Priority strategies to reduce socio-gendered inequities in access to person-centred osteoarthritis care: Delphi survey

Abstract

ObjectivesOsteoarthritis (OA) prevalence, severity and related comorbid conditions are greater among women compared with men, but women, particularly racialised women, are less likely than men to access OA care. We aimed to prioritise strategies needed to reduce inequities in OA management.DesignDelphi survey of 28 strategies derived from primary research retained if at least 80% of respondents rated 6 or 7 on a 7-point Likert scale.SettingOnline.Participants35 women of diverse ethno-cultural groups and 29 healthcare professionals of various specialties from across Canada.ResultsOf the 28 initial and 3 newly suggested strategies, 27 achieved consensus to retain: 20 in round 1 and 7 in round 2. Respondents retained 7 patient-level, 7 clinician-level and 13 system-level strategies. Women and professionals agreed on all but one patient-level strategy (eg, consider patients’ cultural needs and economic circumstances) and all clinician-level strategies (eg, inquire about OA management needs and preferences). Some discrepancies emerged for system-level strategies that were more highly rated by women (eg, implement OA-specific clinics). Comments revealed general support among professionals for system-level strategies provided that additional funding or expanded scope of practice was targeted to only formally trained professionals and did not reduce funding for professionals who already managed OA.ConclusionsWe identified multilevel strategies that could be implemented by healthcare professionals, organisations or systems to mitigate inequities and improve OA care for diverse women.

Policies in Canada fail to address disparities in access to person-centred osteoarthritis care: a content analysis

“…For example, a qualitative study was conducted to understand the lived experience of Aboriginal and Torres Strait Islander people with OA, knowledge essential to developing policies that guide culturally-safe care [ 57 ]. Another way to ensure that policies reflect the perspectives of equity-seeking groups is to engage them in policy development, as was done in Australia when developed a system-wide model of care for hip and knee osteoarthritis [ 58 ]; and in another study that generated consensus among women with OA and healthcare professionals on multi-level strategies need to improve equitable, person-centred OA care for diverse women [ 59 ].…”