Understanding barriers to use of outpatient physical therapy in minoritized individuals: A qualitative study

When compared to white individuals, there is documented lower use of outpatient physical therapy (PT) for musculoskeletal conditions in minoritized individuals; however, little research has attempted to identify potentially unique perceived barriers to use of PT in this group.

The aims of this study were to 1) qualitatively explore attitudes, beliefs, and perceived barriers to attending outpatient PT in individuals with a musculoskeletal condition who were referred to PT but did not attend, and 2) identify any differences in attitudes, beliefs, and perceived barriers between white and minoritized individuals.

One-on-one semi-structured qualitative interviews.

Twenty-five adults completed the interviews, including 12 white and 13 minoritized individuals. Interviews lasted less than 30 min. Interviews were transcribed and thematic analysis was performed. Individual groups were then compared within and between to identify any differences in themes.

Three barriers to the use of outpatient PT were identified in both groups: 1) structural and logistical barriers, 2) perceptions and experiences of PT, and 3) psychological and emotional factors. Structural and logistical barriers and psychological and emotional barriers appeared to be more salient in minoritized participants. Participants often cited multiple barriers to use and their responses highlighted the interaction and compounding effect of multiple barriers being present.

Multiple system- and individual-level barriers to use of outpatient PT were present in this cohort. Addressing these barriers may improve more equitable access and use of outpatient PT in minoritized individuals.