Exploring the barriers and facilitators to accessing and engaging with information resources about rheumatoid arthritis (RA) by ethnic minority or non-native patients: A systematic review and thematic synthesis.

Abstract

To identify and synthesise existing literature describing barriers and facilitators to accessing and engaging with rheumatoid arthritis (RA) self-management information by non-native and ethnic minority groups. Four electronic databases were searched from inception to October 2024 and screened by two independent reviewers against the following prespecified inclusion criteria: 1. must include participants who are diagnosed with RA and non-English language speakers; 2. Had participants who were adults. 3. Adopt a qualitative study design. 4. Address the research question. Line-by-line coding of findings was carried out and was supported by NVivo software. Codes were then grouped to represent themes and sub-themes of key concepts commonly described across included studies. The themes were discussed and modified among the wider research team. The quality appraisal of the studies was performed by two independent reviewers using the CASP checklist, assessing methodological rigour and the validity of results to identify any potential sources of bias. A total of eight studies were included, and three main themes were identified: 1) A lack of awareness, knowledge and understanding of RA and its treatments (2) Mistrust of healthcare professionals (3) Uncertainties and concerns about the risks and benefits of treatments, impacting adherence CONCLUSION: The collective evidence suggests that ethnic minority and non-native patients encountered barriers to accessing information about RA, which likely impacts patients overall health and outcomes. Future work should focus on designing and delivering more acceptable educational resources for non-native and ethnic minority individuals with RA, to ensure that information is accessible and equitable. The development of culturally tailored, multi-format educational resources that integrate patient input and include visual aids on topics relevant to ethnic minority groups is required. In clinical practice, trained interpreters should be employed and communication strategies that respect cultural and linguistic needs adopted. Policy should ensure adequate funding for translation services and community-based health education. Further research should explore participatory design approaches to create interventions aligned with patient perspectives.