Rheumatoid Arthritis Care for Diverse Populations in Canada – Supporting Changes to Better Reflect Realities


Scientific Study Title:


Principal Investigator:

Cheryl Barnabe – MD, MSc, FRCPC, Senior Scientist, Arthritis Research Canada

Associate Professor, Division of Rheumatology, Department of Medicine and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary



Diane Lacaille,  MD, MHSc, FRCPC
Scientific Director, Arthritis Research Canada
Mary Pack Chair in Rheumatology Research
Professor, Division of Rheumatology, Associate Head of Academic Affairs, Department of Medicine, University of British Columbia


Glen Hazlewood, MD, PhD, FRCPC,
Assistant Professor, Division of Rheumatology, Department of Medicine, Cumming School of Medicine, University of Calgary
Research Scientist, Arthritis Research Canada


Dr. Aurore Fifi-Mah
Clinical Associate Professor- Division of Rheumatology, Department of Medicine, Cumming School of Medicine, University of Calgary


Dr. Nicole Johnson
Clinical Associate Professor- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Alberta Children’s Hospital


Dr. Brett Thombs, Professor- McGill University
Lead- Scleroderma Patient-centered Intervention Network (SPIN)


Dr. Richard Henry, PostDoctoral Fellow
Scleroderma Patient-centered Intervention Network (SPIN)


Cheryl Koehn, President, Arthritis Consumer Experts (ACE)
Therese Lane, Michael Kuluva, Canadian Arthritis Patient Alliance (CAPA)
Kelly English, Arthritis Patient Advisory Board (APAB)
Nejat Hassen, Masters student, The University of British Columbia (UBC)
Megan Thomas, PhD student, The University of British Columbia (UBC)


Start Date:



End date:



Why did we do research?

Some healthcare providers and researchers have a limited understanding of the barriers to care that exist for people who are members of populations that experience inequities. We needed to determine which approaches in rheumatology care are desired, effective and improve outcomes for all people with Rheumatoid Arthritis (RA) and put them into practice. The two years previous to this research, we explored the experiences of RA care of various populations: persons from rural and remote areas, those who are of Indigenous ethnicity, persons who are elderly with frailty, population groups who have immigrated to Canada, those who are homeless or have low income, and who are women pursuing motherhood. In speaking with people from these diverse communities and their healthcare providers, we developed guiding principles for RA treatment recommendations reflective of their unique circumstances. With this research, we sought to expand this work further.


What was done?

We gathered information to understand the RA care experience for Black Canadians and Canadians with diverse sexual orientation, gender identity and expression. This informed how RA treatment recommendations are put into practice, so that the approaches taken reflect their needs and realities. We shared the information we gathered by developing materials and an online medical education program for arthritis care providers in Canada. Our evaluation included the impact of this work on providers’ awareness and any changes they make in their approach to providing arthritis care.


Who was involved?

The research team included researchers with expertise in equity and guideline development, rheumatologists and patients representing Black Canadians and persons with diversity in sexual orientation, gender identity and expression. We recruited up to 15 patients from each of these 2 population groups who have RA, and up to 15 rheumatology care providers who had experience in delivering care to persons from these populations. Once we designed the continuing medical education program, we advertised it to rheumatology care providers throughout Canada to take.


Funding Agency:

Canadian Initiative for Outcomes in Arthritis Care (CIORA)


This study has been approved by the University of Calgary Conjoint Health Research Ethics Board (REB19-0695).