VietAmerican Health Pilot Study

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 related to patient education and socioeconomic status, lifestyle practices, cultural beliefs and assimilation, and a number of modifiable factors including lack of awareness of OA symptoms and knowledge of appropriate OA management. VietAmericans are more vulnerable to develop OA because they are more likely to perform manual labor, adding stress to joints in the knees and hands. They may be less aware because they have less education attainment and have less English proficiency. In addition, they are more likely to suffer from mental stress compared with their Asian counterparts and US Caucasians which may impact their pain perception, coping strategies, and health care seeking behaviors. By understanding and effectively addressing potentially modifiable factors, we may help VietAmericans increase their awareness of OA risk factors and symptoms, and remove barriers to appropriate OA management. Unfortunately, there is little information about the descriptive epidemiology of OA in VietAmericans nor linguistically and culturally appropriate instruments or protocol for OA research in these individuals. Our long-term goal is to decrease disparities in health and healthcare utilizations in vulnerable populations, including people of Vietnamese descent. As a fundament step towards this goal, and to fill several critical knowledge gaps, we propose to conduct an R21 pilot study of middle-aged and older (>=45 years) VietAmericans living in the greater Dallas-Arlington-Fort Worth area (TX). We will examine factors associated with the occurrences, symptoms, risk factors, awareness and management of OA, and barriers to appropriate OA care. The specific aims of this pilot study include the following: 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-Arlington-Fort Worth area (TX). Aim 2: To enroll and retain a cohort of VietAmericans, and develop and pilot test a detailed protocol to prepare for a larger longitudinal cohort study in order to be able to compare with Vietnamese living in Vietnam, as well as with a concurrent population-based cohort of US Caucasians and other racial groups. Aim 3: To apply a mixed methods approach for the purposes of providing an initial assessment of possible barriers to OA awareness and approaches to prevention and care, including acculturation factors and cultural beliefs, 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. These data will be used to conceptualize and generate testable hypotheses for the subsequent longitudinal study. Results from this study will help us to more systematically design a larger cohort study of OA among VietAmericans living in Texas. Feasibility data will be gathered to refine the study protocol for the larger cohort study, including information on recruitment and retention, linguistic and cultural appropriateness, quality of data, likely effect sizes, and necessary sample sizes to more systematically study OA in a population with little data on OA, including its prevention and optimal car