Table 3.

Theme 2 illustrative quotes

Theme 2: preventive interventions to reduce the risk of developing RA
Descriptive theme	Illustrative quotes
Understanding the role and value of preventive interventions
Individuals at-risk of RA acknowledged that preventive interventions have a role in modifying risk.	‘I think drugs would be involved, drugs that are less strong than those used to treat the disease’.29 ‘ifestyle 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’.30
Engagement with preventive interventions
Individuals at-risk of RA identified that engagement with a preventive intervention would be influenced by its effectiveness in reducing risk.	‘I’ve got to take a medication for how long, the rest of my life? … It’s a big commitment when the odds of developing the disease is still fairly high if I’ve got a 50% risk of still developing it, whereas if you tell me, ‘Well, actually, if you take it and based on what we can tell you about your predictability factors, your odds of developing the disease are gonna be down to 5%,’ then I might consider it’.30
Having symptoms would make individuals at-risk of RA more willing to consider preventive interventions.	‘Well, changing lifestyle means changing diet, difficult, because changing your diet, abstaining from certain food that you like to eat, means reducing your quality of life. I personally don’t agree with that, I’m definitely not going on a diet because of a disease I don’t have at the moment! But I certainly would if I had any symptoms’.28 ‘The chance that I would do it would increase hand over hand if I had severe pain’.34
Seeing the impact of RA on a relative would make individuals at-risk of RA more willing to consider preventive interventions.	‘RA is in my family unfortunately. My mother, my grandmother, they’re both gone (…). And the fact that I participate in the medication trial is just like, yes, I’ve seen what RA can do’.34
Individuals at-risk of RA had concerns about taking preventive medication.	‘I prefer a drug that doesn’t affect the immune system(…)drugs can make us more vulnerable to infections’.29 ‘You know, I went to Europe last year with my wife. We were gone for, you know, half a year. Now if I wasn’t able to do that because I had to go to a specific doctor twice a week to get this thing, no thanks. I’m good’.32
Individuals at-risk of RA highlighted a need for more information about their actual risk and preventive interventions before engaging.	‘Only under the condition that a person would receive the necessary information to be able to decide whether to take a preventive medicine’.28 ‘From where it would be coming from, Dr.— was like, ‘Hey, you know, there’s this treatment. You know, I know how badly it effects your mother. I think that you are possibly at-risk for having it,’ and he suggested it to me, I would definitely take a look at it’.32

RA, rheumatoid arthritis.