BARRIERS AND MOTIVATORS TO ENGAGEMENT IN SELF-MANAGEMENT FOR JOINT PAIN IN OLDER AFRICAN AMERICANS

Osteoarthritis represents one of the leading causes of chronic joint pain in older adults. Over 60% of older African Americans (AAs) attribute chronic pain to arthritis, and joint pain is more frequently reported than stiffness or swelling. A higher proportion of AAs (38.7%), experience severe osteoarthritis pain as compared to 36.4% of Hispanic Americans, 28.7% American Indians, 23.1% Caucasian Americans, and 18.5% Asian Americans. Managing osteoarthritis requires both self-management and provider management. Land- and water-based exercise, thermotherapy, pharmacological interventions, use of assistive and/or orthotic devices, and participation in self-management programs are key self-management strategies to manage osteoarthritis symptoms. Because older AAs have less control over pain, some suggest they may need more assistance with self-management; however, identification of barriers and motivators to engagement key strategies has been overlooked. A convergent, parallel mixed-methods study, using surveys and qualitative interviews, was conducted with 70 community-dwelling African American seniors (67.2 ± 13.2). The majority of AAs did not engage in water-based exercise, use assistive/orthotic devices, or ever participated in a self-management program, while most used thermotherapy and pharmacological interventions. Content analysis indicate major barriers to engagement as issues/work commitments, no motivation or interest to exercise and fear of falling, lack of knowledge on appropriate exercises, no access to pool and inability to swim, unaware of any osteoarthritis self-management programs, need to protect organs from side effects of pharmacological interventions, and the pain itself. Motivators were a need to maintain health, mobility and function, exercising with a group, and to obtain pain relief.