About Us

 

 

Our Story

The Rheumatology Access Expansion (RAE) Initiative was established in 2021 to support people living with rheumatoid arthritis in communities with limited access to local rheumatologists. 

A Shortage of Rheumatology Providers

Rheumatoid arthritis (RA) is the most common form of autoimmune arthritis, affecting more than 1.3 million Americans. When inadequately treated, RA is associated with substantial pain, deformity, and disability. However these poor outcomes can largely be avoided through early diagnosis and appropriate management. It is well-established that the burden of RA in the United States falls disproportionately on communities of color and rural populations. Navajo Nation, the largest American Indian reservation, is an example of a community that is especially hard-hit, faced with high RA prevalence and disease severity, and limited access to local rheumatology specialists.

Given the shortage of local rheumatology providers in many rural and suburban communities across the US (and worldwide), a large portion of of RA care falls to primary care providers (PCPs). Supporting PCP-lead management of RA is key to reducing suffering and improving the lives of those living with RA. 

Our project uses an established educational model, Project ECHO (Extension for Community Healthcare Outcomes), to remotely mentor PCPs in the diagnosis and evidence-based treatment of RA, with the primary goal of improving RA disease-associated outcomes and reducing health disparities. Weekly interactive Zoom conferences are led by an interdisciplinary team of RA experts, and include high-yield didactics on core topics in RA diagnosis and treatment, as well as interactive case-based discussion. 

1.3 million Americans

affected by RA

A Spotlight on Navajo Nation

When the RAE Initiative was first established in 2021, our core mission was to support people living with RA on Navajo Nation. Navajo Nation is the largest American Indian reservation, home to over 170,000 on-reservation tribal members. It is estimated that the Navajo community has approximately 5 times the prevalence of RA compared to the overall US population. Given the vast size and rurality of Navajo Nation, combined with the scarcity of local rheumatology providers, people living with RA and other rheumatologic conditions on Navajo often face significant barriers to accessing specialty care. 

The first RA ECHO Curriculum was created in close partnership with community health leaders and providers on Navajo, specifically to support PCPs and patients on Navajo Nation. In partnership with local community health organizations, the RAE Initiative continues to promoting community awareness about RA and celebrating the strength and resilience of those living with RA on Navajo Nation. Community-centered projects have included:

  • – Digital Storytelling Workshop, led by Healthy Native Communities Partnership, in which individuals shared their personal stories of how RA has impacted their lives. 
  • – Rez Cafes (community round-table discussions) focused on arthritis
  • – A Joint Health training symposium for Community Health Representatives
  • – Development of RA patient education materials specifically for the Navajo community
  • Be

 

Expanding the Reach of the RAE Initiative

Since 2023, we have partnered with Indian Country ECHO to offer access to the Rheumatoid Arthritis ECHO Curriculum to all primary care providers serving Indian Country, nation-wide. To date, more than 100 PCPs have completed the RA ECHO curriculum, from 16 different states. In the future, we hope to expand the reach of Rheumatology ECHO programs further, to reach all PCPs who wish to enhance their knowledge of common rheumatologic diseases, with the hope of expanding access to excellent rheumatology care and reducing health disparities.

A

Nearly 5X

the national prevalence of RA on Navajo Nation

Rheumatoid arthritis (RA) is the most common form of autoimmune arthritis, affecting more than 1.3 million Americans. When inadequately treated, RA is associated with substantial pain, deformity, and disability. However these poor outcomes can largely be avoided through early diagnosis and appropriate management. It is well-established that the burden of RA in the United States falls disproportionately on communities of color and rural populations. Navajo Nation, the largest American Indian reservation, is especially hard-hit, faced with high RA prevalence and disease severity, and very limited access to rheumatology specialists.

Given the shortage of local rheumatology providers, the majority of RA care falls to primary care providers (PCPs). Supporting PCP-lead management of RA is key to reducing suffering and improving the lives of those with RA on Navajo Nation.

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Our project uses an established educational model, Project ECHO (Extension for Community Healthcare Outcomes), to remotely mentor Navajo Nation PCPs in the diagnosis and evidence-based treatment of RA, with the primary goal of improving RA disease-associated outcomes and reducing health disparities. Weekly interactive Zoom conferences are led by an interdisciplinary team of RA experts in and around Navajo Nation, and from the University of California San Francisco.

In partnership with local community health organizations, the RAE Initiative is promoting community awareness about RA and celebrating the strength and resilience of those living with RA on Navajo Nation. Projects for 2022 include a Digital Storytelling Workshop, led by Healthy Native Communities Partnership, in which individuals will share their personal stories of how RA has impacted their lives.

Rheumatoid arthritis (RA) is the most common form of autoimmune arthritis, affecting more than 1.3 million Americans. When inadequately treated, RA is associated with substantial pain, deformity, and disability. However these poor outcomes can largely be avoided through early diagnosis and appropriate management. It is well-established that the burden of RA in the United States falls disproportionately on communities of color and rural populations. Navajo Nation, the largest American Indian reservation, is especially hard-hit, faced with high RA prevalence and disease severity, and very limited access to rheumatology specialists.

Given the shortage of local rheumatology providers, the majority of RA care falls to primary care providers (PCPs). Supporting PCP-lead management of RA is key to reducing suffering and improving the lives of those with RA on Navajo Nation.

1.3 million Americans

affected by
Rheumatoid arthritis (RA)

Nearly 5X

the national prevalence of RA in the Navajo Nation

Our project uses an established educational model, Project ECHO (Extension for Community Healthcare Outcomes), to remotely mentor Navajo Nation PCPs in the diagnosis and evidence-based treatment of RA, with the primary goal of improving RA disease-associated outcomes and reducing health disparities. Weekly interactive Zoom conferences are led by an interdisciplinary team of RA experts in and around Navajo Nation, and from the University of California San Francisco.

In partnership with local community health organizations, the RAE Initiative is promoting community awareness about RA and celebrating the strength and resilience of those living with RA on Navajo Nation. Projects for 2022 include a Digital Storytelling Workshop, led by Healthy Native Communities Partnership, in which individuals will share their personal stories of how RA has impacted their lives.

Our Collaborators

Gwendolyn Grant

Jeannie Hong

Jennifer Mandal (PI)

Jinoos Yazdany

Marita Jones

Mimi Margaretten

Nat Cabrera

Tabitha Carroway

Tina Tso

Starla Hairston Blanks

Our Supporters

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