Interventions aimed at advancing gender equity in rheumatology: Insights from the Coalition for Health and Gender Equity (CHANGE) survey.
Abstract
Background
Gender disparities in rheumatology persist despite increasing female representation. This comprehensive global survey, conducted by the Coalition for Health and Gender Equity (CHANGE) group, examined preferences for gender equity interventions among rheumatology professionals.
Methods
A cross-sectional online survey of rheumatologists and allied health professionals was conducted across 105 countries (January 2023-May 2024). Intervention preferences spanned four domains: conference-based, organizational, skills training, and work-based strategies. Gender differences were evaluated using logistic regression adjusted for years of work experience, with subgroup analyses by Human Development Index (HDI), Gender Inequality Index (GII), professional role, and caregiving responsibilities. Multiple comparisons were adjusted using Benjamini- Hochberg correction for false discovery rate.
Results
Among 1945 respondents (66.4% female), the most widely endorsed interventions overall were family- and child-friendly conference policies (71.4%), communication and scientific writing training (52.6%), and engagement of national rheumatology groups (46.9%). Women demonstrated significantly stronger support for increasing the visibility of female role models (11.89% vs 5.81%, OR = 3.29, p < 0.01), establishing gender-balanced committees (17.66% vs 16.01%, OR = 1.76, p < 0.01), and gender-sensitive editorial board policies (12.70% vs 10.66%, OR = 1.77, p < 0.01). Respondents from higher-GII countries prioritised scientific writing masterclasses (OR = 4.58, p < 0.05) and career planning training (OR = 3.90, p < 0.05) but showed lower endorsement of unconscious bias training (OR = 0.48, p < 0.05) and male allyship programmes (OR = 0.42, p < 0.05). Women in low/middle-HDI countries more frequently selected grant writing support (40.3% vs 26.4%, p < 0.01).
Conclusion
Gender equity intervention preferences vary systematically across contexts. These findings provide empirical foundations for developing culturally responsive, evidence-informed intervention frameworks to advance gender equity in rheumatology.