Rheumatoid Arthritis Clinical Trial
Official title:
Health Beliefs and Health Behavior Practices Among Minorities With Rheumatic Diseases
This study will explore the diverse health beliefs and behaviors among minority patients with
rheumatic diseases. These diseases may cause joint pain, stiffness or swelling. Some can
involve bones, muscles, tendons or ligaments. Some cause abnormalities of the immune
system-the body's defense against disease. Some rheumatic diseases are painful or deforming
and some can be life-threatening. Many rheumatic diseases occur more often and more severely
in certain minority communities. This study will explore psychosocial and cultural factors
related to rheumatic disease in minorities.
Patients enrolled in the NIAMS protocol Natural History or Rheumatic Disease in Minority
Communities (protocol #01-AR-0227) may participate in this study. Participants will be
evaluated at the NIAMS Community Health Center at the Upper Cardozo Health Center in
Washington, D.C.
Participants will be interviewed about individual and community health behavior, and health
beliefs about rheumatic disease and its effects on several areas of their life, including
mood and physical activity. The interview will be in one of the following formats: 1)
in-depth cognitive interview, 2) focus group, or 3) face-to-face interview, as follows:
In-Depth Cognitive Interview
Participants take part in a one-time interview conducted by one investigator, observed by
another, and tape recorded. The interview lasts from 1 to 2 hours.
Focus Groups
Participants take part in a group interview of from 6 to 10 people during a one-time
tape-recorded session that lasts from 2 to 2-1/2 hours. The group discussion is led by a
moderator and a facilitator, who takes notes and makes observations.
Face-to Face Interview
Participants are interviewed twice - first upon enrollment at the NIAMS Community Health
Center and again after 6 months' follow-up at the Center.
Rheumatic diseases are among the most common health problems in the United States. They are a
diverse group of disorders, with several shared characteristics. Marked differences in the
incidence, prevalence, severity, processes of care, and outcomes in a number of rheumatic
conditions exist among racial and ethnic groups as compared to white Americans. Furthermore,
access to health care and treatment also differs in the minority community as compared with
the majority.
The effects of the disease may be modifiable by changes in life style, diet, activities and
exercise. Such changes are difficult for patients to accomplish and various strategies have
been developed to facilitate success. Strategies include educational materials and programs,
diet and exercise programs, patient support and empowerment programs and the like.
Differences in culture and environment, lack of culturally sensitive materials and
approaches, and lack of trained personnel may make these tools ineffective in the minority
community. Their effectiveness in the African-American or Latino clinic population has not
been assessed to date.
This is a descriptive, exploratory study designed to examine the diverse health beliefs and
behaviors among the minority patients who are enrolled in the NIAMS Natural History of
Rheumatic Disease in Minority Communities protocol (# 01-AR-0227). Qualitative and
quantitative methodology will be used to assess the psychosocial and cultural correlates of
rheumatic diseases in newly enrolled patients both at intake and after six months of being
followed at the NIAMS Community Health Center, an outreach site located in the District of
Columbia in the Upper Cardozo Health Center.
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