What Community Resources Do Older Community-Dwelling Adults Use to Manage Their Osteoarthritis? A Formative Examination

Abstract

Community resources can influence health outcomes, yet little research has examined how older individuals use community resources for osteoarthritis (OA) management. Six focus groups were conducted with 37 community-dwelling older adult African Americans and Caucasians who self-reported OA and resided in Johnston County, North Carolina. Descriptive analyses and qualitative constant comparison methodology revealed individuals use local recreational facilities, senior centers, shopping centers, religious organizations, medical providers, pharmacies and their social network for OA management. Participants also identified environmental characteristics (e.g., sidewalk conditions, curb-cuts, handicapped parking, automatic doors) that both facilitated and hindered use of community resources for OA management. Identified resources and environmental characteristics were organized around Corbin & Strauss framework tasks: medical/behavioral, role, and emotional management. As older Americans live with multiple chronic diseases, better understanding of what community resources are used for disease management may help improve the health of community-dwelling adults, both with and without OA.

Primary family caregivers' observations and perceptions of their older relatives' knee osteoarthritis pain and pain management: a qualitative study

“…Another important player in older people's OA pain management and treatment was their physician. Indeed, healthcare providers were reported as resources for older North Americans with OA to learn about medical directives, services and information related to managing OA (Martin et al 2012) and how to manage their OA using medication (Holroyd et al 2012).…”

Social Determinants and Osteoarthritis Outcomes

“…Keysor and colleagues confirmed the hypothesis that people who reported more mobility barriers and fewer facilitators in the community perceived more limitation in their daily activities [89]. A recent qualitative study with six focus groups in Johnston County (NC, USA), identified community resources and environmental characteristics that are facilitators or barriers to OA disease management [39]. Using the Corbin and Strauss chronic illness trajectory framework, the study divided emergent community resources into three self-management tasks: medical and behavioral management, role management and emotional management.…”

“…Focus group participants also discussed environmental features in their neighborhood as barriers and facilitators for OA management. Although short distances between residences and community resources promoted physical activity, the availability and quality of lighting, sidewalks and level surfaces could limit one’s ability to engage in physical activity [39]. However, although Martin and colleagues’ research revealed older adults’ recognition of existing neighborhood barriers, Keysor and colleagues found no association with the way people perceived how often daily activities were performed; while features in the neighborhood may make involvement in daily activities difficult, older adults with functional limitations are able to adapt (Table 3) [89].…”

“…Recent data suggest that the social context (i.e., factors in society that cannot be directly measured at the individual level), or socioeconomic environment of an individual’s neighborhood may be relevant to arthritis prevalence and health outcomes as well. Although studies have focused on how community contexts interact with individual characteristics for individuals with rheumatoid arthritis (R A), systemic lupus erythematosus and self-reported arthritis [32–38], far fewer studies have investigated this relationship with populations of individuals with OA [22,39,40]. …”

Managing Chronic Illness

“…Our findings also did not account for environmental and community resources that contribute to the effectiveness of care for older adults with chronic illnesses (Martin, Schoster, Woodard, & Callahan, 2012); thus, future studies are also warranted to examine how providers of care coordination integrate their work with other community or environmental resources, such as recreational centers and pharmacies. Perhaps most importantly, findings underscore the centrality of relationships and continuity in care designed to engage and assist older adults in their self-management of chronic illness.…”