Discussion
Skin Cancer, Colitis, Crohn, Pneumonia, IBD
SKIN CANCER, COLITIS, SHINGLES, INFLUENZA, CROHN, PNEUMONIA, INFLUENZA
In this study, we developed IBD-focused animated videos for preventive health education with direct patient input and tested their efficacy in a randomized controlled trial using a large web-based cohort. We did not find a difference in the immediate postintervention intention to receive preventive health services between groups of patients receiving text-only versus video interventions, nor did we observe a difference in the actual uptake of these services by messaging type.Prior studies have assessed the knowledge, attitudes, and beliefs of patients with IBD regarding preventive care using the IBD Partners PPRN [The role of text-based electronic reminders emailed to patients was also previously investigated for preventive health recommendations in IBD Partners [We were unable to demonstrate an advantage of video-based messaging relative to text-only messages. Short educational videos have previously been associated with higher self-reported IBD patient activation scores and perspective-taking levels (ability to understand thoughts, feelings, and behaviors of patients with IBD) among family and friends [Although it is unlikely that messages conveyed by either text or video will modify knowledge, attitudes, and beliefs regarding preventive health, both text-based and video-based messages may be useful tools to open discussion between physicians and patients. Our video content and text-based messaging are now freely available to providers and patients, including a toolkit for physicians to share with patients and tailored video and text-based messaging to patients based on responses to a short health survey that determines eligibility for specific preventive health services. Notably, a portion of patients in both the video and text-based groups had intended to be vaccinated but did not follow through, suggesting an opportunity to address barriers to vaccination and access to influenza vaccine services.Although our study findings suggest that video education is not more effective than text-only messages to educate patients with IBD about preventive health, there are potential alternative explanations and limitations to our study. The first consideration is the “ceiling effect,” which occurs when a high proportion of participants already achieve the study objective, so that variance is no longer easily measured above a certain threshold. Several studies in both the adult [In summary, we show that vaccine uptake is neither affected by short educational videos nor by short text-based educational interventions in a cohort of highly educated patients with IBD with high baseline vaccination levels. The largest predictor for vaccine uptake is prior receipt of the influenza vaccine, which suggests that future research should specifically focus on patients without prior vaccinations. Further investigation into the optimal means to deliver effective educational messages about preventive health is warranted.This study was supported by an independent educational grant from Pfizer. Pfizer had no role in the design, conduct, analysis, or decision to publish this study.Authors' Contributions: MDL, LW, WKvD, CK, CYH, CVA, BMRS, and GYM conceptualized and designed the study. MDL, LW, WKvD, and CK acquired the data. MDL, LW, WKvD, GYM, and XZ analyzed and interpreted the data. KLA drafted the manuscript. All authors did the critical revision of the manuscript for important intellectual content. WKvD, XZ, and WC performed the statistical analysis. MDL and GYM obtained funding and also supervised the study.Conflicts of Interest: WKvD has consulted for the Crohn and Colitis Foundation. GYM has consulted for AbbVie, Arena Pharmaceuticals, Boehringer-Ingelheim, Bristol-Meyers Squibb/Celgene, Entasis, Janssen, Medtronic, Pfizer, Prometheus Labs, Samsung Bioepis, Shionogi, Takeda, and Techlab, and has received research funding from Pfizer for an unrelated investigator-initiated study. BMRS reports grants from Takeda, Ironwood, and Amgen, and advisory board participation for Ardelyx, Exact Sciences, and Ferring. CYH is on the advisory board for Abbvie, Janssen, Pfizer, Takeda, Roivant, BMS, and Lilly, and receives grant support from Pfiser and Helmsley Charitable Trust. MDL has consuled for AbbVie, Takeda, Janssen, Pfizer, Lilly, BMS, Prometheus, Roche/Genentech, and Target RWE. GYM is a consultant for Abbvie, Arena, Briatol Myers Squibb, Celgene, Janssen, Medtronic, Pfizer, Takeda, Viatris, Fresenius Kabi, Prometheus Labs, Oshi, and Dieta. Research funding for this project was provided by Pfizer, but Pfizer had no role in study design, execution, interpretation of results, or decision to publish. No other conflicts are reported.
This randomized study was only retrospectively registered, explained by authors with the reasoning that it was not a therapeutic interventional trial. The editor granted an exception from ICMJE rules mandating prospective registration of randomized trials because the risk of bias appears low and the study was considered formative. However, readers are advised to carefully assess the validity of any potential explicit or implicit claims related to primary outcomes or effectiveness, as retrospective registration does not prevent authors from changing their outcome measures retrospectively.Prevention Bone Health.Prevention Influenza.Prevention Pneumonia.Prevention Shingles.Prevention Skin Cancer.Similar loss to follow up between text and video education groups.Intent to complete prevention interventions immediately after text or video reminders (N=1056).Predictive model of factors associated with intent to complete influenza vaccine (n=502).CONSORT-eHEALTH checklist (V 1.6.1).