RESUMEN
BACKGROUND: Mobile health technologies can be useful for providing disease self-management information and support to people with inflammatory bowel disease (IBD). OBJECTIVE: The aim of this study was to test a self-management SMS text messaging intervention for people with IBD. Our goal was to examine intervention feasibility, acceptability, and engagement and to preliminarily evaluate improvements in certain self-reported health outcomes among participants. METHODS: We developed an SMS text messaging program called Text4IBD. The program sent daily support messages and resources about disease self-management over the course of a 2-week, single-group, pretest-posttest intervention to participants (N=114) diagnosed with IBD. We examined intervention feasibility, acceptability, and engagement through Text4IBD message topic recall and use of resources (ie, visiting supplemental websites recommended by the Text4IBD program). We also assessed pretest-posttest measures of IBD-related distress, self-efficacy, perceived support, use of coping strategies, and medication adherence. Analyses examined participants' evaluations of the intervention and compared pretest-posttest changes in secondary outcomes using paired-samples statistics. RESULTS: Approximately all participants who completed the intervention (n=105) were receptive to Text4IBD and viewed the program as feasible and acceptable. In addition, most participants (103/105, 98.1%) recalled at least one of the message topics sent by the program, and 79% (83/105) of them self-reported engaging with at least one of the external self-management resources recommended by the Text4IBD program. Pretest-posttest results showed reduced IBD-related distress (mean 3.33, SD 0.68 vs mean 2.86, SD 0.73; P<.001) and improvements in most other secondary outcomes. CONCLUSIONS: Findings from this study highlight the value of SMS text messaging as a useful digital medium for providing support to people with IBD, particularly to those who may struggle with disease-related distress. Text4IBD was highly feasible and acceptable and may help people self-manage their IBD. Future studies should aim to evaluate this program in a randomized controlled trial in clinical settings.
RESUMEN
BACKGROUND: Inflammatory bowel disease, which can take the form of ulcerative colitis or Crohn's disease, is said by most doctors to be incurable, although surgery is sometimes considered a cure for ulcerative colitis but not Crohn's disease. Because of the unpredictable nature of the disease, however, and the devastating symptoms it can have, many people are driven to search for cures online, despite what their doctors may recommend. METHODS: This qualitative content analysis looked at the top search results in Google and Bing for inflammatory bowel disease cures. We examined 63 search results returned using a variety of search terms. Search results included articles, entire Web sites, YouTube videos, health forums, and an e-book. RESULTS: The Web sites generally fell into 2 categories: those that said no cure exists and those that advocated for specific cures. The following themes were pulled from the data: an inconsistent definition of a cure; an anti-Western medicine bias; medical disclaimers that are ignored by Web sites that feature them; a lack of clarity in cure regimens; and inter-article contradictions. CONCLUSIONS: Many people with inflammatory bowel disease do not like hearing that the disease has no cure or they do not believe their doctor when told this. Medical professional Web sites often say very little about what a cure looks like or how it is defined medically. Well-meaning patients have filled this void with their own definitions of a cure. Physicians need to be aware of what information patients can find online because many patients are unwilling to share this information.
