Effectiveness of a multi-component intervention program for self-management behaviors in adolescents and young adults with inflammatory bowel disease based on the self-determination theory: A randomized controlled trial across two centers

Background: The incidence of inflammatory bowel disease has been increasing, with the peak incidence in adolescence and young adults. Self-management behaviors are of great significance for adolescents and young adults with inflammatory bowel disease to maintain disease remission and improve their quality of life. However, their self-management behaviors urgently need to be optimized.

Objective: To evaluate the impact of a multi-component intervention program constructed based on the self-determination theory on the self-management behaviors and related health outcomes of adolescents and young adults with inflammatory bowel disease.

Methods: A single-blind, two-arm randomized controlled trial was conducted from August 2024 to January 2025. Adolescents and young adults aged 13 to 24 years old with inflammatory bowel disease were recruited from the gastroenterology wards of two tertiary hospitals in Chongqing, China. Participants were randomly assigned (1:1) to the control and intervention groups. The control group received routine care, and the intervention group received an additional multi-component intervention program. Outcome indicators included self-management behaviors, perceived social support, basic psychological needs, anxiety, depression, and disease activity, evaluated immediately post-intervention (T1) and 12 weeks post-intervention (T2). Repeated-measures ANOVA and the Friedman test were used for analysis, following the intention-to-treat principle.

Results: A total of 74 participants were recruited, with 37 in the intervention group and 37 in the control group. There were no statistically significant differences in the baseline data between the two groups. Data analysis of the outcome indicators showed that: (a) The self-management behaviors scores of the intervention group at the T1 and T2 time points were significantly higher than the control group (P < 0.05). (b) The scores of perceived social support scores and basic psychological needs of the intervention group at the T1 and T2 time points were significantly higher than the control group (P < 0.05), while the anxiety and depression scores were significantly lower than those of the control group (P < 0.05). (a) There was no statistically significant difference in the disease activity levels at T1 (P > 0.05), and at T2, the proportion of the intervention group in the remission phase was significantly higher than that of the control group (P < 0.05).

Conclusion:  The  multi-component  short-term  group  intervention  program constructed based on the self-determination theory in this study can effectively improve the self-management behaviors and related health outcomes of adolescents and young adults with inflammatory bowel disease in a short and medium term.