Candidate Career Goals: Dr. Ernest R. Vina's long-term career goal is to promote equity for patients with rheumatic and musculoskeletal diseases through the development of interventions to eliminate racial disparities and improve outcomes for patients with these diseases. With his research and clinical experience in addressing the sources of racial disparities in the health and health care of patients with rheumatic diseases, Dr. Vina is well-suited to build a research career in this area. However, he will require additiona training and skills in order to address knowledge gaps by exploring patient characteristics and health beliefs that may contribute to disparities in the medical care of patients with osteoarthrits (OA). Dr. Vina's short-term career goals are 1) to develop the expertise required to study the reasons why race disparities in the use of different types of non-surgical OA treatment exist; and 2) to learn to develop an intervention and implement a clinical trial to reduce racial disparities n the use of various OA treatments. Research Background: OA is a highly prevalent and disabling disease. Racial disparities in the outcomes of OA patients have also been demonstrated, with African-Americans (AAs) carrying a greater burden than whites (WHs). In addition, AAs are also less likely to have history of use of various pharmacologic and non- pharmacologic therapies for OA. Sources of racial healthcare disparities in OA are only partially known.
Research Aims : There are two main aims for this K23. The first is to examine the determinants of, and barriers to, the utilization of various OA treatments that contribute to disparities in the care of AAs and WHs. The second is to pilot-test the impact of an intervention designed to improve the utilization of effective, non- surgical OA treatments. Methods: To achieve the goals of the first aim, surveys of patients with knee or hip OA will be conducted. The survey will determine patient demographic information, psychosocial characteristics, disease severity, treatment history and health-related knowledge, beliefs and attitudes. The primary outcomes of interest will include utilization of various treatments, including exercises, topical medications, non-steroidal anti- inflammatory drugs and opioid agents. Hierarchical statistical modeling will be conducted to determine which patient-level variables may mediate racial disparities in the utilization of the various OA treatments. For the second aim, an existing educational tool will be chosen and enhanced with the goal of improving patient understanding of OA treatments and increasing the use of available OA therapies. Thereafter, this instrument will be pilot-tested to a relatively smal group of patients with knee or hip OA. The impact of this educational tool in improving the utilization of various OA therapies will be preliminarily determined.

Public Health Relevance

Osteoarthritis (OA) is the most common form of arthritis and is a leading cause of pain and disability among the elderly. Racial differences in the outcomes of OA patients exist; African-Americans are more likely to experience pain from OA and are less likely to be using effective OA treatments than whites. The current project proposes to identify the contributors to racial differences in the use of various OA therapies and to develop an educational tool that will improve understanding and use of these treatments.

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
3K23AR067226-04S1
Application #
9628377
Study Section
Arthritis and Musculoskeletal and Skin Diseases Special Grants Review Committee (AMS)
Program Officer
Zheng, Xincheng
Project Start
2015-03-26
Project End
2020-02-29
Budget Start
2018-03-01
Budget End
2019-02-28
Support Year
4
Fiscal Year
2018
Total Cost
Indirect Cost
Name
University of Arizona
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
806345617
City
Tucson
State
AZ
Country
United States
Zip Code
85721
Abbate, Lauren M; Jeffreys, Amy S; Coffman, Cynthia J et al. (2018) Demographic and Clinical Factors Associated With Nonsurgical Osteoarthritis Treatment Among Patients in Outpatient Clinics. Arthritis Care Res (Hoboken) 70:1141-1149
Hausmann, Leslie R M; Ibrahim, Said A; Kwoh, C Kent et al. (2018) Rationale and design of the Staying Positive with Arthritis (SPA) Study: A randomized controlled trial testing the impact of a positive psychology intervention on racial disparities in pain. Contemp Clin Trials 64:243-253
Vina, Ernest R; Ran, Di; Ashbeck, Erin L et al. (2018) Race, sex, and risk factors in radiographic worsening of knee osteoarthritis. Semin Arthritis Rheum 47:464-471
Kabadi, S; Yeaw, J; Bacani, A K et al. (2018) Healthcare resource utilization and costs associated with long-term corticosteroid exposure in patients with systemic lupus erythematosus. Lupus 27:1799-1809
Vina, Ernest R; Kwoh, C Kent (2018) Epidemiology of osteoarthritis: literature update. Curr Opin Rheumatol 30:160-167
Vina, E R; Ran, D; Ashbeck, E L et al. (2018) Natural history of pain and disability among African-Americans and Whites with or at risk for knee osteoarthritis: A longitudinal study. Osteoarthritis Cartilage 26:471-479
Vina, Ernest R; Kallan, Michael J; Collier, Aliya et al. (2017) Race and Rehabilitation Destination After Elective Total Hip Arthroplasty: Analysis of a Large Regional Data Set. Geriatr Orthop Surg Rehabil 8:192-201