move to an action stage on the exercise contemplation ladder (RR = 2.1). There was no difference between the groups for diet or weight-control ladders. Conclusions The risk calculator is a useful intervention for knee OA education and may motivate some exercise-related behavioral change.

Disclosure of Personalized Rheumatoid Arthritis Risk Using Genetics, Biomarkers, and Lifestyle Factors to Motivate Health Behavior Improvements: A Randomized Controlled Trial

“…Rungs on the ladder correspond to stages of motivation to change behavior according to the trans-theoretical model as a progression through precontemplation, contemplation, preparation, action, and maintenance (27). The contemplation ladder outcome was originally validated in studies investigating behavior change in smokers and has been commonly used as an outcome in clinical trials measuring motivation to change many health behaviors (25,26,(28)(29)(30).…”

Peer Review #1 of "Crowdsourcing in medical research: concepts and applications (v0.1)"

“…Crowdsourcing approaches have already been used to enhance formative, pre-clinical, and clinical research (Table 3) Manuscript to be reviewed Amazon Turk or other platforms to recruit study participants into online randomized controlled trials. (Jones et al 2013;Losina et al 2017;Tang et al 2016a;Tang et al 2016b) While such approaches are often rapid and save money, there are concerns about generalizability.…”

Crowdsourcing in medical research: theory and practice

“…Many studies have used Amazon Turk or other platforms to recruit study participants into online randomized controlled trials. 7,[71][72][73] While such approaches are often rapid and save money, there are concerns about generalizability. 74 Crowdsourcing has been used to identify potentially relevant citations as part of systematic reviews.…”