Acceptability and Preferences for Multimodal Inflammatory Bowel Disease (IBD) Self-Help Resources: Patients' and Providers' Perspectives

Introduction: Clinic visits for IBD are often focused on disease management with limited time for a holistic approach, thus self-help resources (tools/programs) for self-management (knowledge/behaviors) are vitally important. We aim to elucidate patients’ and providers’ acceptance of and preferences for 4 publicly available, low-cost IBD self-help resources. Methods: We surveyed 216 adults with IBD from Feb-May 2023 about their preferences for 4 multimodal IBD self-help interventions: a 1-on-1 peer-to-peer IBD support program, an IBD help center (email/phone/online chat), 2 smartphone apps (access washrooms and track symptoms), and an IBD cognitive behavioral therapy (CBT) workbook. We used logistic regression to identify patient/disease factors associated with patients’ preferences. IBD remission was defined using the 2-item patient-reported outcome measure (PRO-2). Low health confidence was defined as a Wasson’s health confidence score < 8 (range 0-10). We also conducted a focus group with 10 IBD providers to assess acceptability from the providers’ perspectives from the Crohn’s and Colitis Foundation’s IBD Qorus Learning Health System. Results: Of the 216 adults with IBD (66% female; 83% White, 12% Black, 4% Asian; 56% CD, 44% UC; 54% active, 46% remission), 53% reported low health confidence to manage IBD. Most patients selected asynchronous, self-directed self-help interventions (79% smartapps; 76% CBT workbook) over synchronous, person-to-person interactions (62% help center; 46% peer-to-peer program). Patients with active IBD, low health confidence, not employed, or high school/sub-Bachelor’s degrees as their highest educational attainment (vs. graduate/professional degrees) were 2-5x more likely to select self-help interventions (Table 1). IBD subtype, gender, and ethnicity were not associated with patients’ preferences. IBD providers expressed patient-provider relationships affect their patients' confidence in managing IBD, but that short office visits limit their ability to spend more the time educating patients (Figure 1). IBD providers valued IBD self-help interventions as resources for patients to access information, share experiences, improve self-management, and engage with mental health support. Conclusion: Patients and providers value self-help resources to extend IBD care beyond the traditional patient-provider context. Disease activity and sociodemographic factors are associated with patients' preferences for IBD self-help resources. Table 1. - Patient and Disease Characteristics Associated with Patients’ Preferences for IBD Self-Help Intervention. Logistic regression was performed to assess patient and disease characteristics associated with patients’ preferences for various IBD self-help interventions. IBD subtype (Crohn’s disease vs ulcerative colitis), gender, and ethnicity were not statistically significant (not presented) Odds Ratio (95% Confidence Interval) Smartphone App n=178 Peer-To-Peer Support n=203 Information Center n=186 Cognitive Behavioral Therapy Workbook n=183 IBD Disease Activity (Active vs. Remission) 2.9 (1.3-6.4) 2.0 (1.1-3.6) 1.1 (0.6-2.1) 1.3 (0.6-2.7) Health Confidence (Low vs. High) 3.3 (1.5-7.2) 2.3 (1.3-4.2) 1.9 (1.03-3.5) 1.6 (0.8-3.2) Education Attainment High School/sub-Bachelor’s degree vs. Graduate/Professional Degree 5.2 (1.2-23.8) 5.1 (1.9-13.6) 3.4 (1.2-9.2) 0.9 (0.3-3.6) High School/sub-Bachelor’s degree vs. Bachelor’s/Associate Degree 3.8 (0.8-18.0) 2.8 (1.1-7.7) 2.0 (0.7-5.6) 1.3 (0.5-3.4) Bachelor’s/Associate vs. Graduate/Professional Degree 1.4 (0.6-2.9) 1.8 (0.9-3.5) 1.7 (0.8-3.3) 1.4 (0.6-3.1) Employment (Not Employed vs. Employed) 1.8 (0.5-6.5) 3.0 (1.1-8.1) 5.2 (1.5-18.3) 2.4 (0.7-8.5) Abbreviations: IBD, inflammatory bowel diseases. Figure 1.: Providers’ Perspectives on Patients’ Health Confidence and IBD Self-Help Resources.