Ethnic Differences in the Management of Osteoarthritis

骨关节炎治疗的种族差异

• 批准号: 7085135
• 负责人: C KENT KWOH
• 金额: $ 4.81万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-09-25 至 2006-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7085135
• 关键词: African American; arthroplasty; behavioral /social science research tag; belief; caucasian American; clinical research; coping; functional ability; gender difference; health behavior; health care referral /consultation; health care service utilization; health disparity; health economics; health services research tag; hip prosthesis; human subject; joint prosthesis; knee; osteoarthritis; patient care management; preference; quality of life; racial /ethnic difference; social support network; statistics /biometry

DESCRIPTION (provided by applicant): Health disparities in the utilization of elective total joint replacement has been targeted as a priority area for additional research by NIAMS. The proposed study seeks to examine factors that may provide the basis for these health disparities and builds on two federally funded studies. The first examines ethnic differences in the management of osteoarthritis (OA) among male veterans. The second, the Study of Health Aging: Body Composition (Health ABC) study, is a NIA-funded longitudinal evaluation focusing on two population-based cohorts of individuals between the ages of 70 to 79 recruited from the Pittsburgh, PA and Memphis, TN metropolitan areas. The overall goal of this research is to better understand the reasons behind ethnic variations in the utilization of lower extremity total knee arthroplasty (TKA) or total hip arthroplasty (THA). The proposed study will examine the health beliefs, practices, preferences and perceptions of African American women and men, as well as white women and men with knee or hip OA and how these factors may influence consideration of TKA/THA. A cross-sectional study design will be utilized to examine the following Specific Aims: 1) To examine ethnic/gender differences in individuals' self-report of symptoms and functional status among individuals with OA of similar radiologic severity; 2) To examine ethnic/cultural differences in perceptions of the efficacy of specific treatment options for arthritis and willingness to have TKA/THA; 3) To examine gender differences in perceptions of specific treatment options for arthritis and willingness to have TKA/THA; and 4) To examine ethnic/gender differences in provider-level factors related to access to TKA/THA. The 518 individuals from the Health ABC study with symptomatic and radiographic knee OA and 271 with symptomatic and radiographic hip OA will be surveyed. Regarding Specific Aims 1 and 2, major variables that may confound the relationship between ethnicity or gender and willingness to have joint replacement include understanding the risks and benefits of joint replacement; pain coping strategies; perceptions of the efficacy of a specific treatment option such as prayer, and perceptions of health care. The proposed study is unique in that it will examine ethnic and gender differences in the management of OA across patients with varying disease severity, focusing on specific factors that may explain health disparities.

描述（由申请人提供）：NIAMS的选择性总置换术的健康差异已成为NIAMS的其他研究的优先领域。拟议的研究旨在检查可能为这些健康差异提供基础的因素，并以两项联邦资助的研究为基础。首先研究了男性退伍军人的骨关节炎（OA）管理的种族差异。第二个是健康衰老的研究：身体组成（健康ABC）研究，是NIA资助的纵向评估，重点是从匹兹堡，宾夕法尼亚州和孟菲斯，TN Metropolitan地区招募的两个基于人群的人群的70至79岁。这项研究的总体目标是更好地了解下肢全膝关节置换术（TKA）或总髋关节置换术（THA）的种族变化背后的原因。拟议的研究将研究非洲裔美国妇女和男性的健康信念，实践，偏好和看法，以及膝盖或髋关节OA的白人男女，以及这些因素如何影响对TKA/THA的考虑。将利用横断面研究设计来检查以下特定目的：1）检查个体自我报告的种族/性别差异在具有相似放射学严重程度的OA中的症状和功能状态； 2）检验对关节炎特定治疗选择和愿意患有TKA/THA的特定治疗选择的感知的种族/文化差异； 3）检查性别差异在对关节炎的特定治疗方案和愿意患有TKA/THA的意愿方面存在性别差异； 4）检查提供者级别的因素中与访问TKA/THA有关的种族/性别差异。对症状和射线照相膝关节OA的健康ABC研究的518名患者将接受症状和射线照相髋关节OA的271。关于特定目标1和2，可能混淆种族或性别之间关系以及愿意进行联合替代的关系的主要变量包括了解关节替代的风险和收益；疼痛应对策略；对特定治疗方案的功效（例如祷告）和对医疗保健的看法的看法。拟议的研究是独一无二的，因为它将检查各种疾病严重程度不同的患者的OA管理中的种族和性别差异，重点关注可能解释健康差异的特定因素。