ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 1249

“There Are Still a Lot of Things That I Need”: A Qualitative Study Exploring Opportunities to Improve the Health Outcomes of First Nations People with Arthritis Seen at an on-Reserve Outreach Rheumatology Clinic

Adalberto Loyola-Sánchez1, Lynden Crowshoe2, Tyler White3, Diane Lacaille4 and Cheryl Barnabe5, 1Rheumatology, University of Calgary, Calgary, AB, Canada, 2Family Medicine, University of Calgary, Calgary, AB, Canada, 3Siksika Health Services, Siksika, AB, Canada, 4Rheumatology, Arthritis Research Canada, Richmond, BC, Canada, 5Division of Rheumatology, University of Calgary, Calgary, AB, Canada

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: arthritis management, health disparities, qualitative and quality improvement

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print
Session Information

Date: Monday, November 14, 2016

Title: Healthcare Disparities in Rheumatology - Poster II

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: A rheumatology specialty clinic embedded in a primary health care clinic on a First Nations reserve was established six years ago to improve access to care and reduce arthritis outcome inequities. Although the clinic has proved successful to achieve inflammatory arthritis physician-derived disease control targets during a 24-month follow-up period, patient-reported pain, disease severity and physical function did not significantly improve. The objective of this study was to explore remaining care needs from patient and provider perspectives, to inform enhancements to the model of care in this clinic.

Methods: A qualitative study with patients and their family members (n=10), health providers (n=14) and administrative staff (n=10) was performed. Thirty-four in-depth interviews were conducted to reach thematic saturation. Interviewing was assisted by semi-structured guides to focus on personal narratives and perceptions of needs and solutions. Interviews were audio recorded, transcribed verbatim and coded to find meaningful concepts. Concepts were then grouped into themes, which were validated using a member-checking strategy. An inductive interpretation was then conducted using “health service quality” and “cultural competency” theoretical frameworks.

Results: Four main themes of improvement areas were identified (see Table). The first three themes were related to the concept of health service quality: service organization, communication between patients and providers, and holistic patient support mechanisms integrating mainstream and traditional knowledge. Participants stressed that in order to realize treatment goals and thereby reduce health disparities, it was important to improve the administrative and inter-personal quality of existing services. Suggested strategies included administrative and organizational accommodations, health-interpreter services, cultural training and cultural immersion for providers, coordination with traditional healers, use of community health workers, culturally competent health promotion activities and involvement of family and other community members in the management of arthritis. The last theme identified was the need to enhance service availability and expand the scope of provided services beyond the health clinic, such as exercise programs and support groups.

Conclusion: Enhancements to an existing model of care needed to better meet the needs of the community, which could reduce arthritis outcome disparities in an outreach specialty clinic, were identified. Improved service organization, communication strategies, holistic patient support mechanisms and an expansion of services outside of the health clinic were suggested.

Enhancement Required Illustrative Participant Quote
Service organization “There’s a fragmentation and disintegration of health services on reserve.” (Male, clinical services)
Communication between providers, patients and their families “That (a) client agrees with you…that does not mean you know that person, you have to learn how to think Indian, think like an Indian to know that person…(we need someone)to speak for you if (you) do not understand…” (Female, RA patient)
Support for patients to adequately manage their disease in a holistic manner, integrating mainstream and traditional knowledge “I need to understand more…I need to meet other people who are living this…mentally, I am traditional, I got to sweat, I leave things on creators hands… I am trying to figure out how to help her…It is a chronic disease…it is not going to get better…I want to prepare to help her anyway I can” (Male, husband of a woman with RA)
Expansion of services outside of the health clinic “They do not have support groups out here for smoking, dieting, they do exercising but…even arthritis support groups that would be easier to associate with other people with arthritis cause they know exactly what are you going through…becoming more acceptable in the society to have arthritis…I think exercises for peoples needs… there are certain exercises that we can do and we cant do.” (Female, client)

Disclosure: A. Loyola-Sánchez, None; L. Crowshoe, None; T. White, None; D. Lacaille, None; C. Barnabe, None.

To cite this abstract in AMA style:

Loyola-Sánchez A, Crowshoe L, White T, Lacaille D, Barnabe C. “There Are Still a Lot of Things That I Need”: A Qualitative Study Exploring Opportunities to Improve the Health Outcomes of First Nations People with Arthritis Seen at an on-Reserve Outreach Rheumatology Clinic [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/there-are-still-a-lot-of-things-that-i-need-a-qualitative-study-exploring-opportunities-to-improve-the-health-outcomes-of-first-nations-people-with-arthritis-seen-at-an-on-reserve-o/. Accessed .
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to 2016 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/there-are-still-a-lot-of-things-that-i-need-a-qualitative-study-exploring-opportunities-to-improve-the-health-outcomes-of-first-nations-people-with-arthritis-seen-at-an-on-reserve-o/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology