Assessment of inflammatory bowel disease educational videos for increasing patient engagement and family and friends' levels of understanding

Development and Validation of Crohn's Perianal Fistula Educational Videos and Website for Increasing Patient Knowledge and Engagement

INTRODUCTION

There are few online resources that provide authoritative and comprehensive information on Crohn's perianal fistula (CPF). In this study, we aimed to use a human-centered design thinking approach to develop and validate 2 educational CPF videos and an accompanying website to support patients with CPF.

METHODS

We used a design thinking approach to understand the unmet educational needs of patients with CPF. We conducted 3 rounds of interviews with a diverse sample of patients with CPF and used the resulting insights to iteratively develop 2 unbranded educational videos optimized for social media and an accompanying website. To validate the 2 videos, we performed an online survey with CPF patients to assess the impact of the videos on patient activation as measured by the patient activation measure (PAM).

RESULTS

Our design thinking approach with 20 CPF patients allowed us to empathize with them, gain an in-depth understanding of their informational needs, and iteratively test and update the educational materials based on their input. Using their feedback, we created 2 videos ("What is a Crohn's perianal fistula?" and "How to treat Crohn's perianal fistula?") and a corresponding website called "Heal My Fistula." In qualitative testing, patients described both videos and the website as "accurate", "informative", "simple", "easy to understand", and in line with their expectations. In validation testing through a pre-post survey (N=357), both videos led to statistically significant improvements in PAM scores (P<0.001).

CONCLUSION

Through a human-centered design thinking approach, we developed and validated 2 informative videos and a website (healmyfistula.org) for addressing the educational needs of patients with CPF.

Unveiling the impact of perceived stigma on psychological well-being in adult patients with inflammatory bowel disease: The mediating role of patient engagement

This study elucidated the impact of perceived stigma on the well-being of inflammatory bowel disease (IBD) patients and explored the mediating role of patient engagement. A descriptive cross-sectional study was conducted using an online survey, recruiting participants through the Italian IBD patient organization. The survey assessed perceived stigma, psychological well-being, and patient engagement using validated instruments. Data were analyzed using multiple regressions and bias-corrected bootstrapping analysis. Perceived stigma significantly predicted psychological well-being, and patient engagement significantly predicted well-being. Patient engagement partially mediated the relationship between perceived stigma and well-being, suggesting that lower levels of patient engagement were associated with higher perceived stigma, negatively affecting well-being. Perceived stigma significantly impairs the psychological well-being of IBD patients. However, patient engagement is important for mitigating adverse effects of stigma and enhancing overall well-being. Interventions to reduce stigma and promote patient engagement are essential for improving health outcomes in IBD management.

Web-Based Video Education to Improve Uptake of Influenza Vaccination and Other Preventive Health Recommendations in Adults With Inflammatory Bowel Disease: Randomized Controlled Trial of Project PREVENT

BACKGROUND

Patients with inflammatory bowel disease (IBD) are at increased risk of infections, bone fractures, and skin cancers.

OBJECTIVE

We developed preventive health videos using a patient-centered approach and tested their impact on preventive health uptake.

METHODS

Five animated videos explaining preventive health recommendations in IBD were iteratively developed with patient-centered focus groups and interviews. A randomized controlled trial was then conducted in a web-based IBD cohort to test the impact of video- versus text-based educational interventions. The primary outcome was receipt of the influenza vaccine. Secondary outcomes included intention to receive other preventive health services.

RESULTS

Five animated videos were developed with patient input. A total of 1056 patients with IBD were then randomized to receive the video (n=511) or text-only (n=545) interventions; 55% (281/511) of the video group and 57% (311/545) of the text-only group had received their influenza vaccine in the prior year. Immediately after the intervention, 73% (502/683) of patients reported their intention to receive the vaccine, with no difference by the type of intervention (75%, 231/307, for the video group and 72%, 271/376, for the text-only group). The proportion of patients who actually received the influenza vaccine after the intervention also did not differ by messaging type (P=.07). The strongest predictor of both intention to receive and actual receipt of the influenza vaccine was prior influenza vaccination. Older age was also associated with a higher likelihood of the intention to receive (age 36-75 years relative to 18-35 years; P=.006) and actual receipt (age >75 years relative to 18-35 years; P=.05) of the influenza vaccine.

CONCLUSIONS

The proportion of patients receiving the influenza vaccine was high in both groups, but there was no difference in receipt of or in the intention to receive preventive health recommendations by type of messaging. Notably, a portion of patients in both groups had intended to be vaccinated but did not ultimately receive the vaccine. Further evaluation of patient-education strategies is warranted to improve preventive health uptake among patients with IBD.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05997537; https://clinicaltrials.gov/ct2/show/NCT05997537.

Addressing and evaluating health literacy in mHealth: a scoping review

Background

Recent surveys have revealed many adults have basic or below basic health literacy, which is linked to medical errors, increased illness, and compromised public health. Health literacy as a concept is multi-faceted extending beyond the individual to include social structures and the context in which health information is being accessed. Delivering health information via mobile devices (mHealth) expands the amount of information available while presenting challenges to ensuring these materials are suitable for a variety of literacy needs. The aims of this study are to discover how health literacy is addressed and evaluated in mHealth app development.

Methods

A scoping review of 5 peer-reviewed databases was conducted. Eligible articles were written in English, addressed general literacy or mHealth/digital/eHealth literacy, and collected literacy information in order to incorporate literacy into the design and/or modification of an app or collected literacy information to describe the population being studied. The "Health Literacy Online" (HLO) United States (U.S.) government guide was used as a framework.

Results

Thirty-two articles were reviewed. Articles included health literacy recommendations for all HLO categories and some recommendations not aligned with these categories. Most articles addressed health literacy using specific HLO categories though none incorporated every HLO category. The most common categories addressed engagement and testing of mHealth content. Though several studies addressed health literacy through a formal assessment tool, most did not. Evaluation of health literacy in mHealth was end-user focused and did not extensively evaluate content for fit to a variety of individuals with limited health literacy.

Conclusions

The recommendations seen consistently in our results in conjunction with formal HLO categories can act as beginning steps towards development of a health literacy evaluation tool for mHealth apps themselves. It is clear efforts are being made to reduce barriers to using mHealth for those with literacy deficits, however, it was also clear that this space has room to be more pragmatic in evaluation of mHealth tools for literacy. End user engagement in design and testing is necessary in future mHealth literacy tool development.

Social Media for the Dissemination of Educational Videos About Inflammatory Bowel Diseases

INTRODUCTION

To broadly disseminate 5 user-centered educational videos for patients with inflammatory bowel disease and their family and friends on social media.

METHODS

Relevant social media users were iteratively identified based on their online behavior. For each video, 2 different accompanying texts were tested.

RESULTS

We reached 4.2 million social media users of whom 320,302 watched at least 50% of the video. A short description resulted in higher view rates than posing an open-ended question.

DISCUSSION

We showed the feasibility of large-scale dissemination of health-related educational videos through social media. Our findings can inform future online dissemination approaches of educational content.