Osteoarthritis (OA) is the leading cause of functional disabilities in middle-aged and older American adults. The healthcare costs associated with OA is $185 billion per year. One-third of older Americans suffer from OA. Substantial racial and ethnic differences have been reported on the prevalence, symptoms, severity and treatment of OA. However, little is known about OA in Asian Americans, especially Vietnamese-Americans (VietAmericans). Studies conducted in Asia have shown that Vietnamese and Chinese adults have a higher prevalence of knee OA than Caucasians, despite being thinner. VietAmerican adults may have an even higher prevalence of knee OA than their counterparts in Asia, due to increased obesity and more sedentary practices. Little is known about hand OA in VietAmericans, though many work in jobs requiring frequent use of their hands. While the prevalence of knee and hand OA may be disproportionally high, awareness of OA symptoms and appropriate OA management is likely disproportionally low among VietAmericans. Disparities in this population are likely due to many domains of patient factors. Many of these factors are modifiable. By effectively addressing them, studies may help VietAmericans increase awareness and overcome barriers to appropriate OA care and management, and thus make profound impacts on the health and health care of this socially disadvantaged and medically underserved population. Our long-term goal is to decrease health disparities in underserved population, including that of Vietnamese Americans. To fill several critical knowledge gaps, we propose to conduct a pilot study (n=200) of VietAmericans (>=45 years old) living in the greater Dallas-Fort Worth Metroplex (TX) area.
The specific aims i nclude:
Aim 1, to translate, refine, and pre-test culturally and linguistically appropriate standardized survey instruments of hand and knee OA symptoms and risk factors, OA awareness and management, and related patient factors among a group of VietAmericans from faith-based and community-based organizations in greater Dallas-Fort Worth Metroplex;
Aim 2, to demonstrate the feasibility of enrolling and retaining a cohort of VietAmericans, including obtaining X-Rays of their hands and knees, and develop and pilot test a detailed protocol to prepare for a larger longitudinal cohort study;
Aim 3, to apply a mixed-methods approach for purposes of providing an initial assessment of possible barriers to OA awareness and approaches to prevention and care, and to examine whether such barriers exist at the patient, provider, and/or system level(s) in a targeted group of VietAmerican participants with OA. Feasibility data will be gathered to refine the study protocol for the larger cohort study to more systematically study OA in a population with little data on OA, including its prevention and optimal care. These data will be used to conceptualize and generate testable hypotheses and will help us to design a larger cohort study of OA in VietAmericans living in the US, with the potential to compare results with that of Vietnamese in Vietnam and other racial groups in the US, as well as provide evidence for more targeted interventions.
Osteoarthritis is a leading cause of pain and disability in middle-aged and older Americans, and is associated with $185 billion dollars in health care costs each year in the US; yet, little information is available on the extent of the problems associated with osteoarthritis in Asian Americans, especially in Vietnamese Americans. The goal of our study is to understand risk factors associated with osteoarthritis of the hands and knees, awareness and management of OA, and barriers to appropriate OA care in Vietnamese Americans, using language and culturally appropriate instruments. The knowledge gained will help us to develop a larger longitudinal study of Vietnamese Americans and other comparison groups so that we can ease the burden and risk of these disabling conditions in an especially hard-to-reach and underserved population.
