Exploring Functional Recovery and the Lived Experiences of Underrepresented Populations with Dysvascular Lower Limp Amputation: A Mixed-Methods Pilot Study (RPA Pilot / Seed Project)

Racial, ethnic, and socioeconomic disparities in the prevalence of dysvascular lower limb amputation are well-established. Persons who identify as Black/African American, or are of Hispanic ethnicity, or Native American heritage are at substantially greater risk of undergoing amputation due to vascular disease causes like peripheral artery disease and/or diabetes mellitus. Additionally, people of lower socioeconomic status and those living in rural locales experience higher amputation rates. However, little is known about whether these disparities persist into recovery and quality of life post-amputation or how socioenvironmental factors may be affecting optimal functioning with a prosthetic leg. Furthermore, there is currently no research available on the lived experience of persons with lower limb amputation from underrepresented and under-resourced populations. This creates large gaps in the evidence surrounding the perceptions and beliefs of this population, making it difficult to understand how to mitigate potential barriers to recovery and optimize quality of life. The overall objective of this CHS/UNITE proposal is to contribute new, and vital, information to the amputation literature regarding the lived experiences of prosthetic leg wearers who identify as Black/African American, and interpreting any relationships to functional recovery and quality of life. We propose to comprehensively address the gaps in knowledge by performing semi-structured interviews with up to 20 prosthetic limb users who identify as Black, living in both urban and rural environments, while also collecting quantitative data examining functional mobility with a prosthetic limb. Successful completion of this work will establish an evidence-base for barriers and facilitators to functional recovery after LLA in a diverse cohort of people with LLA, specifically in historically underrepresented racial and rural populations who are at greater risk for amputations and poorer outcomes. This proposal is strategically designed to fortify the foundation for a larger, prospective study focused on mitigating barriers to recovery after amputation.