Background: Considerable disparities exist in access to GI care and digestive outcomes across gender, racial, and socioeconomic groups. Notably, socially vulnerable groups have worse outcomes in IBS and IBD due to health care inequities.

Objectives: To characterize 1) whether adults with chronic GI symptoms from diverse demographic groups would use a digital digestive care program and 2) the effects of participation on GI symptom severity and other patient-reported outcomes across groups.

Methods: We evaluated engagement and clinical outcomes associated with the use of a digital digestive chronic care program across diverse populations from baseline up to 90 days post-registration. The intervention included GI symptom tracking, personalized medical nutrition therapy, GI-specific health coaching, and targeted education on nine common GI symptoms. Participants rated their GI symptoms on a scale of 0 (no symptoms) to 4 (very severe symptoms). We calculated changes in symptoms from baseline to the end of the intervention and assessed outcomes across demographic groups, including categorization based on the Social Vulnerability Index (SVI).

Results: 1936 participants enrolled in the study: 67% identified as White/Caucasian, 11% as Asian/Pacific Islander, 6% as Hispanic/Latinx, 7% as Black/African American, and 7% as being of multiple races. Overall average SVI was 0.42 (SD 0.20), with Black/African Americans most likely to live in geographies with the greatest social vulnerability (p<0.001). Mean age was 43.1 years, 75% identified as female, and mean BMI was 28.5. Participants of all genders, races, and SVI groups engaged with the app (e.g., 82% used the app to schedule a synchronous visit with their care team). At baseline, 79% of participants reported at least moderate GI symptom severity for at least one symptom. Baseline symptom severity was highest for Hispanic/Latinx participants (85% reporting at least moderate symptoms) and lowest for Asian/Pacific Islanders (63% reporting at least moderate symptoms) (p<0.001). Overall, 85% of participants improved and participants from all races and SVI groups experienced significant improvement in GI symptoms, with no significant differences in improvements across groups (p>0.05) (Figures 1 and 2). Participants reported feeling greater control of their health (83%), better able to manage their digestive symptoms (83%), increased happiness (76%), and greater productivity at work (54%) with Black/African Americans and Native Americans most likely to report these changes but no differences across SVI groups.

Conclusion: Demographically and socioeconomically diverse participants all utilized a digital digestive chronic care program and reported significant improvements in digestive symptoms and patient-reported outcomes, suggesting that such a program may be of value in reducing healthcare disparities in GI care.

Alex Bullock

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