P1002Health behaviour change in Inflammatory Bowel Disease: Mapping readiness, mobile health preferences, and engagement

Background A Mediterranean Diet (MD), regular moderate to vigorous physical activity (MVPA), and adequate sleep have demonstrated beneficial effects on inflammatory pathways in inflammatory bowel disease (IBD)1,2. Yet, patients with IBD do not meet these targets. Behaviour change (BC) is complex and nuanced, requiring different levels of support depending on the individual’s BC stage. Mobile health (mHealth) tools offer a practical way to provide personalized, behavior-focused support that patients find acceptable and accessible3. The aim was to characterize lifestyle behaviours, preferences of behaviour change support, and stages of BC among IBD patients. Methods A prospective survey assessing lifestyle behaviours and preferences for mHealth tools guided by Michie et al.’s BC Taxonomy4 was administered to IBD patients during routine clinic visits. Participants who completed the survey were offered LyfeMD, a holistic mHealth app supporting diet, physical activity, sleep, cognitive behavioural therapy and mindfulness. App use was monitored and participants were classified according to the Transtheoretical model of BC stages: pre-contemplation (no interest in BC), contemplation (interest in LyfeMD but no action), preparation (downloaded LyfeMD but no engagement), action (active LyfeMD use), and maintenance (sustained use for ≥3 months). Results Of the 177 IBD patients recruited 64.6% were female, 52.9% were in remission, and 166 (93.8%) completed the survey. Diet quality was poor, with 29.8% showing risk of malnutrition and low adherence to the MD, particularly deficient in fish, olive oil, and vegetables. Only 36.7% met physical activity recommendations (≥150 MVPA/week), and 71.6% reported no vigorous activity (Table 1). Additionally, 54.1% reported poor sleep, averaging 6.8 hours per night. Regarding behavior change readiness, 46 participants (27.7%) were in pre-contemplation, 73 (44.0%) in contemplation, 3 (1.8%) in preparation, and 44 (26.5%) in action, therefore in total 120 (72.3%) participants showed interest in LyfeMD. Among those with sufficient follow-up time, 9 of 30 (30.0%) maintained LyfeMD use beyond three months. Key features participants hoped for in a mHealth tool included “Improving diet quality”, “Monitoring BC progress”, and “Education on diet” (Figure 1.). Conclusion Lifestyle behaviors remain suboptimal among people with IBD, emphasizing the need for strategies to support individualized behavior change. While interest in mHealth tools was high, demonstration of progression from contemplation to action was limited. Future mHealth tools should emphasize evidence-based education materials specifically on diet, include tracking tools, and provide additional support to facilitate contemplative IBD patients toward action. References: 1. Hashash JG, Elkins J, Lewis JD, Binion DG. AGA clinical practice update on diet and nutritional therapies in patients with inflammatory bowel disease: expert review. Gastroenterology. 2024;166(3):521-532. 2. Raman M, Rajagopalan V, Kaur S, et al. Physical activity in patients with inflammatory bowel disease: a narrative review. Inflammatory bowel diseases. 2022;28(7):1100-1111. 3. Hirten RP, Stanley S, Danieletto M, et al. Wearable devices are well accepted by patients in the study and management of inflammatory bowel disease: a survey study. Digestive Diseases and Sciences. 2021;66(6):1836-1844. 4. Michie S, Richardson M, Johnston M, et al. The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions. Annals of behavioral medicine. 2013;46(1):81-95. Conflict of interest: Dr. Eisele, Max: No conflict of interest Lewis, Ayva: No conflict of interest Toews, Briana: No conflict of interest Haskey, Natasha: Registered Dietician consultant for LyfeMD Lu, Cathy: Advisory board - Abbvie, JnJ, Takeda, Ferring, Merck, Celltrion, Pfizer Research Funding - Abbvie, JnJ Singh, Harminder: Harminder Singh has been on advisory boards or consulted for Pendopharm, Amgen Canada, Abbvie Canada, Pfizer Canada, Organon Canada, Takeda Canada, Innomar Strategies, Eli Lily Canada and Guardant Health, Inc consulted for the Canadian Agency for Drugs and Technology in Health has received research funding for an investigator-initiated study from Pfizer and holds shares of VasCon. recieved educational grants from Pfizer Canada, Organon Canada in kind research funding from Pendopharm Newhook, Samuel: No conflict of interest Raman, Maitreyi: Abbvie Johnson&Johnson Celltrion LyfeMD