An Intersectional Approach to Researching Racial Disparities in Multiple Sclerosis Outcomes

Research Objectives: Although Black Americans may have the same multiple sclerosis (MS) prevalence rates as White Americans, they experience greater disability burden. Funded by the Consortium of MS Centers, this study asks: what, if any, barriers do Black Americans with MS experience when seeking diagnosis and treatment compared to White Americans with MS? This presentation describes the intersectional research design used to answer this question.

Design: Mixed methods study consisting of 1) a cross-sectional online survey of White and Black Americans with MS to identify differences and similarities in diagnosis and treatment experiences; 2) eight virtual focus groups with a random sample of survey participants from each racial group to explore key survey findings. Intersectional characteristics include: a racially diverse research team, collaboration with an independent sub-council of Black Americans with MS for input on study materials, partnership with iConquerMS, a patient-powered research network, for recruitment and input on instruments, collection of social determinants of health (SDOHs) data, community member checking of findings.

Setting: National online study in the United States (US).

Participants: Survey: a convenience sample of approximately 100 White and 100 Black Americans with MS. Focus groups: a random sample of survey participants of up to 40 Black and 40 White people with MS.

Inclusion criteria: 18 years or older, physician-diagnosed MS, US resident, access to the internet.

Interventions: Not applicable.

Main Outcome Measures: Diagnosis delay, treatment delay, treatment adherence, medical mistrust, medical racism and discrimination, SDOHs.

Results: This study uses an intersectional approach in two ways. First, the design enhances scientific and ethical rigor with a racially diverse research team, collaboration with people with MS, mixed methods, and member checking of findings. Second, collecting SDOH data enables analysis of how race, sociodemographics, and community factors interact to produce disparate MS outcomes.

Conclusions: Research investigating reasons for MS health disparities is nascent. An intersectional approach can further the field by increasing the validity of research findings in an ethical manner while simultaneously representing the complicated reality of how race intersects with other factors.

Author(s) Disclosures: None.