Using focus groups to identify the barriers of arthritis-related disability on food behaviours and guide future nutrition interventions
Introduction: Arthritis is associated with greater functional disability, lower diet quality, and a higher risk of experiencing food insecurity. However, how arthropathies impact food choices, grocery shopping, and food preparation remains largely understudied.  
Objectives: This study sought to describe the impact of arthritis-related disability on aspects of food insecurity and meal preparation and to gain insight on the incentives and deterrents to participating in a nutrition intervention program.
Methods: Twenty-seven individuals diagnosed with arthritis participated in one of four focus groups between April and May 2018 at Concordia’s PERFORM Centre. Participants completed questionnaires relating to socioeconomic status, diet, and health. Audio recordings of the focus groups were transcribed verbatim and were coded using the constant comparative method. Basic descriptive statistics were used to analyze the questionnaire data. 
Results: The themes of pain, fatigue, knowledge, and social support emerged in discussions on food choices, procurement, preparation, consumption, and other lifestyle behaviours. Approximately half of the participants increased diet quality by making specific dietary changes to improve their condition, while others made no modifications, often due to a lack of information.  Several reported changing their grocery shopping and food preparation due to fatigue and pain. The questionnaire results revealed low disability levels and higher socioeconomic status in our groups. Timing, cost, and information quality were deemed to be the most important incentives to participate in a nutrition intervention program. 
Conclusions: Participants reported common barriers, although the extent to which they were impacted differed.  This variability highlights the need for customized, comprehensive interventions that consider disability levels and other factors, such as socioeconomic status and social support.
Significance to the field of dietetics: The information obtained on the challenges of arthritis in nutrition and the incentives to participate in an educational intervention provides valuable insight when adapting dietary recommendations or creating a program.