This project studies the expression of rheumatic diseases in an underserved, largely ethnic minority community in the Washington, DC metropolitan area. Through the NIAMS Community Health Center, subjects with rheumatic complaints are evaluated and provide researchers with first-hand experience in understanding barriers to care. This project has supported research on cultural differences in understanding standardized self-report outcome assessment tools, determination of clinically important improvements in rheumatoid arthritis, use of complementary and alternative medicine in patients with rheumatic symptoms, acceptability of yoga as a treatment for arthritis by minority individuals, understanding of the research process and informed consent among ethnic minorities, and validation in Spanish and English of a rheumatoid arthritis case-finding questionnaire for use in epidemiological studies. In addition, researchers have examined interventions to improve the referral process between primary care providers and subspecialists.

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National Institute of Arthritis and Musculoskeletal and Skin Diseases
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Ward, Michael M; Guthrie, Lori C; Alba, Maria I (2015) Clinically important changes in individual and composite measures of rheumatoid arthritis activity: thresholds applicable in clinical trials. Ann Rheum Dis 74:1691-6
Ward, Michael M; Guthrie, Lori C; Alba, Maria I (2015) Measures of arthritis activity associated with patient-reported improvement in rheumatoid arthritis when assessed prospectively versus retrospectively. Arthritis Care Res (Hoboken) 67:776-81
Ward, Michael M; Guthrie, Lori C; Alba, Maria (2015) Domain-specific transition questions demonstrated higher validity than global transition questions as anchors for clinically important improvement. J Clin Epidemiol 68:655-61
Ward, Michael M; Guthrie, Lori C; Alba, Maria I (2014) Clinically important changes in short form 36 health survey scales for use in rheumatoid arthritis clinical trials: the impact of low responsiveness. Arthritis Care Res (Hoboken) 66:1783-9
Ward, Michael M; Guthrie, Lori C; Alba, Maria I (2014) Brief report: rheumatoid arthritis response criteria and patient-reported improvement in arthritis activity: is an American College of Rheumatology twenty percent response meaningful to patients? Arthritis Rheumatol 66:2339-43
Sansbury, Brittany; Dasgupta, Abhijit; Guthrie, Lori et al. (2014) Time perspective and medication adherence among individuals with hypertension or diabetes mellitus. Patient Educ Couns 95:104-10
Guthrie, Lori C; Butler, Stephen C; Lessl, Kristen et al. (2014) Time perspective and exercise, obesity, and smoking: moderation of associations by age. Am J Health Promot 29:9-16
Ward, Michael M; Guthrie, Lori C; Alba, Maria (2014) Dependence of the minimal clinically important improvement on the baseline value is a consequence of floor and ceiling effects and not different expectations by patients. J Clin Epidemiol 67:689-96
Middleton, Kimberly R; Ward, Michael M; Haaz, Steffany et al. (2013) A pilot study of yoga as self-care for arthritis in minority communities. Health Qual Life Outcomes 11:55
Ward, Michael M (2012) Personalized therapeutics: a potential threat to health equity. J Gen Intern Med 27:868-70

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