Culture-sensitive adaptation and validation of the Community-Oriented Program for the Control of Rheumatic Diseases methodology for rheumatic disease in Latin American indigenous populations

Abstract

The purpose of the study is to validate a culturally sensitive adaptation of the community-oriented program for the control of rheumatic diseases (COPCORD) methodology in several Latin American indigenous populations. The COPCORD Spanish questionnaire was translated and back-translated into seven indigenous languages: Warao, Kariña and Chaima (Venezuela), Mixteco, Maya-Yucateco and Raramuri (Mexico) and Qom (Argentina). The questionnaire was administered to almost 100 subjects in each community with the assistance of bilingual translators. Individuals with pain, stiffness or swelling in any part of the body in the previous 7 days and/or at any point in life were evaluated by physicians to confirm a diagnosis according to criteria for rheumatic diseases. Overall, individuals did not understand the use of a 0-10 visual analog scale for pain intensity and severity grading and preferred a Likert scale comprising four items for pain intensity (no pain, minimal pain, strong pain, and intense pain). They were unable to discriminate between pain intensity and pain severity, so only pain intensity was included. For validation, 702 subjects (286 male, 416 female, mean age 42.7 ± 18.3 years) were interviewed in their own language. In the last 7 days, 198 (28.2 %) subjects reported having musculoskeletal pain, and 90 (45.4 %) of these had intense pain. Compared with the physician-confirmed diagnosis, the COPCORD questionnaire had 73.8 % sensitivity, 72.9 % specificity, a positive likelihood ratio of 2.7 and area under the receiver operating characteristic curve of 0.73. The COPCORD questionnaire is a valid screening tool for rheumatic diseases in indigenous Latin American populations.

Prevalence and factors associated with musculoskeletal disorders and rheumatic diseases in indigenous Maya-Yucateco people: a cross-sectional community-based study

“…The prevalence of self-reported anxiety was 40 % in individuals diagnosed with a rheumatic disease and 16 % in subjects free of MSK disorders. In addition, the municipality of Chankom is classified as highly marginalized [ 23 ]. All these psychosocial factors could be related with the high prevalence of fibromyalgia observed in our study.…”

“…If needed, interviewers visited the same household as many as seven times to administer the questionnaire. Surveys were cross-checked by different interviewers during screening and later by the coordinators; (7) evaluation of mechanical stress (activities involving repeated handling objects >20 kg, standing for more than 30 min, and other physical activities such as bending); (8) administering the Health Assessment Questionnaire (HAQ-DI) validated for the Maya-Yucateco population [ 23 ] along with a socioeconomic questionnaire (level of education, monthly income, living conditions, access to health care, and material situation); (9) examination of positive cases—individuals with pain, stiffness and/or inflammation during the last 7 days or at some point in life—conducted by primary care physicians previously trained by a certified rheumatologist in MSK assessment; (10) examination of the probable rheumatic disease cases by a rheumatologist and a physiatrist to make a diagnosis based on the accepted classification criteria [ 24 – 31 ].…”

Epidemiology and socioeconomic impact of the rheumatic diseases on indigenous people: an invisible syndemic public health problem

“…The main outcome of this study was the presence of RD, which was assessed through a cross-culturally validated COPCORD questionnaire 22. Bilingual community members trained as interviewers administered this questionnaire.…”

Developing Community-Based Rehabilitation Programs for Musculoskeletal Diseases in Low-Income Areas of Mexico: The Community-Based Rehabilitation for Low-Income Communities Living With Rheumatic Diseases (CONCORD) Protocol

“…Trained personnel will administer the survey to both communities in person. In the case of Chankom, a cross-cultural adaptation of the instrument to the Mayan language was conducted [ 52 ]. A trained general physician will assess all adults that reported any musculoskeletal symptoms at their homes using standardized criteria for the diagnosis of rheumatologic diseases.…”