title: Knowledge and attitudes about Parkinson's disease among a diverse group of older adults.
abstract: Underserved minorities are vulnerable to diagnostic delays and under-treatment of Parkinson's disease (PD). The purpose of this mixed-methods study was to understand knowledge and attitudes about PD among a racially/ethnically diverse group of community members. In the qualitative arm, ten homogeneous focus groups of 6 to 8 White, African-American and Chinese American older adults at senior centers in Philadelphia were conducted. Next, for the quantitative arm, a questionnaire of knowledge and attitudes about PD was administered among a larger group of senior center members. Themes were identified from the focus group discussions. ANOVA and chi-square tests were used to assess differences in PD knowledge and attitudes among the different racial/ethnic groups. Logistic regression analyzed for independent factors associated with barriers to treatment. Seventy-five adults participated in the focus groups (23 Whites, 36 African-Americans and 16 Chinese-Americans) and 154 completed the questionnaire (62 Whites, 47 African-Americans and 45 Chinese-Americans). One common theme about developing PD was fear of losing independence. Racial/ethnic groups identified unique barriers to care: mistrust in the healthcare system by African-Americans and language difficulties by Chinese-Americans. Eighty percent of all participants had no to some knowledge of PD. African-Americans and Chinese-Americans were more likely to perceive PD as a part of normal aging than whites. Chinese-Americans were more likely to perceive barriers to treatment than whites. A diverse sample of older adults demonstrated low levels of PD knowledge through both qualitative and quantitative methods. Many barriers to PD care were identified. Targeted community outreach and education efforts should incorporate information about PD and how to receive care.
authors.affiliation: Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, PA, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Pan
authors.forename: Julie
authors.initials: J
authors.lastname: Stutzbach
authors.forename: Suzanne
authors.initials: S
authors.lastname: Reichwein
authors.forename: Brian K
authors.initials: BK
authors.lastname: Lee
authors.forename: Nabila
authors.initials: N
authors.lastname: Dahodwala
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000523:psychology*; D015143:Philadelphia; D011795:Surveys and Questionnaires
references.citation: N Engl J Med. 2005 Sep 8;353(10):1021-7
references.pmid: 16148287
references.citation: Int J Geriatr Psychiatry. 2003 Nov;18(11):1029-36
references.pmid: 14618555
references.citation: Mov Disord. 2003 Jan;18(1):19-31
references.pmid: 12518297
references.citation: Arch Fam Med. 2000 Nov-Dec;9(10):1156-63
references.pmid: 11115223
references.citation: N Engl J Med. 1999 Nov 25;341(22):1661-9
references.pmid: 10572155
references.citation: Clin Psychol Rev. 2011 Aug;31(6):934-48
references.pmid: 21683671
references.citation: Neurology. 2002 Jun 25;58(12):1820-5
references.pmid: 12084883
references.citation: J Gen Intern Med. 2004 Dec;19(12):1228-39
references.pmid: 15610334
references.citation: Acta Neurol Scand. 1994 Aug;90(2):111-5
references.pmid: 7801736
references.citation: Ann Neurol. 2009 Aug;66(2):142-5
references.pmid: 19743462
references.citation: Am J Epidemiol. 2003 Jun 1;157(11):1015-22
references.pmid: 12777365
references.citation: Ann Intern Med. 2011 Jul 19;155(2):97-107
references.pmid: 21768583
references.citation: Neurology. 1985 Jun;35(6):841-5
references.pmid: 4000484
references.citation: J Gen Intern Med. 2006 Jul;21(7):786-91
references.pmid: 16808783
references.citation: Parkinsonism Relat Disord. 2010 Jul;16(6):415-7
references.pmid: 20061175
references.citation: Alzheimer Dis Assoc Disord. 2003 Jan-Mar;17(1):19-26
references.pmid: 12621316
references.citation: BMC Public Health. 2011 Apr 08;11:219
references.pmid: 21477284
references.citation: Parkinsonism Relat Disord. 2008;14(1):8-14
references.pmid: 17702625
references.citation: Int Psychogeriatr. 2012 Jan;24(1):108-16
references.pmid: 21849100
references.citation: Neurology. 2011 Aug 30;77(9):851-7
references.pmid: 21832214
references.citation: Alzheimer Dis Assoc Disord. 2009 Apr-Jun;23(2):110-6
references.pmid: 19474569
references.citation: Neuroepidemiology. 2011;36(3):150-4
references.pmid: 21508648
references.citation: Mov Disord. 1997 Mar;12(2):197-205
references.pmid: 9087978
references.citation: Mov Disord. 2008 Aug 15;23(11):1567-672
references.pmid: 18581482
references.citation: Neurology. 1995 Dec;45(12):2143-6
references.pmid: 8848182
references.citation: Health Educ Q. 1984 Spring;11(1):1-47
references.pmid: 6392204
references.citation: Int J Clin Pract Suppl. 2005 Mar;(146):8-14
references.pmid: 15801185
references.citation: J Neurosurg. 2003 Nov;99(5):863-71
references.pmid: 14609166
references.citation: Psychol Rep. 2005 Feb;96(1):204-6
references.pmid: 15825927
references.citation: Parkinsonism Relat Disord. 2009 May;15(4):258-62
references.pmid: 18693062
references.citation: Aging (Milano). 1993 Feb;5(1):27-37
references.pmid: 8481423