Objective. Rheumatoid arthritis (RA) is a chronic inflammatory disease that affects the synovial joints. RA affects 0.5-2% of the population. Though it is predominantly a progressive disease, adjunct therapy may slow the destructive pathway or alleviate affiliated symptoms. This study examined the effects of lifestyle (diet and exercise) and self-efficacy on symptoms of RA as measured by disease activity and health satisfaction.

Methods. Seventy-five RA patients (77% female) from the Loma Linda University Faculty Medical Offices, Rheumatology Department completed self-assessment surveys on their lifestyle practices and RA affliction. Disease symptoms and activity were assessed with the Arthritis Impact Measurement Scales-symptoms (pain) component (AIMS2) and the Rapid Assessment of Disease Activity in Rheumatology (RADAR). Subjects also completed a RA self-efficacy scale and three outcome expectation items and questions that assessed their exercise patterns, dietary intake and current use of RA medication.

Results. Stepwise regression analysis revealed that, after controlling for demographics (n=60), high self-efficacy was associated with significantly fewer RA symptoms (AIMS2 [R2=.43; F (1,60) 6.06, p=.00001]; RADAR [R2=.59; F (1,60) 10.69, p^.000000004]) and greater health satisfaction (R2=.31; F [1,60] 4.39, p=.0002). A healthier diet was also associated with significantly greater health satisfaction.

Separate analysis was conducted among exercisers due to the unique patterns and differences compared to all subjects. Among RA subjects who exercised (n=43). those who had higher self-efficacy and exercised more frequently had less pain (R2=.44; F [1,43] 4.31, p=.001). Higher self-efficacy was associated with less disease activity (R2=.49; F [1,43] 5.62, p=.0001). Exercisers with high self-efficacy and a strong belief that exercise can reduce the symptoms of RA reported greater health satisfaction (R2=.54; F [1,43] 5.51, p=.0001).

Conclusions. Results suggest that RA patients with greater self-efficacy report more favorable RA disease activity scores. Patients who followed a healthy diet and who exercised experienced improved RA outcomes. Future research should include diet and exercise recommendations and techniques for improving self-efficacy among RA patients.


School of Public Health

First Advisor

Helen Hopp Marshak

Second Advisor

Edwin Krick

Third Advisor

Jennifer Mason

Degree Name

Doctor of Public Health (DrPH)

Degree Level


Year Degree Awarded


Date (Title Page)




Subject - Local

Arthritis, Rheumatoid; Cross-Sectional Studies; Life Style.



Page Count

xii; 136

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives