Background/Purpose:

First Nation community consultations identified arthritis as a priority health concern and the need for culturally sensitive health services adapted to community needs. In partnership with the communities, a self-management program, the Arthritis Wellness Program (AWP) was developed to improve the health and well-being of people living with arthritis, in collaboration with family members. We report on the process evaluation of the pilot testing.

Methods:

Pilot testing of the AWP was performed twice in each of two on-reserve communities (March 2016 – May 2018). Inclusion criteria: i) arthritis (OA, RA, PsA, AS, or SLE) for > 6 months, ii) age > 19, iii) English speaking, iv) residing on-reserve in one of the two communities and v) having an adult family member or close friend willing to participate.

Developed based on initial focus group input with people living with arthritis and family members, health professional interviews, and community consultations, the AWP follows principles of self-management and holistic First Nations approaches to health and wellness. Six evening group sessions were attended by people living with arthritis and a family member, focused on improving understanding of arthritis and treatment options (traditional medicines, medications, nutrition, physical activity), supporting behavior change for healthy lifestyle, learning strategies to cope with the physical, emotional, mental, and spiritual impact of arthritis, improving communication, and optimizing social support.

Results:

29 people with arthritis participated in pilot sessions (21 female, mean age: 56.5 years, range: 22 – 75 years). For nine pairs, both participants had arthritis. 28% had multiple forms of arthritis, RA:55.17%, OA: 68.97%, AS: 10.34%, PsA: 3.45%, SLE: 3.45%, FM: 6.90%. 10.34% were unsure of their diagnosis. All participants had high levels of pain, fatigue, and difficulty coping with activities of daily living due to their arthritis. Attendance for the six sessions ranged from 51 – 81%, mean 67.5%. Overall feedback was positive. Mean ratings (scale of 1-5) for the six group sessions of: usefulness of the group meetings ranged from 4.25 to 4.66, satisfaction with group dynamic: 4.07 – 4.63; satisfaction with amount of information: 4.15 – 4.84. In one-on-one interviews post program, participants appreciated learning more about how to live with arthritis, highly valued the group interaction, and the ability to share with and learn from others with arthritis. Suggestions for enhanced interaction and more hands-on activities were noted. Participants in all four pilot groups wished to continue to interact as a group.

Conclusion:

Pilot testing of the AWP revealed it is feasible to deliver to people living with arthritis and family members, and participants were very satisfied with the intervention. The AWP offers support and strategies to help First Nations people live well with their arthritis and encourage effective family support to their loved ones. The AWP is an example of community-based research to improve arthritis care that is culturally sensitive and meets the needs of First Nations communities. Once testing is complete, the AWP will be adopted by the communities for ongoing delivery.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/process-evaluation-of-a-culturally-sensitive-community-based-self-management-program-for-first-nations-people-with-arthritis-and-their-families/