Effectiveness of a Remote Intervention Program for Self-Management Behaviors in Adolescents and Young Adults With...

The prevalence of inflammatory bowel disease (IBD) has been on the rise, with adolescents and young adults experiencing the highest incidence rates. For these young patients, self-management behaviors are critical to maintaining disease remission and improving quality of life and yet their current self-management status remains suboptimal.

This study aimed to evaluate the impact of a remote and multicomponent intervention program (integrating health education, solution-focused intervention, peer support, and mindfulness training) on the self-management behaviors and related mental health outcomes in young adults and adolescents with IBD.

From July 2024 to January 2025, we conducted a 2-arm, single-blind randomized controlled trial. Adolescents and young adults with IBD (aged 13-24 years) were recruited from gastroenterology wards of 2 tertiary hospitals in Chongqing, China, and randomized 1:1 to the intervention (extra multicomponent program) or control (routine care) group. Outcomes (self-management behaviors, perceived social support, basic psychological needs, anxiety, depression, and disease activity) were assessed postintervention (T1) and 12 weeks later (T2). Intention-to-treat analysis was used: normally distributed data via mixed-design analysis of variance, and nonnormal data via rank sum and Friedman tests.

A total of 74 participants (mean age 18.95, SD 2.96 years; 53/74, 72% males) were enrolled (37 per group) with no baseline differences. Compared with the control group, the intervention group showed significantly higher self-management scores at both T1 (mean difference -16.676, 95% CI -24.370 to -8.982; P<.001, η²=0.206) and T2 (mean difference -14.189, 95% CI -22.594 to -5.784; P=.001, η²=0.136), along with higher perceived social support scores at T1 (mean difference -9.000, 95% CI -13.932 to -4.068; P=.001, η²=0.155) and T2 (mean difference -6.649, 95% CI -11.890 to -1.407; P=.01, η²=0.082). Basic psychological needs scores were also higher in the intervention group at T1 (mean difference -4.946, 95% CI -8.323 to -1.569; P=.005, η²=0.106) and T2 (mean difference -3.946, 95% CI -7.720 to -0.172; P=.04, η²=0.057), while anxiety (T1: P=.04; T2: P=.007) and depression (T1: P=.048; T2: P=.03) scores were lower. In addition, the intervention group had a higher disease activity remission rate at T2 (P=.03).

This study extended the application of self-determination theory to adolescents and young adults with IBD, offering a novel theoretical basis for self-management practice in this population. It was shown that this multicomponent intervention was a valuable addition to standard care in enhancing self-management behaviors and related mental health outcomes while lowering disease activity. In addition, its alignment of intrinsic behavioral motivation with nurse-driven clinical settings boosted clinical operability of the intervention.

Chinese Clinical Trial Registry ChiCTR2400086703; https://www.chictr.org.cn/showproj.html?proj=235313.