Effectiveness of a Remote Intervention Program for Self-Management Behaviors in Adolescents and Young Adults With Inflammatory Bowel Disease Based on the Self-Determination Theory: Randomized Controlled Trial Across 2 Centers.

Résumé

BACKGROUND: 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.OBJECTIVE: 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.METHODS: 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.RESULTS: 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