0181: Patient Perspective of Unique Support and Education Needs of Latinx/Latino(a)/Hispanic Rheumatoid Arthritis Patients: Implications for a Culturally Tailored and Disease Specific Intervention

Anna Balakrishnan¹, Adena Batterman¹, Daniel Hernandez², Angel Tapia³, Joan Westreich¹, Roberta Horton¹ and Theodore Fields¹, ¹Hospital for Special Surgery, New York, NY, ²Global Healthy Living Foundation, Nyack, NY, ³Global Healthy Living Foundation, Upper Nyack, NY

Background/Purpose: Health disparities for Latinx RA patients, including higher pain, fatigue, disability, and risk for depression are well documented.^{1, 2, 3, 4} Support and education programs have been shown to enhance self-management and coping efforts of people with rheumatic disease. ^{5, 6} To address disparities, researchers call for interventions that are culturally tailored to meet the needs of this community. ^{7, 8, 9}

Well-studied self-management programs have been adapted for Latinx populations. ^{10, 11} Aligned with OMERACT's call to incorporate the patient perspective in all stages of program development¹², our aim is to identify unique education and support needs, as defined by Latinx RA patients, as there is a gap in the literature in this area. This input will be integrated into critical elements of an intervention, including culturally tailored content areas, implementation, and outreach strategies.

Methods: In a mixed methods qualitative study, a licensed bilingual social work (SW) researcher conducted semi-structured interviews with MD-diagnosed Latinx RA patients (18+ years). Interviews were conducted via Zoom in patients' preferred language, averaged 1.5 hours in length, and were recorded and transcribed verbatim. Participants were recruited from a NYC academic hospital, by MDs and SWs.

Using thematic analysis and NVivo Software, 3 reviewers conducted preliminary analysis of data to identify emerging themes.

Validated scales in English and Spanish, including mHAQ, illness and medication beliefs (IPQ, BMQ), depression (PHQ-8), and self-efficacy (SEMCD), were administered and will be included in future analysis.

Results: To date, 17 Latinx RA patients (8 Spanish-speaking, 9 English-speaking) have participated. (Table 1: Demographics). Recruitment is ongoing. Preliminary results have revealed 9 emerging themes. These themes are interrelated, and include: RA's impact on emotional health (connected to pain, feelings of loss about roles and abilities, and stress); willingness to seek mental health care; medication and illness beliefs affecting patients' approach to RA management; essential features of a good patient-provider relationship (trust, feeling cared for and heard, kindness, and consistency); value of participating in a support group (sharing, connection, and feeling less alone); impact on family (relationship dynamics, presence/absence of support); patient experience of systemic barriers to care; varied preferences on structure and format (group size, facilitator attributes, in-person or virtual), and varied preferences on outreach strategies (postal mail, referral source, phone calls, emails, and social media). (Table 2: Preliminary Themes and Quotes).

Conclusion: Preliminary findings are consistent with Latinx culturally relevant concepts such as familismo, confianza, personalismo and respeto,¹³ and will be used as a framework for content and implementation of this program.

Possible limitations: During COVID-19, interviews have been conducted via phone or Zoom, limiting inclusion of those without access to or facility with these technologies.

Preliminary Themes and Quotes

Demographics

References
Disclosures: A. Balakrishnan, None; A. Batterman, None; D. Hernandez, None; A. Tapia, None; J. Westreich, None; R. Horton, None; T. Fields, Novartis Pharmaceuticals, Horizon Pharmaceuticals, Avion Pharmaceuticals.