Abstract Background Inflammatory bowel diseases -Crohn’s disease (CD) and ulcerative colitis (UC)- are chronic relapsing gastrointestinal conditions generating high burden for patients. Patient-reported concerns and expectations can help identify areas of unmet needs, which may differ according to social determinants. Using an intersectionality approach (3,4), we investigated sex and social determinants interactions to identify groups with different IBD-related concerns and expectations. Methods Retrospective reanalysis of data from patients enrolled in a national cohort. A self-reported survey was doneto collect concerns and expectations items, rated on a 100-point scale, grouped in main dimensions (1,2). We performed latent class analysis (LCA) to identify clusters based on sex, education, employment status, ethnicity, health-related behaviors, and sociodemographic variables (language, foreign-born residency, marital status). Differences in concerns and expectations across classes were evaluated. Results LCA identified 5 classes (C) with distinct sociodemographic profiles. Proportions of patients included in C0-4: 29.6%, 31.4%, 11.0%, 16.0%, and 12.0%. Characteristics of class members: C0: 52.3% males, mean age 38.5, 97.2% foreign-bord resident (FBR), 55.6% CD; C1: 86% males, mean age 50.5y, 33.9% FBR, 65.2% married, 51% CD; C2: 50.8% males, mean age 24.0y, 77.1% in training, 97.6% single, 61.8% CD; C3: 86% females, mean age 39.5, 33.9% FBR, 46.5% single and 23.7% divorced, 63% CD; C4: 94.5% females, mean age 52.1, 90% married, 44.4% housewife/-husband, 50.9 UC/IBDU%. Among 1,074 patients completing the questionnaire, we observed differences in main dimensions of concerns and expectations, fig1. C0 members showed high concerns on constraints, uncertainties (58.2), long-term impact (57.8) related to the disease; C3 showed high concerns on symptoms (59.3). C1 0.001; C4 vs C1: +8.18, p 0.01) and pain (C3 vs C1: +15.16, p 0.001; C4 vs C1: +10.78, p 0.001). C3 vs. C1 reported higher concerns for loss of attractiveness (+10.16, p 0.001), feeling alone (+9.47, p 0.001). Among others, C3 vs C1 reported higher expectations on adapted solutions for professional life (+16.46, p 0.001), psychological help (+16.42, p 0.001), FU through other professionals (alternative therapy) (+12.83, p 0.001). Conclusion Identifying target groups with different levels of concerns / expectations is essential. Intersectional perspective taking into account sex and socioeconomic variables might help that purpose and provide clinicians tools for tailored communication and FU. References: 1. Pittet V, Vaucher C, Froehlich F, Burnand B, Michetti P; Swiss IBD Cohort Study Group. Patient self-reported concerns in inflammatory bowel diseases: A gender-specific concern index (GCI). PLoS One. 2017;12(2):e0171864. doi:10.1371/journal.pone.0171864 2. Pittet V, Vaucher C, Froehlich F, Maillard MH, Michetti P; Swiss IBD Cohort Study Group. Patients’ information needs: A survey among patients with inflammatory bowel disease. PLoS One. 2018;13(5):e0197351. doi:10.1371/journal.pone.0197351 3. Bauer GR, Mahendran M, Walwyn C, Shokoohi M. Latent variable analysis of biopsychosocial measures related to multiple dimensions of health. Soc Psychiatry Psychiatr Epidemiol. 2022;57(2):221-237. doi:10.1007/s00127-021-02195-6 4. Bauer GR. Incorporating intersectionality theory into population health research methodology: Challenges and the potential to advance health equity. Soc Sci Med. 2014;110:10-17. doi:10.1016/j.socscimed.2014.03.022 Conflict of interest: Espinosa, Pedro: No conflict of interest Gschwend, Adelia: No conflict of interest Restellini, Sophie: No conflict of interest Pittet, Valérie: No conflict of interest
Espinosa et al. (Thu,) studied this question.