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BackgroundMusculoskeletal (MSK) conditions are the most common cause of severe chronic pain and disability worldwide. Despite the impact of these conditions, disparity exists in accessing high quality basic care. As a result, effective treatments do not always reach people who need services. The situation is further hampered by the current models of care that target resources to a limited area of health services (eg, joint replacement surgery), rather than the entire continuum of MSK health, which includes services provided by primary care physicians and health professionals. The use of digital media offers promising solutions to improve access to services. However, our knowledge in this field is limited. To advance the use of digital media in improving MSK care, we held a research planning meeting entitled “PEOPLE: Partnership to Enable Optimal Primary Health Care by Leveraging Digital Media in Musculoskeletal Health”. This paper reports the discussion during the meeting. ObjectiveThe objective of this study was to: (1) identify research priorities relevant to using digital media in primary health care for enhancing MSK health, and (2) develop research collaboration among researchers, clinicians, and patient/consumer communities. MethodsThe PEOPLE meeting included 26 participants from health research, computer science/digital media, clinical communities, and patient/consumer groups. Based on consultations with each participant prior to the meeting, we chose to focus on 3 topics: (1) gaps and issues in primary health care for MSK health, (2) current application of digital media in health care, and (3) challenges to using digital media to improve MSK health in underserviced populations. ResultsThe 2-day discussion led to emergence of 1 overarching question and 4 research priorities. A main research priority was to understand the characteristics of those who are not able to access preventive measures and treatment for early MSK diseases. Participants indicated that this information is necessary for tailoring digital media interventions. Other priorities included: (1) studying barriers and ethical issues associated with the use of digital media to optimize MSK health and self-management, (2) improving the design of digital media tools for providing “just-in-time” health information to patients and health professionals, and (3) advancing knowledge on the effectiveness of new and existing digital media interventions. ConclusionsWe anticipate that the results of this meeting will be a catalyst for future research projects and new cross-sector research partnerships. Our next step will be to seek feedback on the research priorities from our collaborators and other potential partners in primary health care.

Objective: The objective of this study was to investigate a profile of cardiovascular disease (CVD) risk factors by sex among individuals with and without osteoarthritis (OA) and to consider single‐site and multisite joint OA. Methods: Data were sourced from Cycle 1, Comprehensive Cohort, Canadian Longitudinal Study on Aging, a national sample of individuals ages 45 to 85 years. Systemic inflammatory/metabolic CVD risk factors collected were high‐sensitivity C‐reactive protein (hsCRP) level, high‐density lipoprotein, triglycerides, total cholesterol, body mass index (BMI), systolic blood pressure, and hemoglobin A1c. Smoking history was also collected. Respondents indicated doctor‐diagnosed OA in the knees, hips, and/or hands and were characterized as yes/no OA and single site/multisite OA. Individuals with OA were age‐ and sex‐matched to non‐OA controls. Covariates were age, sex, education, income, physical activity, timed up and go test findings, and comorbidities. A latent CVD risk variable was derived in women and men; standardized scores were categorized as follows: lowest, mid‐low, mid‐high, and highest risk. Associations with OA were quantified using ordinal logistic regressions. Results: A total of 6,098 respondents (3,049 with OA) had a median age of 63 years, and 55.8% were women. One‐third of OA respondents were in the highest risk category versus one‐fifth of non‐OA respondents. Apart from BMI (the largest contributor in both sexes), hsCRP level (an inflammation marker) was predominant in women, and metabolic factors and smoking were predominant in men. Overall, OA was associated with worse CVD risk quartiles compared with non‐OA. OA was increasingly associated with worse CVD risk quartiles with increasing risk thresholds among women with multisite OA, but not men. Conclusion: Findings suggest unique CVD risks by sex/multisite subgroups and point to a potentially important role for inflammation in OA over and above traditional CVD risk factors. [ABSTRACT FROM AUTHOR]

This study examined the impact of the 1998 Canadian ice storm on the physical and psychological health of older adults (age greater than 55 years) living with a chronic physical illness, namely osteoarthritis and/or osteoporosis. Although disasters are relatively rare, they are a useful means of examining the impact of a single stressor on a group of individuals. Specifically, we took advantage of a natural experiment to compare the responses of a group of 59 ice storm victims to those of 55 matched controls living outside the ice storm area. Data on disability, pain, self-reported health, helplessness, depression, and independence were assessed prior to the ice storm and approximately 17 months later. Older adults who reported greater helplessness and lost independence prior to the storm reported significantly greater ice storm stress and rumination and were more likely to report that the storm affected their condition. In addition, participants exposed to the ice storm reported significant changes in disability and pain nearly a year and a half later, compared to matched controls. These results suggest that older adults with chronic physical illness may be particularly vulnerable when faced with additional stressful events. (Contains 3 tables and 2 figures.) [Abstract provided in both French and English.]

We examined how perceived need for workplace accommodation affects labor-force participation in people with disabilities. We analyzed a Canadian survey with structural equation modeling to test a model incorporating activity limitations and perceived need for workplace accommodations. The results suggested that the effect of upper- and lower-body activity limitation on labor-force participation was mediated by perceived need for workplace accommodations. Thus, the provision of adequate workplace accommodations could enhance labor-force participation in people with disabilities.