Moving forward, Dr. Mandal and colleagues plan to expand their outreach to additional Native American communities, starting in January 2023. They are also exploring the creation of similar ECHO training for the Navajo Nations covering spondyloarthritis, another condition of increased prevalence in this population.
Ultimately, the team would also like to gather patient outcome data to better understand the impact of rheumatoid arthritis on the Navajo Nation and find areas for intervention.
Dr. Mandal noted that many community members deeply mistrust requests for private health information, based on centuries of unfair treatment and exploitation. “Asking for private health information before establishing a long track record of trust, even if it is well-intentioned, can lead to harm,” she said. “We are also focusing on continuing to build a legacy of trust and longevity in the Navajo community, so that in the future we can ethically ask for patient outcome data.
“We believe the RAE Initiative’s remote rheumatology training program is an example of an effective, low-cost and scalable model that we hope might serve as a blueprint to develop similar programs to support other vulnerable communities and ultimately reduce disparities in rheumatology care,” she concluded.
Ruth Jessen Hickman, MD, is a graduate of the Indiana University School of Medicine. She is a freelance medical and science writer living in Bloomington, Ind.
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