Corsino Leonor, Coffman Cynthia J, Stanwyck Catherine, Oddone Eugene Z, Bosworth Hayden B, Chatterjee Ranee, Jeffreys Amy S, Dolor Rowena J, Allen Kelli D
1Department of Medicine, Division of Endocrinology, Metabolism and Nutrition, Duke University Medical Center, Box 3451, Durham, NC 27710 USA.
2Center for Health Services Research in Primary Care, Department of Biostatistics and Bioinformatics, Durham VA Medical Center, Duke University Medical Center, Duke Box 3827, Med Ctr, Durham, NC 27710 USA.
Pilot Feasibility Stud. 2018 Jul 4;4:89. doi: 10.1186/s40814-018-0280-x. eCollection 2018.
Arthritis affects approximately 50 million adults in the USA. Hispanics/Latinos have a higher prevalence of arthritis-attributed activity limitations primarily related to osteoarthritis (OA). Hispanic/Latinos are less likely to receive hip replacement independent of health care access, and they are less likely to receive knee replacement. There have been few interventions to improve OA treatment among the Hispanic/Latino population in the USA. In our study, we aimed to develop and test a telephone delivered culturally appropriate Spanish behavioral intervention for the management of OA in Hispanic/Latino adults.
We conducted a feasibility study in an academic health center and local community in Durham, North Carolina. We enrolled self-identified Spanish speaking overweight/obese adults (≥ 18) with OA of the knee and/or hip under the care of a primary health care provider. The 12-month patient intervention focused on physical activity, weight management, and cognitive behavioral pain management skills. The patient intervention was delivered via telephone with calls scheduled twice per month for the first 6 months, then monthly for the last 6 months (18 sessions). The one-time provider intervention included delivery of patient-specific OA treatment recommendations, based on patients' baseline data and published guidelines. The primary measures were metrics of feasibility, including recruitment and intervention delivery. We also assessed pain, stiffness, and function using the Spanish-Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).
A total of 1879 participants were identified for potential enrollment. Of those, 1864 did not meet inclusion criteria, were not able to be reached or refused. Fifteen participants enrolled in the intervention. The mean number of phone calls completed was 14.7. Eighty percent completed more than 16 calls. The mean WOMAC baseline score (SD) was 39 (20); mean improvement in WOMAC scores between baseline and 12 months, among 11 participants who completed the study, was - 13.27 [95% CI, - 25.09 to - 1.46] points.
Recruitment of Hispanics/Latinos, continues to be a major challenge. A Spanish-based telephone delivering lifestyle intervention for OA management in Hispanic/Latino adults is feasible to deliver and may lead to improved OA symptoms. Future research is needed to further test the feasibility and effectiveness of this type of intervention in this segment of the population.
NCT01782417.
在美国，关节炎影响着约5000万成年人。西班牙裔/拉丁裔人群中，因关节炎导致的活动受限患病率较高，主要与骨关节炎（OA）相关。无论医疗保健机会如何，西班牙裔/拉丁裔接受髋关节置换的可能性较低，接受膝关节置换的可能性也较低。在美国，针对西班牙裔/拉丁裔人群改善OA治疗的干预措施很少。在我们的研究中，我们旨在开发并测试一种通过电话提供的、符合文化背景的西班牙语行为干预措施，用于管理西班牙裔/拉丁裔成年人的OA。
我们在北卡罗来纳州达勒姆的一家学术健康中心和当地社区进行了一项可行性研究。我们纳入了自我认定为讲西班牙语的超重/肥胖成年人（≥18岁），他们在初级医疗保健提供者的照料下患有膝关节和/或髋关节OA。为期12个月的患者干预措施侧重于身体活动、体重管理和认知行为疼痛管理技能。患者干预通过电话进行，前6个月每月安排两次通话，后6个月每月一次（共18次通话）。一次性的提供者干预包括根据患者的基线数据和已发表的指南提供针对患者的OA治疗建议。主要测量指标是可行性指标，包括招募和干预实施情况。我们还使用西班牙文版的西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评估疼痛、僵硬和功能。
共识别出1879名潜在参与者。其中，1864名不符合纳入标准、无法联系到或拒绝参与。15名参与者纳入了干预。完成的电话通话平均次数为14.7次。80%的参与者完成了超过16次通话。WOMAC基线平均得分（标准差）为39（20）；在完成研究的11名参与者中，基线至12个月期间WOMAC得分的平均改善为-13.27[95%置信区间，-25.09至-1.46]分。
招募西班牙裔/拉丁裔人群仍然是一项重大挑战。一种通过电话提供的、基于西班牙语的生活方式干预措施，用于管理西班牙裔/拉丁裔成年人的OA是可行的，并且可能会改善OA症状。需要进一步的研究来进一步测试这种干预措施在该人群中的可行性和有效性。
NCT01782417。
