{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T11:18:41Z","timestamp":1789471121925,"version":"build-2803163510"},"reference-count":15,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:00:00Z","timestamp":1759795200000},"content-version":"unspecified","delay-in-days":98,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Lupus Sci Med"],"accepted":{"date-parts":[[2025,9,17]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>There is increasing recognition of the need for patient-centred lupus self-management (SM) programmes to improve outcomes. The purpose of this manuscript is to describe the underlying methodology and initial pilot results of Strategies to Embrace Living with Lupus Fearlessly (SELF): an evidence-based digital SM intervention designed for individuals with lupus based on the Transtheoretical Model of Behaviour Change.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We describe pilot testing and initial feasibility and acceptability results of SELF among individuals with lupus. Participants for the 90-day pilot test were recruited through three Centers for Disease Control &amp; Prevention-funded lupus registry sites across the USA and the Lupus Foundation of America\u2019s constituency, including a diverse sociodemographic lupus population, using varied sources. Feasibility, acceptability and preliminary impact were assessed using data on enrolment, retention, ease of utilisation and satisfaction with SELF\u2019s features, changes in readiness for SM behaviours, impact on patient-reported outcomes (eg, fatigue interference) and user feedback.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Nearly 80% of participants had moderate or high skill gaps at programme intake (ie, were in an early stage of change for a key SM skill), underscoring the importance of digital SM programmes like SELF. Among those who completed the programme, almost 60% of participants closed a skill gap by mastering one or more SM skills. Significant effects on patient\u2013provider interactions and fatigue interference were also noted, highlighting a need for future investigation. Qualitative data were mostly positive in terms of feasibility and acceptability, with specific recommendations for future improvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SELF utilisation and pilot data indicate that SELF is generally feasible and acceptable, particularly among those needing to build lupus SM skills. Future work will explore ways to improve the digital SM intervention and reduce barriers to initial and ongoing engagement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/lupus-2025-001580","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T05:30:48Z","timestamp":1759901448000},"page":"e001580","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Programme evaluation of Strategies to Embrace Living with Lupus Fearlessly (SELF): an evidence-based digital programme to build and improve lupus self-management skills"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1885-0017","authenticated-orcid":false,"given":"Sarah D","family":"Gilman","sequence":"first","affiliation":[{"name":"Wayfinder Health Strategies, Falls Church, Virginia, USA"},{"name":"Clinical Research and Leadership, The George Washington University, Washington, District of Columbia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Johnson","sequence":"additional","affiliation":[{"name":"Pro-Change Behavior Systems Inc, Kingston, Rhode Island, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Carpenter","sequence":"additional","affiliation":[{"name":"Lupus Foundation of America Inc, Washington, District of Columbia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"French","sequence":"additional","affiliation":[{"name":"Lupus Foundation of America Inc, Washington, District of Columbia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Castle","sequence":"additional","affiliation":[{"name":"Pro-Change Behavior Systems Inc, Kingston, Rhode Island, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2361-0787","authenticated-orcid":false,"given":"S Sam","family":"Lim","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Emory University School of Medicine, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charmayne","family":"Dunlop-Thomas","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Emory University School of Medicine, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6832-7291","authenticated-orcid":false,"given":"Cristina","family":"Drenkard","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Emory University School of Medicine, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Dall\u2019Era","sequence":"additional","affiliation":[{"name":"UCSF, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily C","family":"Somers","sequence":"additional","affiliation":[{"name":"University of Michigan-Ann Arbor, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanna","family":"Zick","sequence":"additional","affiliation":[{"name":"University of Michigan-Ann Arbor, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melicent","family":"Miller","sequence":"additional","affiliation":[{"name":"Lupus Foundation of America Inc, Washington, District of Columbia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2502-1372","authenticated-orcid":false,"given":"Daniel J","family":"Wallace","sequence":"additional","affiliation":[{"name":"Rheumatology, Cedars-Sinai Medical Center, West Hollywood, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5396-4362","authenticated-orcid":false,"given":"Victoria P","family":"Werth","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA"},{"name":"Philadelphia Veteran\u2019s Administration Medical Center, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Crimmings","sequence":"additional","affiliation":[{"name":"Lupus Foundation of America Inc, Washington, District of Columbia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,10,7]]},"reference":[{"key":"2026010700555730000_12.2.e001580.1","doi-asserted-by":"publisher","DOI":"10.7326\/M17-0102"},{"key":"2026010700555730000_12.2.e001580.2","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1097\/BOR.0000000000000646","article-title":"Update on lupus epidemiology: advancing health disparities research through the study of minority populations","volume":"31","author":"Drenkard","year":"2019","journal-title":"Curr Opin Rheumatol"},{"key":"2026010700555730000_12.2.e001580.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.rdc.2020.07.002"},{"key":"2026010700555730000_12.2.e001580.4","doi-asserted-by":"publisher","DOI":"10.1207\/S15324796ABM2601_01"},{"key":"2026010700555730000_12.2.e001580.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0738-3991(02)00032-0"},{"key":"2026010700555730000_12.2.e001580.6","first-page":"1586","article-title":"Benefits of a self-management program in low-income African-American women with systemic lupus erythematosus: results of a pilot test","volume":"21","author":"Drenkard","year":"2012","journal-title":"Lupus (Los Angel)"},{"key":"2026010700555730000_12.2.e001580.7","doi-asserted-by":"crossref","unstructured":"Fortin PR , Neville C , Julien A-S , et al . Measuring the Impact of MyLupusGuideTM in Canada: Results of a Randomized Control Study. Arthritis Care Res (Hoboken) 2010. doi:10.1002\/acr.24871","DOI":"10.1002\/acr.24871"},{"key":"2026010700555730000_12.2.e001580.8","unstructured":"LFA . Lupus foundation of america launches online self-management program, self, to support people living with lupus. 2022. PR newswire; 2022."},{"key":"2026010700555730000_12.2.e001580.9","doi-asserted-by":"publisher","DOI":"10.4278\/0890-1171-12.1.38"},{"key":"2026010700555730000_12.2.e001580.10","unstructured":"Carpenter K , French M , Balestrieri S , et al . Feasibility and acceptability of an online intervention for lupus self-management based on the transtheoretical model of change. 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