A265 BARRIERS TO DIETARY MODIFICATION IN INFLAMMATORY BOWEL DISEASE (IBD): A MIXED-METHODS ASSESSMENT OF PATIENT PERCEPTIONS
Bibliographic record
Abstract
Abstract Background Many patients living with IBD identify diet as a key factor in managing their disease, symptoms and general health, and many report implementing dietary restrictions in response to disease activity and symptoms. Despite increasing data on the role of diet, IBD patients face a variety of challenges that can compromise adherence to dietary recommendations in clinical practice. Aims To identify IBD patients’ perceptions regarding barriers to dietary modification and to understand their experiences and expectations of dietary advice from gastroenterologists (GI) or dietitians (RD). Methods A mixed-method qualitative data collection strategy with semi-structured focus group and individual one-on-one interviews moderated by a clinical psychologist over a web-based, video communication platform (Zoom). Adult IBD patients (between 18 to 75 years old) attending the McMaster University Medical Centre IBD Clinic were invited to join a focus group consisting of 2-6 individuals or a one-on-one interview. All participants were asked to complete a demographics survey (REDCap) before the session. Recorded audio files for all sessions were transcribed, de-identified and reviewed for accuracy by 2 reviewers with an independent adjudicator to resolve discrepancies followed by thematic analysis (NVIVO). Results Between May to December 2022 and May 2023, 38 of 90 invitees took part in 11 focus groups and 9 chose individual interviews. Most participants (mean age 42 years; 60% female) were Caucasian (87%); 42% had a self-reported history of mental health disorders. Mean IBD duration was 16 years (min-max: 0.5–44 years); 73% were in remission and 68% had Crohn’s disease. Thematic analysis identified 5 primary and 11 secondary barriers to dietary adoption (Table). Participants reported positive and negative experiences with dietary advice from GIs and RDs; expectations included GI referral to a specialist RD and integration of an RD into the health care team. Conclusions IBD patients report multiple, varied barriers to dietary adoption and identify a need for improved access to dietary advice and other resources, including integration of RDs into primary and IBD Clinic care teams. The identification of multiple, varied patient-reported barriers offers an opportunity to develop personalized dietary advice for IBD patients to enhance health, well-being and quality of life. Thematic map of barriers experienced by patients when adopting dietary modifications Funding Agencies Farncombe Family Digestive Health Research Institute; Douglas Family
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.038 | 0.031 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.001 | 0.004 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".