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Table 4 Modifying risk through lifestyle changes

From: Perceptions of first-degree relatives of patients with rheumatoid arthritis about lifestyle modifications and pharmacological interventions to reduce the risk of rheumatoid arthritis development: a qualitative interview study

1 “Well, I would gather information ahead of time about this disease, so, what issues are there, what characteristics, and how can you get rid of it, how can you prevent it so that it doesn’t break out. Well, I would be more careful about my life or my health than I have up to now.” (Participant 33; male)
2 “…..it would strike a chord with me to eat healthier and be healthier if they said I can have five years extra when I’m possibly not going to get it. I’d rather not have RA than have it and I’d do everything in my power not to have it because it doesn’t seem that much fun.” (Participant 5; female)
3 “Well, I don’t smoke and I hope I’ve got a reasonably healthy diet. Yes, if there are changes necessary to be made, I’d be happy to make them.” (Participant 3; male)
4 “Lifestyle changes, I’m up for any kind really, yeah. Healthy eating and exercise, although I can’t do a lot but I do try and do as much as I can.” (Participant 13; female)
5 “How I look at it is, it’s part of… if you get it the only way that you can actually do something about it is change … what you eat, the foods you consume and stuff like that. So I’m the only one in my family that eats organic or free range food and I drink whole milk and I eat saturated fat as well so I avoid low fat stuff so I believe it’s to do with your diet as well. By changing your diet you can actually change the way your body functions and what happens to it.” (Participant 14; female).
6 “I think it probably half depend on what kind of person you are, I know for my sister she was much more worried than I was only because she’s a lot older than me and she’s overweight and she saw that as kind of, like without reading the letters I could figure she was going to get it more than me.” (Participant 5; female)
7 “I would prefer to know about (my risk of developing RA) because then I can potentially try and manage my lifestyle better in general ..…” (Participant 24; male)
8 “So,… lifestyle changes, yeah definitely, particularly with things like exercise, because that’s something, I’m not a particularly sporty person, and I know my dad’s been very, very sporty throughout his life and, you know, what are the risks I suppose, of that? Or whether (it is) osteoarthritis that puts the weight on your joints or, you know, that kind of information that I wouldn’t necessarily know; that’d be the kind of thing I’d be looking to find out.” (Participant 1; female)
9 “I think that I might behave more consciously in ways of diet or, yes generally, maybe I would try somehow to prevent that it actually happens. Well, of course, I would have to read up on what is possible in that regard, but I think I would do that.” (Participant 31; female)
10 “Well, I wouldn’t change anything about my diet and concerning sports, as I said, that’s the question, I don’t think so, due to the fact that I think it wouldn’t stress me, I wouldn’t change my habits in sports as in doing less or doing more, whatever, because I just think, then I would become so careful that in the end I would just sit around and not do anything anymore or exaggerate everything. That wouldn’t be a good idea, well I can’t really imagine that, because basically I would change little or nothing.” (Participant 28; female)
11 “If all I know that I am at a heighted risk, I don’t think I would change my diet” (Participant 28; female)
12 “Yeah, I think it would have, because after seeing what my mum can go through, when it does trigger and it kicks in, yeah, without a doubt, I think, it brings reality home. So, yeah, I think if, I’d have probably walked out and chucked the fags in the bin there and then if, certainly if they’d come back and said, ‘Yeah, you’re in this category,’ and I thought, certainly if it was in, probably, middle to upwards, I definitely would have. If it had been the other way, I’d have thought, ‘Right, I need to quit,’ and worked on a couple of months’ timescale to do it.” (Participant 6; male)
13 “I’ve been smoking since I was 14. I’m 31 now, so I’m thinking, ‘Well, I’ve been smoking longer than half of my life.’ I wanna be around for my son when he’s older, … I know smoking is – because unfortunately I am a smoker – and my mum was, like, ‘You need to pack it in, anyway, but even more so after it had ...’ Certain things can trigger it …Yeah. I’m trying to quit smoking anyway, at the moment, so I’ve reduced the fags down to four at the moment, so I’m working down to getting to nothing.” (Participant 6; male)
14 “Yes, that’s a very good question. Since I’m a smoker and to be honest my diet isn’t really that great, I don’t know if I’d really – if someone could confirm to me, 100%, that if I stopped smoking and had a healthier diet I could stop myself from developing RA, then I would consider it – I would try to stop smoking and live a healthier life.” (Participant 26; female)
15 “Regarding smoking, I mean I smoke, I wouldn’t know, well if I say I have a heightened risk and that chances are 50:50 I develop it or not, then I don’t know whether I would consider it worth it to stop smoking.” (Participant 28; female)
16 “… ..People can be very touchy, particularly about smoking. About dietary things, people are more willing to take on board the advice about leafy green vegetables and those kind of things, but not smoking. I think there’s a little bit of them that makes them a bit over-defensive about their choice. They get hammered from so many different aspects; I think that it’s, like, one more person, that they don’t wanna be told from another person, that they shouldn’t smoke, so it’s quite a delicate subject. You can, sort of, give them the facts without trying to scare them, I guess.” (Participant 1; female)
17 “I’d be happy to change my lifestyle, if I thought it was going to have an impact on me developing the disease. But like you say, the only real strong lifestyle – well, the only one that I’m really aware of that has a massive impact, is smoking. I don’t smoke. You can’t really help but come into contact with people that do smoke, as much as you try and limit it, and it’s not that much now.” (Participant 10; female)