Understanding knowledge, attitudes, and beliefs about Parkinson's disease in the Philadelphia community: A cross-cultural comparison

Traditionally underserved minorities with Parkinson's disease (PD) are at an increased risk of delayed PD diagnosis. Of those diagnosed, only a small proportion receives adequate care.

To develop strategies for reducing PD treatment disparities, we aimed to understand knowledge, attitudes, and beliefs about PD across different racial/ethnic groups.

We conducted focus groups (n=10) and administered surveys (n=154) about knowledge and attitudes of Parkinson's disease to Caucasian, African-American and Chinese older adults at senior centers in Philadelphia. Major themes were identified from focus groups and compared by race/ethnicity. ANOVA and chi-square tests were used to assess differences in PD knowledge and attitudes. Potential confounders were controlled for in regression analyses.

Focus group participants included 23 Caucasian, 35 African-American and 16 Chinese older adults while 62 Caucasian, 47 African-American and 45 Chinese individuals completed the survey. Common themes across race/ethnicity about PD were: fear, loss of independence, hopefulness for a cure, and worry of burdening their family. Unique themes were mistrust in the healthcare system and language as barriers to care among African Americans and Chinese, respectively. Significantly more Caucasians and African-Americans than Chinese older adults correctly understood that medications can improve PD symptoms (p=0.011). Furthermore, 46% of the Chinese agreed that PD is a natural result of aging, compared to 24% of African Americans and 5.3% of Caucasians (p<0.001).

Overall, PD knowledge in the community was relatively low across all groups. Several racial/ethnic differences in barriers to care identified in both focus groups and survey responses may partly explain PD treatment disparities.