Racial minority IBD patients find mental health apps ‘acceptable’

March 14, 2024 - New research shows that Black and Hispanic people with inflammatory bowel disease (IBD) and elevated symptoms of anxiety and depression engaged in digital behavioral health applications, indicating that these mHealth interventions were “feasible and acceptable” for this population.

Published in the journal Inflammatory Bowel Diseases, the study aimed to assess the use of digital behavioral interventions among IBD patients with a predominately low-income, racial minority background with symptoms of anxiety and depression.

The link between mental health conditions and IBD is clear. A study published in 2018 shows that 44.4 percent of 432 IBD patients had anxiety, depression, or both. Another study published in 2021 noted that the onset of the disease, disease activity, side effects of medications, stressful life events, and lower socioeconomic status can negatively affect the mood of IBD patients.

Though digital health tools have proven effective in providing behavioral health interventions, their uptake among low-income and marginalized communities is understudied, the authors of the 2024 study wrote.  

Thus, the researchers included adult patients who self-identified as Black and/or Hispanic and had anxiety or depression as measured by the National Institutes of Health PROMIS-29 in the study. Overall, they included 30 IBD patients with a scheduled gastroenterology visit at an academic medical center between November 2021 and March 2023.

Twenty-one patients completed the post-intervention questionnaire, and 19 were included in the feasibility and acceptability analysis.

Of the 30 patients, 18 were randomly assigned to use a structured, self-guided cognitive behavioral therapy (CBT) app, and 12 were assigned to use a mood-tracking app without specific activities.

All study participants reported regular internet access. Anxiety was the most-elevated reported symptom, followed by pain interference and depression.

Among the patients who completed the post-intervention questionnaire, about 33 percent of patients assigned to the self-guided CBT app and 43 percent of those designated to the mood-tracking app said they used the apps daily. Further, nearly three-quarters (73.7 percent) of participants in both groups said they would recommend the app to someone else.

However, 80 percent of patients using the self-guided CBT app reported that they enjoyed using it compared to only 55.6 percent of patients using the mood-tracking app.

On the flip side, more patients in the self-guided CBT app group (33.3 percent) did not complete follow-up activities than those in the mood-tracking app group (25 percent).

Also, regardless of which digital behavioral health app they used, 57.9 percent of study participants felt that it would be good to talk to a mental health professional in addition to app use, and 52.6 percent thought that it would be better to speak to a mental health professional instead of using the app.

“Advances in digital technology are rapidly emerging and are poised to be a useful tool to assist in integrated mental healthcare in IBD,” the study authors wrote. “However, the role of digital behavioral interventions is most likely best viewed as complementary to the work of mental health professionals in underserved populations.”

Prior research shows underserved populations’ willingness to engage with virtual care and mHealth technologies is growing.

A study published last year showed that Black women, who face numerous challenges in accessing mental healthcare, are open to using voice and video calls and mHealth apps to communicate with mental health providers.

The study assessed survey responses of 395 Black women, finding that 69.9 percent were comfortable with using a voice call, 64.3 percent were open to a video call, and 45.1 percent were comfortable with using an mHealth app for depression treatment.

Further, the study found that higher severity of depression was linked to a 43 percent higher likelihood of using mHealth apps.