About This Step-By-Step Guide

    Who Should Use It
    What Is Its Purpose
    How to Use It



Welcome to the Implementing the Arthritis Foundation Life Improvement Series through Partnerships: A Step-by-Step Guide! This Guide was created as part of an Infrastructure Improvement Project, a collaborative effort between the Arthritis Foundation (AF) and the Centers for Disease Control and Prevention (CDC) Arthritis Program to improve the delivery of and increase the numbers of people reached by effective AF programs.  This section provides a quick overview of the purpose of the Guide and how to effectively utilize this valuable resource.



Different conventions are used throughout this Guide to highlight important information and resources. These include:


  • Key terms are italicized and defined in “Key Definitions” boxes
  • Web site links are underlined


  •    Within the body of a chapter, cross-references to Examples from the Field
                and other sections or resources in the Guide are identified with this icon
  •   The Action Checklists are marked with this icon
  •   Take Note! messages are boxed and marked with this icon
  •   Tip sheets, which provide more detailed “how-to” information, are identified
                with this icon in their header
  •   Tools, which include worksheets and forms, are identified with this icon
                in their header



Arthritis is a significant public health problem, affecting the quality of life of millions of Americans. The Arthritis Foundation (AF) Life Improvement Series, including the AF Aquatic Program, AF Exercise Program and AF Self-Help Program, are effective arthritis self-management education and exercise programs that can decrease the pain and disability that result from arthritis. Today these programs are greatly underutilized. The Arthritis Foundation, state health departments and their partners want to bring these programs to more people who can benefit. How? Some strategies that can improve the dissemination of the programs are outlined below:


  • Embed the AF Life Improvement Series programs in systems. The current approach utilized often involves working with individual facilities. One leader is trained in one of the programs, and that leader in turn teaches one or a few classes at one site, only reaching a limited number of participants. A more effective approach is to disseminate the programs through existing community-based networks of delivery sites (i.e., using system partners). Through this type of systems approach, a number of program personnel in the selected systems are trained to deliver the AF programs in multiple host sites.

    Chapter 1-1: Understanding the Systems Approach and Effective Program Delivery
    Chapter 1-2: Identifying Potential System Partners

  • Redefine staff as facilitators/ brokers instead of doers. AF and state health department staff often spend a significant portion of time leading classes and/or training workshops themselves. This leaves little time for staff to develop partnerships and to market AF programs to organizations that may incorporate the programs into their routine plan of work. Using a system partner’s personnel to implement the programs has the benefit of creating ownership within the partnering organization and increases chances of sustainability.

    See: Chapter 1-4: Securing the Commitment

  • Broaden awareness of the AF programs and their benefits. Market research has shown that there is a low level of awareness among consumers about the AF Life Improvement Series programs and the program benefits. Targeted marketing strategies with a broader reach are needed to increase the number of program participants. In addition, many potential partners do not understand the value of offering these evidence-based programs. Resources have been developed to assist AF and health department staff to inform potential partners about the program benefits.




EVIDENCE-BASED PROGRAMS:  interventions that (1) are packaged so they can be delivered in the same way each time they are offered (i.e. maintaining fidelity) and (2) have an accumulation of data that show they work in people with arthritis. This includes data from randomized controlled studies, published in scientific, peer-reviewed journals. The three AF Life Improvement Series programs (AF Aquatic Program, AF Exercise Program and AF Self-Help Program) meet the criteria of evidence-based interventions.



About This Step-By-Step Guide

The previous section provided an overview of strategies to improve program dissemination and increase the number of people with arthritis who benefit from the programs. The Implementing the Arthritis Foundation Life Improvement Series through Partnerships: A Step-by-Step Guide is designed to help you adopt these strategies. In this section, you will learn about the Guide’s target audiences, its purpose and some tips on how to use it.


Who Should Use It?

This Step-by-Step Guide is designed to be used by organizations charged with coordinating the dissemination of evidence-based arthritis self-management education and exercise programs. Specifically:


  • Staff persons at the Arthritis Foundation
  • CDC-funded health department staff

The Guide also includes resources that will be useful to those involved in program delivery, including:


  • System partners who can use parts of the Guide to support their networks of local service providers
  • "On the ground" service agencies/ facilities and program personnel including trainers, leaders and instructors


What Is Its Purpose?

The Implementing the Arthritis Foundation Life Improvement Series through Partnerships: A Step-by-Step Guide is designed to support your work in embedding evidence-based AF Life Improvement Series programs into sustainable delivery systems. This Guide will provide:


  • Framework that incorporates a systems approach toward building partnerships
  • Information on how to identify potential partners, market your programs, sustain partnerships
  • Tools including practical information, strategies, tips and resources to embed evidence- based programs in sustainable delivery systems


How to Use It

Chapters, states, system partners and communities vary in their needs and resources. Accordingly, this Guide provides a variety of information, tools and resources that you can use and adapt as needed to fit your particular needs. Keep in mind that only parts of the Guide may be applicable to you.

To use this Step-by-Step Guide, first review the table of contents to get an overview of the topics. The Guide is divided into three parts. In Parts 1 and 2, the first few pages of each chapter provide a quick synopsis of the objectives, key topics and principles covered. Each chapter also includes resources and practical tips and how-to information.

Part 1: Establishing and Maintaining System Partnerships (Chapters 1-1 to 1-5), is geared toward helping staff at AF chapters and states understand the process of embedding programs in sustainable program dissemination systems to significantly expand the reach of evidence-based programs. Part 1 also highlights the other essential elements for effective program dissemination.

Part 2: Resources for Program Implementation (Chapters 2-1 to 2-12), covers specific program-delivery related tasks. The sections in Part 2 are designed to be stand-alone pieces that could be given to the agencies or individuals that will be responsible for those tasks.

Part 3: Examples from the Field contains success stories which demonstrate what has worked for AF chapters and state health departments. References to these successes are also included within the earlier chapters.



To find sections quickly, go to the Table of Contents or the alphabetical listing of resources in the Tip Sheets and Tools tab.

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