Health care system factors negatively impact Latine patients with hidradenitis suppurativa

Summary: Abstract Body: Latine patients with hidradenitis suppurativa (HS) face more severe disease and delayed diagnosis compared to White patients. To identify modifiable factors impacting care, we conducted a multi-method study with English- and Spanish-preferring Latine adults diagnosed with HS by dermatologists. We recruited participants from 2 academic and 2 county hospitals in California. Bilingual Latine team members administered validated measures of acculturation (higher scores nearing 5) and discrimination in medical settings (5-point Likert scale responses to 7 scenarios; experience of discrimination defined as ≥1 response of Sometimes, Most of the time, or Always to ≥1 scenario), conducted semi-structured interviews, and coded transcripts. We used thematic analysis of transcripts to develop themes. We used acculturation and discrimination scales to describe the study population. Among 18 participants, median (IQR) age was 37 (30-44) years, 11 (61%) were female, 5 (28%) were Spanish-preferring, and 15 (83%) had Hurley Stage II or III disease. Participants were mostly bicultural with a median (IQR) acculturation score of 3.4 (3-3.8). 7 (39%) participants experienced discrimination in medical settings for HS care. We developed 5 preliminary themes reflecting challenges in HS care and management due to health care system factors: (1) perceived discrimination leads to delays in seeking care, (2) feeling blamed and unheard by clinicians causes patients to avoid care, (3) absence of clinician recommendations for pain control prompts self-management, (4) inconsistent access to wound care expertise and supplies results in self-directed care, (5) burden of HS management undermines patients’ ability to remain in the workforce. Health care system-level interventions are needed to enhance clinician-patient communication, prioritize unmet pain and wound care needs, and streamline processes to implement care plans. Yanel Hernandez¹, Nathaly Gonzalez², Raveena Ghanshani³, Herbert Castillo¹, Erin Amerson¹, Haley Naik¹, Jennifer Hsiao³, Jennifer James¹, Sara Ackerman¹, Aileen Chang¹ 1. University of California San Francisco, San Francisco, CA, United States. 2. Medical College of Wisconsin, Milwaukee, WI, United States. 3. University of Southern California, Los Angeles, CA, United States. Minoritized Populations and Health Disparities Research