Abstract
BACKGROUND: Rheumatoid arthritis (RA) poses significant health challenges worldwide. However, little is known about disparities in knowledge, attitudes, and practices (KAP) regarding RA among ethnic minorities in China. This study aimed to compare KAP outcomes between Han and She ethnic groups and to explore the influencing factors. METHODS: A cross-sectional study was conducted among residents of Ningde City, Fujian Province, China, between June 2023 and January 2024. RESULTS: A total of 546 valid questionnaires were collected. The mean knowledge, attitude, and practice scores for the total sample were 8.85±5.85, 41.10±6.56, and 16.47±3.91, respectively. Han participants exhibited significantly higher attitude (44.02±6.49 vs. 40.46±6.40, P<0.001) and practice scores (17.41±4.15 vs. 16.25±3.82, P=0.005) than She participants, although knowledge scores were slightly lower among Han (7.85±3.60 vs. 9.06±6.21, P=0.119), although this difference was not statistically significant (P = 0.119). Structural equation modeling analysis revealed that education was positively associated with knowledge (β = 1.53, P < 0.001), while knowledge (β = 0.40, P < 0.001) and ethnicity (β = 4.04, P < 0.001) showed direct paths to attitudes. Furthermore, attitudes (β = 0.25, P < 0.001) and income (β = 0.64, P < 0.001) were independently associated with practices. CONCLUSION: Residents in Ningde City demonstrated generally adequate knowledge and positive attitudes towards RA but only moderate levels of proactive practices. Ethnic disparities were observed, with Han participants showing better attitudes and practices than She participants. Targeted educational interventions that consider ethnic and socioeconomic differences are warranted to enhance RA management outcomes in minority communities.