POS0298 UNDERSERVED POPULATIONS IDENTIFY BARRIERS AND PROPOSE SOLUTIONS FOR SELF-MANAGING ARTHRITIS AND CHRONIC CONDITIONS
Authors: S. Mills, K. Khehra, P. Ghuman, D. Au, C. L. Koehn, R. Maynard, N. Clark, C. Davis, A. Cui, C. B. Hamilton, D. Lacaille
Journal: Annals of the Rheumatic Diseases (2021)

Background: Underserved populations, such as ethnic minorities, low-income adults, and Indigenous people living with arthritis are more likely to have lower health literacy, higher rates of multi-morbidity, and face challenges in accessing care 1-3 . Self-management support (SMS) can help to mitigate the impacts of living with arthritis 4 . However, we require a more in-depth understanding of the daily barriers underserved communities face in living with arthritis in order to develop effective SMS that can meaningfully improve well-being and quality of life. Objectives: The study objective was to bring together underserved people living with arthritis to identify common barriers they face in taking care of their conditions in daily life, and to identify their solutions to the identified challenges. Methods: A team of researchers from several universities, nurse practitioners, physicians, policy makers, an arthritis consumer-patient leader and our community partners (Multi-lingual Orientation Service Association for Immigrant Communities and the Portland Hotel Society Community Services Society) engaged in a Community-based Participatory and Concept Mapping (CM) study 5-7 where participants from underserved communities identified major barriers they face in managing arthritis, agreed on key themes that emerged, and determined priorities for actions. This involved three key CM activities: 1) brainstorming ideas; 2) sorting and rating ideas; and 3) analyzing and interpreting concept maps 8 . Data was collected through face-to-face interviews and prioritized and interpreted in workshop settings. Results: Sixty-three individuals who were ethnic minorities, immigrants, refugees, low-income, over 65, and/or housing insecure and living with arthritis identified 35 common barriers and made recommendations in the areas of financial difficulties, social services, access to health services, quality of health services, lack of knowledge, and mental health. Additional funding has been sought through Community-University Engagement Support Funding to enable our community partners to prioritize the recommendations in their communities, and to develop mechanisms for implementation using already existing community structures, processes, and services. Conclusion: Persons living with arthritis in diverse underserved communities face significant health and social inequities, including lack of access to basic life necessities such as food, housing, employment, and safety, which creates barriers to self-managing arthritis and other chronic conditions in daily life. SMS for these communities needs to address these social and environmental barriers shaping capacity for self-management, and ultimately, quality of life and well-being. References: [1]Ackerman I, Busija L. Access to self-management education, conservative treatment and surgery for arthritis according to socioeconomic status. Best Pr Res Clin Rheumatol. 2012;26(5):561–83. [2]Shadmi E. Multimorbidity and equity in health. Int J Equity Heal. 2013;12(59):59. [3]Foster M, Kendall E, Dickson P, Chaboyer W, Hunter B, Gee T. Participation and chronic disease self-management: are we risking inequitable resource allocation? Aust J Prim Health. 2003;9(3):132–40. [4]Brady T, Anderson L, Kobau R. Chronic disease self-management support: public health perspectives. Front Public Heal. 2015;2(234). [5]Trochim W. An introduction to concept mapping for planning and evaluation. Eval Progr Plann. 1989;12(1):1–16. [6]Anderson L, Day K, Vandenberg A. Using a concept map as a tool for strategic planning: the healthy brain initiative. Prev Chronic Dis. 2011;8(5):A117. [7]Petrucci C, Quinlan K. Bridging the research practice gap: concept mapping as a mixed methods strategy in practice-based research and evaluation. J Soc Serv Res. 2007;34(2):25–42. [8]Kane M, Trochim W. Concept mapping for planning and evaluation. Thousand Oaks (CA): SAGE Publications; 2007. Disclosure of Interests: None declared