Self-determination theory (SDT) is a theory of motivation that presumes that humans have three basic psychological needs-autonomy, competence, and relatedness. Each of these needs impacts one's motivation to adhere to a medical regimen. For example, this might mean choosing to take prescribed medications (autonomy), having the mastery to take the medication correctly (competence), and having quality relationships to support those skills (relatedness).

Past research has examined whether SDT can be applied to a variety of health issues, such as asthma, diabetes, and quitting smoking. However, no studies to date have examined this theory in people with ulcerative colitis (UC). Dr. Dasharathy used data from IBD Partners to better understand adherence to oral medications in people with UC, and how this relates to stress, motivation, competence, and relationships with health care providers.

Learn more about this study on our blog.

Patients with inflammatory bowel disease (IBD) are at increased risk of infections, bone fractures and skin cancers. Preventive health educational messages delivered to patients may reduce the risks of these complications. With patient input, we developed video messages and tested their impact compared to text-based messages. 1056 IBD Partners participants received either video or text-based health reminder messages. The study investigated reminder messages for influenza vaccine, pneumonia vaccine, skin cancer screening, bone health and shingles vaccine. This study found that video and text-based messages for all five topics had a similar impact on intent to get needed care. For the main outcome of influenza vaccine, 57% had received a flu vaccine prior to the preventive health messages, while 73% reported they intended to get a flu vaccine after the intervention. Further studies are measuring whether people followed up to get the needed care.



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Our objective was to describe the transition readiness (transitioning from child- to adult-centered healthcare) of children and young adults with inflammatory bowel disease (IBD) and study its relationships with age, sex, IBD activity, and measures of physical, psychological, and social health.

Participants in IBD Partners and IBD Partners Kids & Teens answered questions about demographics, IBD activity, transition readiness, health-related quality of life, and more.

In children and young adults with IBD, transition readiness was related to older age and female sex, but not IBD activity and other measures of physical, psychological, and social health.

Children and teenagers with Inflammatory Bowel Disease (IBD) are at increased risk of being unhappy with their body image. This study aimed to learn more about how common body image dissatisfaction (or "BID") is among these children and teenagers and to see if we could point to any risk factors for having BID. A total of 664 participants in the IBD Partners Kids & Teens study, ages 9-18, completed an online survey about anxiety, depression, disease activity, and quality of life. We found that about 3% of participants met the criteria for having BID by selecting the answer choices "I look awful" or "I look bad" when asked about their appearance. Young patients with BID tended to have worse disease, to be taking steroids, to be female, and to be diagnosed at an older age. These participants were also much more anxious and depressed than those who were satisfied with their appearance. Pediatric patients with BID should discuss these concerns with their physicians and healthcare teams.

People with inflammatory bowel disease, or IBD, commonly experience diarrhea and abdominal pain. These symptoms are often related to inflammation associated with IBD. Sometimes these symptoms are related to both IBD and irritable bowel syndrome, or IBS. IBS is sensitivity of the intestine without inflammation. Patients with IBD who are diagnosed with IBS may experience changes in their care and well-being. We looked at the rate of IBD-IBS diagnosis in the CCFA Partners network. We also looked at how a diagnosis of IBD-IBS impacts outcomes, such as ability to perform normal daily activities, and use of specific medications. A total of 6309 patients were included, of these, 20% reported being diagnosed with IBS after their IBD diagnosis. Patients with both an IBD and IBS diagnosis had higher rates of narcotic use compared to patients with an IBD diagnosis alone. An IBS diagnosis was associated with anxiety, depression, fatigue, poor sleep quality, pain interference, and decreased social satisfaction. Appropriate diagnosis, treatment, and counseling may help improve outcomes experienced by IBD-IBS patients and reduce narcotic use in this group.

We studied how often women and men with inflammatory bowel disease (IBD) seek care for infertility (problems getting pregnant). We also looked at reasons why individuals had trouble getting pregnant. A total of 12.5% of women in CCFA Partners went to see a doctor for problems getting pregnant. This was a little higher in women with Crohn's disease (14.1%) than in women with ulcerative colitis (9.5%). Risk factors for needing help getting pregnant were: prior GI surgery and older age. The most common cause of fertility problems in women was blocked fallopian tubes. For men, 8.7% needed help with fertility. Age was a risk factor. The most common cause of fertility problems was a problem with their female partner. Nearly 80% of women and men who went to the doctor for fertility problems were able to get pregnant. These rates of pregnancy with fertility treatment are similar to those of people without IBD.

Variation in care of patients with Crohn's disease (CD) and ulcerative colitis (UC) has been used as a marker for quality differences. We studied whether important aspects of IBD patients' care in CCFA Partners varied based on where their GI doctor was in practice. We compared patients who saw an academic (university) GI physician, a private practice GI physician, or other GI physician (such as a Veteran's Affairs physician). The study included about 12,000 IBD patients. Almost 95% reported visiting a GI provider at least once a year: about 74% saw a private practice physician, 15% academic, and 11% other. Those patients with CD seen by academic physicians were younger, has completed higher education, used less mesalamine medications, and used more biologics and immunomodulators. They were more likely to be in remission, were more likely to get a flu shot, smoked less, and were less likely to be on steroids when compared to private or other physicians. Patients with UC seen by academic providers were younger, had more hospitalizations and surgery, with greater biologic and immunomodulator use. There was no difference in steroid use, and no differences in any of the other measures like remission rates, flu shot, quality of life. In summary, there was much more variation in CD care as compared to UC care, with improved outcomes for CD patients seen by academic providers. Studying why this is the case, could help us to improve the quality of care delivered to all IBD patients.

Like many other chronic illnesses, there is inconsistent quality of health care for inflammatory bowel disease, or IBD. In this study, nearly 1000 patients with Crohn's disease or ulcerative colitis took a survey about their experiences with chronic illness care, including questions about goal setting, problem solving and follow-up. Patients who had a recent gastroenterologist visit, hospitalization, surgery, or currently had a pouch or ostomy, reported having higher quality of care. Patients with higher quality of care also reported better quality of life.

Treatment for inflammatory bowel disease, or IBD, puts patients at risk of other infections, like influenza or the "flu", which could be prevented by vaccines. In a study of nearly 1000 patients with IBD, not enough said they were getting the vaccines they needed. Patients with a primary care physician and those taking immunosuppressive medications were more likely to get vaccines. The researchers recommend educating patients and encouraging gastroenterologists to ask and counsel patients on vaccines.

This manuscript describes the creation of CCFA Partners and the first 7,819 participants. Of the people who took the first surveys, 72% were women, the median age was 42 years, 63% had Crohn's disease, 34% had ulcerative colitis and 3% had other IBD. CCFA Partners is a unique resource to study patient outcomes and satisfaction, quality of care and changes in disease management over time.