Rheumatic and Autoimmune Diseases in Minority Communities

该项目研究了华盛顿特区大都市区服务不足的主要少数民族社区风湿病的临床表现。通过NIAMS社区卫生中心，对风湿病患者进行评估，并为临床医生提供第一手经验，了解自身免疫性疾病表型的种族差异以及护理障碍。该项目支持文化差异研究，以理解标准化自我报告结果评估工具，确定类风湿关节炎临床重要改善，在风湿性症状患者中使用补充和替代医学，少数民族个体对瑜伽作为关节炎治疗的可接受性，以及了解研究过程和少数民族的知情同意。此外，研究人员还研究了干预措施，以改善初级保健提供者和专科医生之间的转诊过程。目前正在进行血清学研究，以检查类风湿关节炎和系统性红斑狼疮患者的免疫异常。

This project studies the clinical presentation of rheumatic diseases in an underserved, largely ethnic minority community in the Washington, D.C. metropolitan area. Through the NIAMS Community Health Center, subjects with rheumatic complaints are evaluated and provide clinicians with first-hand experience in understanding ethnic differences in autoimmune disease phenotypes as well as barriers to care. This project has supported research on cultural differences in understanding standardized self-report outcome assessment tools, determination of clinically important improvements in rheumatoid arthritis, use of complementary and alternative medicine in patients with rheumatic symptoms, acceptability of yoga as a treatment for arthritis by minority individuals and understanding of the research process and informed consent among ethnic minorities. In addition, researchers have examined interventions to improve the referral process between primary care providers and subspecialists. Serological studies are currently underway to examine immune abnormalities in patients with rheumatoid arthritis and systemic lupus erythematosus. We have been actively involved in an observational study to characterize how COVID-19 modulates systemic inflammation, autoimmune features and vasculopathy in adult and pediatric patients with a prior diagnosis of systemic autoimmunity, and their overall outcomes including response to antiviral treatments or vaccines. We have opened an additional clinic site in Northeast Washington D.C. to improve access and increase our outreach to the minority community with rheumatic diseases. We are starting collection of disease activity indices and patient reported outcome data including social determinants of health to better understand healthcare disparities in minority communities.