The impact of COVID-19 on trial participants' engagement with IBD-BOOST: a digital cognitive behavioural intervention

Background/Aims: The COVID-19 pandemic coincided with a randomised-controlled trial of an online-supported self-management intervention for fatigue, pain and urgency in inflammatory bowel disease (IBD). The aim of the present study was to investigate how the pandemic affected engagement with the IBD-BOOST programme. Methods: Intervention participants were invited to complete an online survey at 6-month follow-up, including both pre-defined and open-ended questions. A mixed methods quantitative and qualitative analyses were conducted. People who had participated in the online intervention (n= 354) were invited to answer questions about the impact of COVID-19 on their ability to engage with the online intervention Results: A total of 171 (48.31%) responded to the survey, with their experiences of the pandemic encompassing both negative and positive impacts on their engagement, as well as those who felt that the pandemic had no impact. For those who reported negative impact (19.30%): the pandemic created additional work and home-life responsibilities, the pandemic-induced emotional and psychological burden contributed to decreased participation, and engagement was reduced due to direct COVID-19 infection. For those who reported a positive impact (9.94%): the pandemic allowed for increased time availability due to pandemic-induced lifestyle changes. For those who felt the pandemic had no impact (50.29%): adaptability helped to maintain their engagement. The remaining 20.47% of participants reported that they were uncertain, or that their involvement varied. Conclusion: For some participants, the pandemic negatively impacted their engagement. However, 60% reported that the pandemic had either no or a positive impact on their engagement with IBD-BOOST, indicating the resilience of online delivery of behavioural interventions.