Digital Mind Body Intervention among Black and Hispanic Patients Living with Inflammatory Bowel Disease

While people from racial and ethnic minority groups are an increasing segment of the inflammatory bowel disease (IBD) population, they are currently underrepresented in research. Efforts to increase the participation of racial and ethnic minority groups in IBD research should consider their social context in the design and delivery of interventions. An important aspect of managing IBD is addressing psychological distress (anxiety, depression, perceived stress), which is more elevated in IBD than non-IBD adults. Appreciation for psychological distress as a driver of IBD activity and poor outcomes has led to increased efforts to integrate psychological interventions into IBD medical care. High-quality evidence exists for the efficacy of mindfulness, acceptance, and values-based interventions delivered digitally in improving psychological distress and quality-of-life in IBD. However, data is lacking on the feasibility and acceptability of digital mind body intervention (DMBI) among people from racial and ethnic minority groups with IBD who often have socioecological factors, such as healthcare access and views on mental healthcare, that impede their use of psycho-behavioral resources. In our pilot studies utilizing existing digital behavioral interventions among Black and Hispanic patients with IBD from the integrated health system at Einstein/Montefiore, we found that digital delivery of the intervention was feasible. However, patients desired information that was more relevant to their IBD. Based on preliminary qualitative study of illness perceptions, views on mental healthcare, and digital technology use among Black and Hispanic patients with IBD and psychological distress, we have developed a prototype 8-week mobile health application DMBI. We propose to develop the DMBI with user-centered, participatory design approaches. We will then test the app in a separate cohort of patients to evaluate its acceptance and use and to explore effects on psychological and disease-related factors. We hypothesize that the adapted DMBI will result in high adherence and satisfaction and preliminary efficacy in improving psychological and disease related factors. This study will provide evidence for acceptability of a DMBI app to be refined for later efficacy and optimization in a larger randomized trial among Black and Hispanic patients with psychological distress. Through this mentored research study, Dr. Greywoode will build upon her strong clinical and research skills to develop expertise in participatory research, technology-based behavioral treatment development, applying psychosocial interventions to IBD care, and advanced clinical trial design towards her career goal of becoming an independent clinical investigator focused on optimizing IBD care through patient-centered psychosocial interventions.