Preferences, Acceptability, and Utilization of Multimodal Self-Help Interventions in Adults with Inflammatory Bowel Diseases: A Pragmatic Multicenter Study with Patients and Clinicians

Background Despite the benefits of self-help resources in several chronic diseases, a knowledge gap exists regarding patients' and clinicians' experiences and attitudes toward multimodal self-help resources in inflammatory bowel diseases (IBD). Methods Confidence Optimization through Resources for Education, Engagement, and Empowerment (CORE) was a prospective, convergent parallel mixed-methods study conducted across 5 gastroenterology practices participating in the Crohn's & Colitis Foundation's IBD Qorus Learning Health System from 2022 to 2023. Five IBD-specific multimodal self-help resources (workbook, 2 smartphone apps, help center, and peer mentoring) were offered to patients. E-surveys (weeks 0, 6, and 12) and three 60-minute focus groups elicited the perspectives and experiences of patients and providers regarding self-help resources. Univariate, bivariate, and multivariate statistical analyses explored patients' preferences, acceptability, and utilization of self-help resources. Results Of 536 patients with IBD, only 3.7% previously used self-help resources, yet 80.0% (427/536) selected at least one multimodal self-help resource when offered. Patients with low health confidence in managing IBD (adjusted odds ratio [aOR] 2.5, 95% CI, 1.1-5.6, P = .03) and females (aOR 2.5, 95% CI, 1.2-5.2, P = .02) were more likely to choose self-help resources. After 12 weeks, 75.0% (81/108) used at least 1 self-help resource. Asynchronous resources (books and smartphone apps) were used more often than synchronous resources (help center and peer mentorship). Patients preferred resources suggested by their clinicians, although clinicians expressed a lack of time in the clinic and a lack of knowledge about self-help resources as barriers. Conclusions Few patients with IBD use self-help resources, even though the majority regard multimodal self-help resources as acceptable and feasible to get information, find community and support, and manage living with IBD.