Predictors of disability in middle-aged and older African American women with osteoarthritis
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Given the percentage of African American women in the general U.S. population, the number of African American women with functional limitations and disabilities is disproportionate; although chronic conditions such as osteoarthritis may contribute to these disparities it is unclear what environmental factors may affect these outcomes in the women. Hence, the purpose of this study was to examine biological factors (age, body mass index, and waist circumference), psychosocial intra-individual factors (health care utilization, trust in health care providers, pain, pain beliefs, and depression), and cumulative extra-individual environmental factors (racial discrimination, stress from racial discrimination, and health care access) that may influence function and disability outcomes in African American women with osteoarthritis 50-80 years of age. The disablement process model combined with the cumulative inequality theory served as theoretical guides used for this study. This study was a non-experimental, descriptive correlational study. The study included a sample of 120 African American women with OA from Texas and New Mexico. Surveys were mailed to participants or distributed in person. The statistical analysis consisted of correlations, linear regressions, multiple regressions and hierarchical regressions. The significant predictors of function were BMI, pain severity and pain beliefs. Pain severity and pain beliefs predicted disability. Depression mediated the relationship between racial discrimination and disability. It was demonstrated that biological risk factors, intra-individual and extra-individual factors are related to disablement outcomes in this sample of African American women. This study can inform the development of future interventions designed to decrease the risk of functional limitations and disabilities in middle-aged and older African American women with osteoarthritis.