title: Why do people delay accessing health care for knee osteoarthritis? Exploring beliefs of health professionals and lay people.
abstract: OBJECTIVE
  In knee osteoarthritis (OA), opportunity for non-surgical intervention is reduced by time lost between symptom onset and diagnosis. The study's purpose was to understand, from the perspective of various stakeholders, the reasons for delay and useful strategies to enhance early awareness of knee OA.
  
  
  METHODS
  In this qualitative study, focus groups of health professionals (n=6) and community-dwelling individuals (n=7) discussed questions relating to knowledge, attitudes, and beliefs about OA; experiences with people with OA; health care seeking behaviour; and access to services, and suggested strategies to enhance public awareness. Qualitative analyses identified dominant themes.
  
  
  RESULTS
  Reasons for delay from the laypersons' perspective included lack of knowledge about risk factors and prevention and a belief that knee pain is expected with age. Reasons related to the health care system included long wait times and frustration getting appointments. Health professionals were unclear on which discipline should discuss prevention and risk factors. Suggested strategies included advocating a healthy lifestyle, developing prevention programs, and using celebrities to inform the public.
  
  
  CONCLUSIONS
  Participants identified multiple reasons for delays and strategies to counter them. Knowledge about gaps in the OA care process can facilitate physiotherapists' participation in developing strategies for early intervention.
authors.affiliation: School of Physical and Occupational Therapy, McGill University ; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC.
authors.forename: Shreya S
authors.initials: SS
authors.lastname: Prasanna
authors.affiliation: School of Physical and Occupational Therapy, McGill University ; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC.
authors.forename: Nicol
authors.initials: N
authors.lastname: Korner-Bitensky
authors.affiliation: School of Physical and Occupational Therapy, McGill University ; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC.
authors.forename: Sara
authors.initials: S
authors.lastname: Ahmed
keywords: attitude to health; focus groups; health promotion; knee; osteoarthritis; patient acceptance of health care