S1639 Perception of Care in Immigrant and Non-Immigrant Persons With Inflammatory Bowel Disease: A Survey-Based Study
Bibliographic record
Abstract
Introduction: Immigrant persons are at a heightened risk of developing inflammatory bowel disease (IBD) following relocation and their interactions with the healthcare system differ from non-immigrants. This study aimed to explore the challenges and perspectives of immigrants living with IBD regarding their healthcare. Methods: We recruited persons aged 18 or over with IBD to anonymously complete an online survey on the REDCap platform. We included persons with and without an immigration history. Descriptive statistics were reported as frequencies and cross-group comparison was completed using the chi-square test. Results: We included 75 immigrant and 150 non-immigrant persons with IBD. The baseline demographics were similar between the 2 groups: many participated from Canada (73 (95%) vs 114 (100%)), most were women (40 (53.3%) vs 99 (66%)) and had a full-time job (48 (64% vs 84 (56%)). The distribution of IBD was also non-significant with immigrant persons slightly more likely to have a diagnosis of ulcerative colitis compared to non-immigrant persons (41 (54.7%) vs 60 (40%), P = 0.16). Concerning access to care, immigrant persons reported lower access to a dedicated IBD nurse (48 (64%) vs 63 (42%), P = 0.004). Immigrant persons were more likely to report no access to formal translational services during their appointment (14 (36%) vs 2 (1.8%), P < 0.001) despite 1 in 3 not speaking the same language as their GI doctor (31 (41.3%) vs 3 (2%), P < 0.001). With respect to financial considerations, compared to non-immigrant persons, they were more likely to be unable to miss work for their healthcare appointments (24 (32%) vs 17 (11.3%), P < 0.001). Despite the majority of immigrant persons being diagnosed after immigrating (58 (77.3%) P > 0.001), more than 1/3 of immigrant persons with IBD had contacted physicians in their home countries (29 (38.7%) and bought medicine from their home countries (8 (10.7%)). Finally, most immigrant persons had concerns that “Western” foods in their current country contributed to their IBD flares (44 (58.7%)) compared to only 11 (14.7%) worried about their home countries food. Conclusion: This data reveals that immigrants encounter significant barriers to care, including poor communication, financial constraints regarding the logistics of appointments, in addition to cultural preferences, including diet. Future research should expand on these themes by conducting focus groups and studying larger cohorts to explore differences in communication, finances and culture.
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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 | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".