Equity in Osteoarthritis Diagnosis and Treatment


In this project, we aim to improve equity in OA diagnosis and treatment by exploring how to support patients in communicating pain symptoms and functional limitations to primary care clinicians. We'll do this through interviews and co-design sessions with patients being seen in a community health clinic in the Chicago area.


This project is a collaboration among researchers, designers, and clinicians from Northwestern University, Tapestry 360 Health, AllianceChicago, and Illinois Institute of Technology's Institute of Design.


Osteoarthritis (OA) is a leading cause of disability in the United States. While exercise, weight loss, self-management education, and other interventions effectively mitigate pain and disability from OA, they are underutilized. Furthermore, there are disparities in the diagnosis and treatment of OA. Black/African American and Hispanic adults report higher rates of joint pain, activity limitation, and work limitation due to OA compared to White adults, but fewer Black/African American and Hispanic adults report receiving an OA diagnosis from a healthcare provider. This is a barrier to treating pain and disability associated with OA. 

Implementing patient-reported outcome measures (PROMs) in primary care is a promising avenue for addressing inequities in diagnosis and treatment of knee and hip OA. These are already used effectively in orthopedic specialty care to monitor knee OA pain and associated limitations in physical function. In our team's prior research over 35,000 adults successfully reported OA outcomes over time. But, PROMs have not yet been used consistently in primary care.

Collecting information about symptoms and functional limitations from patients before and after clinic visits via digital technologies could ensure consistent and equitable data collection, aiding diagnosis and treatment while minimizing impact to clinical workflow. To date, PROM implementation has prioritized technology capabilities, but digital tools must be accessible and usable by people from diverse racial, ethnic, and socioeconomic groups to avoid exacerbating health disparities. Thus, in this project we will engage people from groups with historically under-recognized and under-treated OA, including Black/African American adults and Hispanic adults. We will elicit their input on how best to support them in communicating symptoms and functional limitations to primary care providers, and in receiving adequate care that aligns with their values and preferences.


This one-year project is intended as preliminary work for future projects in which we will build, refine, implement, and evaluate interventions to improve equity in OA diagnosis and treatment. This work is funded by a seed grant from the Northwestern Primary Care Practice-Based Research Program (NP3).

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