Background: Children with inflammatory bowel disease (IBD) have a significant life-long burden as a result of disease, impacted by environmental and individual barriers. Successful health system interventions require a comprehensive approach, informed by various stakeholders. The main objective was to identify health system barriers, challenges, and potential solutions from existing patients, families, and providers via focus groups, which was the first part of a larger, prospective study. Methods: Participants for the focus groups were existing English-speaking patients (ages 9-18) with IBD, their caregiver(s), and providers including multiple professions (e.g., physician, nurse, pediatrician, social worker, care coordinator, scheduler, psychologist). Separate focus groups were led by experienced personnel for parents, children, and providers, using a standardized interview guide. Sessions were recorded, transcribed, and verified. Using content analysis, we systematically classified data through coding and identified themes. Results: Three patient (n=20, 50% female; younger group M=11.4 ±1.5 years, older groups M=15.6±1.3 years), 3 parent (n=24, 83% female), and 2 multidisciplinary provider (n=19) focus groups were conducted. Barrier themes are summarized in Table 1. Families shared several common concerns with providers (e.g., school, care delay, psychosocial, financial) but varied on specifics. Some barriers may be addressable through family or staff education, improved communication (e.g., care delay/ access, transition), or training (e.g., labs, diet), while others may require change at an institutional or policy level (e.g., insurance). Conclusions: This qualitative analysis identified several barriers to IBD care, some shared, some unique to patients, parents, and providers, and with varying degrees of tractability.
