User testing to inform modification of the MyHealthyGut digital health application in inflammatory bowel disease

Introduction Inflammatory bowel disease (IBD), characterized by chronic intestinal inflammation, can be subcategorized into Crohn’s disease and ulcerative colitis. The treatment for these conditions is unique to each patient, and may include lifestyle changes, pharmaceutical intervention, and surgery. Lifestyle changes, such as dietary intervention, are a cornerstone of IBD symptom management. Given the daily burden of this disease, self-management is paramount in coping with and/or minimizing symptoms. The MyHealthyGut application (app), successfully proven to be a self-management tool for celiac disease, shows promise for use in an IBD patient population. Objective To undertake user testing to inform the development of an IBD-focused version of the current MyHealthyGut app. Methods This study was undertaken between October 2021 and April 2022. Participants included IBD patients and healthcare practitioners (HCPs) (physicians, registered dietitians [RD], and registered nurses [RN]), using social media postings and convenience sampling. Two RDs demonstrated how to use the current functions and features of the app with each participant. Participants used the app for a 2-week period which was followed by participation in a focus group or individual interview to provide feedback on the app. Qualitative questionnaires, tailored to each patient category, were administered verbally and feedback was recorded. Thematic analysis techniques were used for data quantification and analysis. Results 15 participants were recruited and enrolled. Of these, 14 participants took part in the focus group and/or individual interviews. The feedback suggested changes related to clinical uses (e.g. incorporating information collected by the app into electronic medical record systems), food and symptom tracking (e.g. the option to track water intake), ease of use (e.g. the option to autofill food tracker with frequently consumed meals), and app content (e.g. information about IBD treatments). All (100%) of participants reported that they would either use the app themselves or recommend the app to patients, once their suggestions were implemented. Conclusion Through user testing and feedback collection, priorities for app modification were identified. Areas of modification in the app functions and features, ease of use, and content were identified. Once updated to meet the needs of IBD patients, the MyHealthyGut app may be a useful tool for IBD self-management. Funding Source Canadian Foundation of Dietetic Research ### Competing Interest Statement K. Jacobson: Advisory board: Abbvie, Janssen, Amgen; Merck; Viatris; Mckesson Canada; Speakers bureau: Abbvie Janssen; Investigator initiated research support: Janssen; Stock options: Engene ### Funding Statement This study was funded by Canadian Foundation of Dietetic Research ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Research ethics board of University of British Columbia gave ethical approval for this work (H21-02662) I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors * (IBD) : Inflammatory Bowel Disease (HCP) : Health Care Practitioner (RD) : Registered Dietitian (RN) : Registered Nurse (CD) : Crohn’s Disease (UC) : Ulcerative Colitis (eHealth) : electronic health (MHG) : MyHealthyGut (CeD) : Celiac Disease (GF) : gluten free (app) : application