{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T23:47:41Z","timestamp":1792021661458,"version":"4.4.0"},"reference-count":110,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T00:00:00Z","timestamp":1764720000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Inflammatory bowel disease (IBD), including Crohn\u2019s Disease and Ulcerative Colitis, requires complex treatment and active patient participation. Health literacy (HL), defined as the ability to access, understand, and apply health information, is a key factor influencing adherence, self-management, and quality of life in chronic illness. However, evidence regarding HL in IBD remains limited and fragmented. This systematic review aimed to synthesize existing literature on HL in IBD, exploring its impact on outcomes, as well as its predictors and barriers. Methods: A systematic search of PubMed, Scopus, CINAHL, and Cochrane Library identified studies published between January 2000 and August 2025 in English or Italian. Eligible studies examined HL among adults with IBD and its associations with clinical, behavioral, or psychosocial outcomes. Methodological quality was assessed using the QuADS tool. Due to heterogeneity across studies, a narrative synthesis was conducted. Results: Seventy studies were included, comprising observational, qualitative, mixed-methods, and interventional designs. Higher HL was consistently associated with better treatment adherence, self-management, communication with healthcare providers, and quality of life. Conversely, low HL was linked to poor adherence, greater disease activity, and lower psychological well-being. Predictors of low HL included older age, lower education, minority status, and socioeconomic disadvantage. Barriers included inadequate communication, lack of tailored information, cultural and linguistic challenges, and the digital divide. Interventions such as structured education, telemedicine, and digital tools showed potential to improve HL and patient engagement. Conclusions: HL is a crucial determinant in IBD management. Enhancing HL through integrated clinical, educational, and digital strategies is essential to improve outcomes and reduce health disparities.<\/jats:p>","DOI":"10.3390\/jcm14238577","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T16:20:29Z","timestamp":1765210829000},"page":"8577","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Health Literacy in Inflammatory Bowel Disease: A Systematic Review of Health Outcomes, Predictors and Barriers"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-0949-4900","authenticated-orcid":false,"given":"Caterina","family":"Mercuri","sequence":"first","affiliation":[{"name":"Clinical and Experimental Medicine Department, Magna Graecia University, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4681-546X","authenticated-orcid":false,"given":"Rita","family":"Nocerino","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Sciences, University of Naples \u201cFederico II\u201d, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3351-4265","authenticated-orcid":false,"given":"Vincenzo","family":"Bosco","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, University Hospital Mater Domini, Magna Graecia University, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6444-0951","authenticated-orcid":false,"given":"Teresa","family":"Rea","sequence":"additional","affiliation":[{"name":"Department of Public Health, University of Naples \u201cFederico II\u201d, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenza","family":"Giordano","sequence":"additional","affiliation":[{"name":"Department of Public Health, University of Naples \u201cFederico II\u201d, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4619-0711","authenticated-orcid":false,"given":"Michele","family":"Virgolesi","sequence":"additional","affiliation":[{"name":"Department of Public Health, University of Naples \u201cFederico II\u201d, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrizia","family":"Doldo","sequence":"additional","affiliation":[{"name":"Clinical and Experimental Medicine Department, Magna Graecia University, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvio","family":"Simeone","sequence":"additional","affiliation":[{"name":"Clinical and Experimental Medicine Department, Magna Graecia University, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Saez, A., Herrero-Fernandez, B., Gomez-Bris, R., S\u00e1nchez-Martinez, H., and Gonzalez-Granado, J.M. (2023). Pathophysiology of Inflammatory Bowel Disease: Innate Immune System. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms24021526"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"101672","DOI":"10.1016\/j.disamonth.2023.101672","article-title":"Factors Influencing the Quality of Life in Inflammatory Bowel Disease: A Comprehensive Review","volume":"70","author":"Khan","year":"2024","journal-title":"Dis. Mon."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Napolitano, D., Bozzetti, M., Lo Cascio, A., De Stefano, G., Orgiana, N., Lopetuso, L.R., D\u2019Onofrio, A.M., Camardese, G., Papa, A., and Scaldaferri, F. (2025). Resilience and Self-Care in Patients with Inflammatory Bowel Disease: A Multicentre Cross-Sectional Study in Outpatient Settings. J. Clin. Med., 14.","DOI":"10.3390\/jcm14113868"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1159\/000530021","article-title":"A Systematic Review of Self-Management Interventions for Patients with Inflammatory Bowel Disease","volume":"8","author":"Iizawa","year":"2023","journal-title":"Inflamm. Intest. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1093\/ecco-jcc\/jjw059","article-title":"EHealth Technologies in Inflammatory Bowel Disease: A Systematic Review","volume":"10","author":"Jackson","year":"2016","journal-title":"J. Crohns Colitis"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Zhu, Y., Liu, K., Jiang, J., Cheng, X., Wang, H., Long, F., Li, K., Mu, C., and Cui, L. (2025). Structural Equation Modeling of the Impact of Disease Activity on Inflammatory Bowel Disease Control: The Mediating Roles of Self-Efficacy and Self-Management Behaviors. BMC Gastroenterol., 25.","DOI":"10.1186\/s12876-025-03623-6"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1016\/S0140-6736(17)31327-2","article-title":"Telemedicine for Management of Inflammatory Bowel Disease (myIBDcoach): A Pragmatic, Multicentre, Randomised Controlled Trial","volume":"390","author":"Becx","year":"2017","journal-title":"Lancet"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"3285","DOI":"10.1007\/s11606-020-05980-2","article-title":"Changes in COVID-19 Knowledge, Beliefs, Behaviors, and Preparedness among High-Risk Adults from the Onset to the Acceleration Phase of the US Outbreak","volume":"35","author":"Bailey","year":"2020","journal-title":"J. Gen. Intern. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1080\/00365521.2025.2497952","article-title":"Mapping Conditional Health Literacy and Digital Health Literacy in Patients with Inflammatory Bowel Disease to Optimise Availability of Digital Health Information: A Cross-Sectional Study","volume":"60","author":"Maurud","year":"2025","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1093\/ibd\/izy280","article-title":"Social Media Use and Preferences in Patients with Inflammatory Bowel Disease","volume":"25","author":"Reich","year":"2019","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"daw003","DOI":"10.1093\/heapro\/daw003","article-title":"Health Literacy and Chronic Disease Management: Drawing from Expert Knowledge to Set an Agenda","volume":"32","author":"Poureslami","year":"2016","journal-title":"Health Promot. Int."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1146\/annurev-publhealth-090419-102529","article-title":"Understanding and Responding to Health Literacy as a Social Determinant of Health","volume":"42","author":"Nutbeam","year":"2021","journal-title":"Annu. Rev. Public Health"},{"key":"ref_13","unstructured":"Weiss, B.D. (2007). Health Literacy and Patient Safety: Help Patients Understand. Manual for Clinicians, American Medical Association Foundation."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1093\/eurpub\/ckv043","article-title":"Health Literacy in Europe: Comparative Results of the European Health Literacy Survey (HLS-EU)","volume":"25","author":"Pelikan","year":"2015","journal-title":"Eur. J. Public Health"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2486","DOI":"10.1093\/ibd\/izae077","article-title":"Inequalities in Healthcare Access, Experience and Outcomes in Adults with Inflammatory Bowel Disease: A Scoping Review","volume":"30","author":"Hawkins","year":"2024","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"17562848221079162","DOI":"10.1177\/17562848221079162","article-title":"Social Barriers Influence Inflammatory Bowel Disease (IBD) Outcomes and Disproportionally Affect Hispanics and Non-Hispanic Blacks with IBD","volume":"15","author":"Damas","year":"2022","journal-title":"Ther. Adv. Gastroenterol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"otaa076","DOI":"10.1093\/crocol\/otaa076","article-title":"Low Health Literacy Exists in the Inflammatory Bowel Disease (IBD) Population and Is Disproportionately Prevalent in Older African Americans","volume":"2","author":"Theiss","year":"2020","journal-title":"Crohns Colitis 360"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/j.clnesp.2022.10.016","article-title":"Inadequate Food Literacy Is Related to the Worst Health Status and Limitations in Daily Life in Subjects with Inflammatory Bowel Disease","volume":"52","author":"Fiorindi","year":"2022","journal-title":"Clin. Nutr. ESPEN"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1016\/j.dld.2016.05.015","article-title":"Disease-Related Knowledge and Smoking Behavior of Patients with Crohn\u2019s Disease","volume":"48","author":"Li","year":"2016","journal-title":"Dig. Liver Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1097\/MCG.0000000000000431","article-title":"Importance of Patients\u2019 Knowledge of Their Prescribed Medication in Improving Treatment Adherence in Inflammatory Bowel Disease","volume":"50","author":"Tae","year":"2016","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1111\/j.1365-2036.2012.05130.x","article-title":"Patients\u2019 Knowledge of Pregnancy-related Issues in Inflammatory Bowel Disease and Validation of a Novel Assessment Tool (\u2018CCPKnow\u2019)","volume":"36","author":"Selinger","year":"2012","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"6848293","DOI":"10.1155\/2020\/6848293","article-title":"Patients\u2019 Educational Program Could Improve Azathioprine Adherence in Crohn\u2019s Disease Maintenance Therapy","volume":"2020","author":"Wang","year":"2020","journal-title":"Gastroenterol. Res. Pract."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1111\/jhn.13297","article-title":"What Do People with Inflammatory Bowel Disease Want to Know about Diet? The Dietary Information Needs of People with Inflammatory Bowel Disease and Perceptions of Healthcare Providers","volume":"37","author":"Miglioretto","year":"2024","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Rubin, D.C., Shaker, A., and Levin, M.S. (2012). Chronic Intestinal Inflammation: Inflammatory Bowel Disease and Colitis-Associated Colon Cancer. Front. Immunol., 3.","DOI":"10.3389\/fimmu.2012.00107"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 Statement: An Updated Guideline for Reporting Systematic Reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1002\/jrsm.1563","article-title":"Citationchaser: A Tool for Transparent and Efficient Forward and Backward Citation Chasing in Systematic Searching","volume":"13","author":"Haddaway","year":"2022","journal-title":"Res. Synth. Methods"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1002\/jrsm.1355","article-title":"Conduct and Reporting of Citation Searching in Cochrane Systematic Reviews: A Cross-sectional Study","volume":"11","author":"Briscoe","year":"2020","journal-title":"Res. Synth. Methods"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Harrison, R., Jones, B., Gardner, P., and Lawton, R. (2021). Quality Assessment with Diverse Studies (QuADS): An Appraisal Tool for Methodological and Reporting Quality in Systematic Reviews of Mixed- or Multi-Method Studies. BMC Health Serv. Res., 21.","DOI":"10.1186\/s12913-021-06122-y"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"20221019","DOI":"10.1259\/bjr.20221019","article-title":"A Systematic Review of Repeatability and Reproducibility Studies of Diffusion Tensor Imaging of Cervical Spinal Cord","volume":"96","author":"J","year":"2023","journal-title":"Br. J. Radiol."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Kaps, L., Omogbehin, L., Hildebrand, K., Gairing, S.J., Schleicher, E.M., Moehler, M., Rahman, F., Schattenberg, J.M., W\u00f6rns, M.-A., and Galle, P.R. (2022). Health Literacy in Gastrointestinal Diseases: A Comparative Analysis between Patients with Liver Cirrhosis, Inflammatory Bowel Disease and Gastrointestinal Cancer. Sci. Rep., 12.","DOI":"10.1038\/s41598-022-25699-w"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e056294","DOI":"10.1136\/bmjopen-2021-056294","article-title":"Definitions and Measurement of Health Literacy in Health and Medicine Research: A Systematic Review","volume":"12","author":"Urstad","year":"2022","journal-title":"BMJ Open"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1097\/SGA.0000000000000467","article-title":"Medication Adherence Across the Life Span in Inflammatory Bowel Disease: Implications and Recommendations for Nurses and Other Health Providers","volume":"43","author":"Knowles","year":"2020","journal-title":"Gastroenterol. Nurs."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1007\/s10620-006-9523-4","article-title":"Feasibility and Acceptance of a Home Telemanagement System in Patients with Inflammatory Bowel Disease: A 6-Month Pilot Study","volume":"52","author":"Cross","year":"2007","journal-title":"Dig. Dis. Sci."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1097\/SGA.0b013e3182747940","article-title":"Evaluation of an Ongoing Psychoeducational Inflammatory Bowel Disease Support Group in an Adult Outpatient Setting","volume":"35","author":"McMaster","year":"2012","journal-title":"Gastroenterol. Nurs."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2972","DOI":"10.1007\/s10620-011-1714-y","article-title":"Disease-Specific Knowledge, Coping, and Adherence in Patients with Inflammatory Bowel Disease","volume":"56","author":"Moradkhani","year":"2011","journal-title":"Dig. Dis. Sci."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"662","DOI":"10.3109\/00365521.2014.896408","article-title":"Patients\u2019 Information-Seeking Activity Is Associated with Treatment Compliance in Inflammatory Bowel Disease Patients","volume":"49","author":"Pittet","year":"2014","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Norouzkhani, N., Bahari, A., Faramarzi, M., Shokri Shirvani, J., Eslami, S., and Tabesh, H. (2023). Development and Validation of an Educational Book on Self-Management in Inflammatory Bowel Disease Based on Patient Preferences and Expert Opinions: A Methodological Study. J. Clin. Med., 12.","DOI":"10.3390\/jcm12247659"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Maurud, S., Lunde, L., Moen, A., and Opheim, R. (2024). Exploring the Foundations of a Digital Health Information Service for Patients with Inflammatory Bowel Disease: A Mixed Method Study in Gravitate-Health. BMC Gastroenterol., 24.","DOI":"10.1186\/s12876-024-03272-1"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"cyw042","DOI":"10.1093\/her\/cyw042","article-title":"Self-Management Education for Rehabilitation Inpatients Suffering from Inflammatory Bowel Disease: A Cluster-Randomized Controlled Trial","volume":"31","author":"Reusch","year":"2016","journal-title":"Health Educ. Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1093\/ibd\/izy237","article-title":"Limited Health Literacy Is Associated with Worse Patient-Reported Outcomes in Inflammatory Bowel Disease","volume":"25","author":"Tormey","year":"2019","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Park, J., Yoon, H., Shin, C.M., Park, Y.S., Kim, N., and Lee, D.H. (2020). Higher Levels of Disease-Related Knowledge Reduce Medical Acceleration in Patients with Inflammatory Bowel Disease. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0233654"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Xie, H., Zhang, J., Liu, C., Yang, B., and Dong, W. (2023). Development and Validation of a Questionnaire to Test Chinese Patients\u2019 Knowledge of Inflammatory Bowel Disease. Sci. Rep., 13.","DOI":"10.1038\/s41598-023-34286-6"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.1093\/ecco-jcc\/jjaa047","article-title":"Knowledge and Attitudes Towards Pregnancy in Females with Inflammatory Bowel Disease: An International, Multi-Centre Study","volume":"14","author":"Laube","year":"2020","journal-title":"J. Crohns Colitis"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"17562848221095372","DOI":"10.1177\/17562848221095372","article-title":"Notable Gaps between Patients\u2019 and Physicians\u2019 Perspectives on Communication and Disease Management in Japan: Multifaceted Ad Hoc Analyses of the Global Ulcerative Colitis Narrative Survey for Further Optimal Care","volume":"15","author":"Watanabe","year":"2022","journal-title":"Ther. Adv. Gastroenterol."},{"key":"ref_45","first-page":"CD013854","article-title":"Patient Education Interventions for the Management of Inflammatory Bowel Disease","volume":"2023","author":"Gordon","year":"2023","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1089\/tmj.2020.0014","article-title":"Social Media Use for Inflammatory Bowel Disease in a Rural Appalachian Population","volume":"27","author":"Chowdhary","year":"2021","journal-title":"Telemed. e-Health"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"S417","DOI":"10.14309\/01.ajg.0000705300.61083.d8","article-title":"S0813 The Effect of Educational Videos on Inflammatory Bowel Disease Patients\u2019 Engagement and Their Friends\u2019 and Family Members\u2019 Level of Empathy","volume":"115","author":"Khalil","year":"2020","journal-title":"Am. J. Gastroenterol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"i1793","DOI":"10.1093\/ecco-jcc\/jjae190.1137","article-title":"P0963 Nationwide Analysis of Targeted Telemedicinal Patient Education in IBD\u2014A Randomized-Controlled Trial","volume":"19","author":"Bacsur","year":"2025","journal-title":"J. Crohns Colitis"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1002\/ibd.22834","article-title":"Internet and Electronic Resources for Inflammatory Bowel Disease: A Primer for Providers and Patients","volume":"18","author":"Fortinsky","year":"2012","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"e36767","DOI":"10.2196\/36767","article-title":"The Effectiveness of Patient Training in Inflammatory Bowel Disease Knowledge via Instagram: Randomized Controlled Trial","volume":"24","author":"Blunck","year":"2022","journal-title":"J. Med. Internet Res."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Mercuri, C., Giordano, V., Bosco, V., Serra, N., Spagnuolo, R., Nocerino, R., Rea, T., Colaci, C., Guillari, A., and Doldo, P. (2024). Impact of Nursing Interventions via Telephone and Email on the Quality of Life of Patients with Inflammatory Bowel Disease: Preliminary Results of a Comparative Observational Study. Healthcare, 12.","DOI":"10.3390\/healthcare12242538"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"2191","DOI":"10.1093\/ibd\/izy149","article-title":"Inflammatory Bowel Disease Telemedicine Clinical Trial: Impact of Educational Text Messages on Disease-Specific Knowledge Over 1 Year","volume":"24","author":"Abutaleb","year":"2018","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1177\/1740774509346978","article-title":"Challenges in the Design of a Home Telemanagement Trial for Patients with Ulcerative Colitis","volume":"6","author":"Cross","year":"2009","journal-title":"Clin. Trials"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"e23","DOI":"10.2196\/resprot.4042","article-title":"Impact of the Mobile HealthPROMISE Platform on the Quality of Care and Quality of Life in Patients with Inflammatory Bowel Disease: Study Protocol of a Pragmatic Randomized Controlled Trial","volume":"4","author":"Atreja","year":"2015","journal-title":"JMIR Res. Protoc."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"e40382","DOI":"10.2196\/40382","article-title":"A Novel Remote Patient and Medication Monitoring Solution to Improve Adherence and Persistence With Inflammatory Bowel Disease Therapy (ASSIST Study): Protocol for a Randomized Controlled Trial","volume":"11","author":"Axelrad","year":"2022","journal-title":"JMIR Res. Protoc."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"28","DOI":"10.12968\/gasn.2021.19.9.28","article-title":"Inflammatory Bowel Disease Nurses\u2019 Views on Taking on a New Role to Support an Online Self-Management Programme for Symptoms of Fatigue, Pain and Urgency: A Qualitative Study to Maximise Intervention Acceptance","volume":"19","author":"Matthias","year":"2021","journal-title":"Gastrointest. Nurs."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"i533","DOI":"10.1093\/ecco-jcc\/jjac190.0533","article-title":"P403 Therapeutic Compliance in Patients with Chronic Inflammatory Bowel Disease","volume":"17","author":"Hajlaoui","year":"2023","journal-title":"J. Crohns Colitis"},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Pint\u00e9r, H.K., Nagy, V.A., Csobod, \u00c9.C., Cseh, \u00c1., B\u00e9res, N.J., Prehoda, B., Dezs\u0151fi-Gottl, A., Veres, D.S., and P\u00e1lfi, E. (2025). Health Literacy and Nutrition of Adolescent Patients with Inflammatory Bowel Disease. Nutrients, 17.","DOI":"10.3390\/nu17152458"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.1093\/ibd\/izaa257","article-title":"Ulcerative Colitis Narrative Global Survey Findings: Communication Gaps and Agreements Between Patients and Physicians","volume":"27","author":"Rubin","year":"2021","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1718","DOI":"10.1111\/jocn.12321","article-title":"What Do Patients Need to Know? Living with Inflammatory Bowel Disease","volume":"23","author":"Lesnovska","year":"2014","journal-title":"J. Clin. Nurs."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"e001510","DOI":"10.1136\/bmjgast-2024-001510","article-title":"Self-Care in Patients Affected by Inflammatory Bowel Disease and Caregiver Contribution to Self-Care (IBD-SELF): A Protocol for a Longitudinal Observational Study","volume":"11","author":"Napolitano","year":"2024","journal-title":"BMJ Open Gastroenterol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1186\/s40337-023-00936-3","article-title":"Risk of Avoidant\/Restrictive Food Intake Disorder in Patients with Inflammatory Bowel Disease: Predictive Value of Disease Phenotype, Disease Activity and Food Literacy","volume":"11","author":"Yin","year":"2023","journal-title":"J. Eat. Disord."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Nam, H.J., and Yoon, J.Y. (2024). Pathways Linking Health Literacy to Self-Care in Diabetic Patients with Physical Disabilities: A Moderated Mediation Model. PLoS ONE, 19.","DOI":"10.1371\/journal.pone.0299971"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/j.pec.2015.08.021","article-title":"Pathways of Empowerment Perceptions, Health Literacy, Self-Efficacy, and Self-Care Behaviors to Glycemic Control in Patients with Type 2 Diabetes Mellitus","volume":"99","author":"Lee","year":"2016","journal-title":"Patient Educ. Couns."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1159\/000452989","article-title":"Beneficial Effects of Education on Emotional Distress, Self-Management, and Coping in Patients with Inflammatory Bowel Disease: A Prospective Randomized Controlled Study","volume":"1","author":"Berding","year":"2016","journal-title":"Inflamm. Intest. Dis."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1097\/NNA.0000000000001364","article-title":"Applying the Patient Empowerment, Engagement, and Activation Survey to Improve Patient Outcomes","volume":"53","author":"Stichler","year":"2023","journal-title":"JONA J. Nurs. Adm."},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Mu\u00f1oz-Villaverde, S., Mart\u00ednez-Garc\u00eda, M., Serrano-Oviedo, L., G\u00f3mez-Romero, F.J., Sobrado-Sobrado, A.M., Cidoncha-Moreno, M.\u00c1., Riesgo-Mart\u00edn, J., Pedreira-Robles, G., and Garcimartin, P. (2024). Impact of Telenurse-Led Intervention in Clinical Trials on Health Literacy, Empowerment, and Health Outcomes in Patients with Solid Tumours: A Pilot Quasi-Experimental Study. BMC Nurs., 23.","DOI":"10.1186\/s12912-023-01641-x"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"55","DOI":"10.21608\/jnsbu.2024.362179","article-title":"Effect of Educational Program on Quality of Life and Health Promoting Lifestyle Behaviors for Patients with Inflammatory Bowel Disease","volume":"5","year":"2024","journal-title":"J. Nurs. Sci. Benha Univ."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1097\/MIB.0000000000000622","article-title":"Understanding Health Literacy and Its Impact on Delivering Care to Patients with Inflammatory Bowel Disease","volume":"22","author":"Tormey","year":"2016","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Carels, C., Wauters, L., Outtier, A., Baert, F., Bossuyt, P., Colard, A., De Looze, D., Ferrante, M., Goegebuer, A., and Hauser, B. (2021). Health Literacy and Quality of Life in Young Adults from The Belgian Crohn\u2019s Disease Registry Compared to Type 1 Diabetes Mellitus. Front. Pediatr., 9.","DOI":"10.3389\/fped.2021.624416"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"4147","DOI":"10.1111\/jan.16138","article-title":"Relationship between Fear of Progression and Quality of Life in Inflammatory Bowel Disease: Mediating Role of Health Literacy and Self-care","volume":"80","author":"Hu","year":"2024","journal-title":"J. Adv. Nurs."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1177\/0272989X16632197","article-title":"Effect of Health Literacy on Decision-Making Preferences among Medically Underserved Patients","volume":"36","author":"Seo","year":"2016","journal-title":"Med. Decis. Mak."},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Norouzkhani, N., Faramarzi, M., Ghodousi Moghadam, S., Karimi, M.A., Shokri Shirvani, J., Bahari, A., ShojaeiBaghini, M., Eslami, S., and Tabesh, H. (2023). Identification of the Informational and Supportive Needs of Patients Diagnosed with Inflammatory Bowel Disease: A Scoping Review. Front. Psychol., 14.","DOI":"10.3389\/fpsyg.2023.1055449"},{"key":"ref_74","doi-asserted-by":"crossref","unstructured":"Ahmed, S., Newton, P.D., Ojo, O., and Dibley, L. (2021). Experiences of Ethnic Minority Patients Who Are Living with a Primary Chronic Bowel Condition: A Systematic Scoping Review with Narrative Synthesis. BMC Gastroenterol., 21.","DOI":"10.1186\/s12876-021-01857-8"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1007\/s11920-021-01274-4","article-title":"Disparities in Health Care and the Digital Divide","volume":"23","author":"Saeed","year":"2021","journal-title":"Curr. Psychiatry Rep."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"e17616","DOI":"10.2196\/17616","article-title":"Digital Divide in Perceived Benefits of Online Health Care and Social Welfare Services: National Cross-Sectional Survey Study","volume":"22","author":"Heponiemi","year":"2020","journal-title":"J. Med. Internet Res."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1097\/MIB.0000000000000241","article-title":"Telemedicine in Inflammatory Bowel Disease: Opportunities and Approaches","volume":"21","author":"Bebia","year":"2015","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1016\/S1091-255X(03)00066-0","article-title":"Patients with Crohn\u2019s Disease Are Unaware of the Risks That Smoking Has on Their Disease","volume":"7","author":"Ryan","year":"2003","journal-title":"J. Gastrointest. Surg."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"2678","DOI":"10.1097\/MIB.0000000000000951","article-title":"A Survey of Social Media Use and Preferences in Patients with Inflammatory Bowel Disease","volume":"22","author":"Reich","year":"2016","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"1672","DOI":"10.1023\/B:DDAS.0000043384.26092.f4","article-title":"Knowledge, Quality of Life, and Use of Complementary and Alternative Medicine and Therapies in Inflammatory Bowel Disease: A Comparison of Chinese and Caucasian Patients","volume":"49","author":"Leong","year":"2004","journal-title":"Dig. Dis. Sci."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1093\/ecco-jcc\/jjx175","article-title":"Patient Education in Inflammatory Bowel Disease: A Patient-Centred, Mixed Methodology Study","volume":"12","author":"McDermott","year":"2018","journal-title":"J. Crohns Colitis"},{"key":"ref_82","first-page":"1057","article-title":"Inviting Patients with Inflammatory Bowel Disease to Active Involvement in Their Own Care: A Randomized Controlled Trial","volume":"20","author":"Hueppe","year":"2014","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1046\/j.1365-2524.2003.00399.x","article-title":"the North-west Region Gastrointestinal Research Group A Cluster-Randomised Controlled Trial of a Patient-Centred Guidebook for Patients with Ulcerative Colitis: Effect on Knowledge, Anxiety and Quality of Life: Information for Patients with Ulcerative Colitis","volume":"11","author":"Kennedy","year":"2003","journal-title":"Health Soc. Care Community"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"1652","DOI":"10.1136\/gut.2010.220160","article-title":"E-Health Empowers Patients with Ulcerative Colitis: A Randomised Controlled Trial of the Web-Guided \u2018Constant-Care\u2019 Approach","volume":"59","author":"Elkjaer","year":"2010","journal-title":"Gut"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"386","DOI":"10.4040\/jkan.24010","article-title":"Effects of a Pre-Conception Care Program in Women with Inflammatory Bowel Disease: A Mixed-Methods Study Including a Randomized Controlled Trial","volume":"54","author":"Lee","year":"2024","journal-title":"J. Korean Acad. Nurs."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"760","DOI":"10.5152\/tjg.2020.19669","article-title":"The Specialized Educational and Psychological Counseling in Inflammatory Bowel Disease Patients\u2014A Target or a Challenge?","volume":"31","author":"Gavrilescu","year":"2020","journal-title":"Turk. J. Gastroenterol."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1136\/pmj.78.924.615","article-title":"Does Patient Knowledge Affect the Colorectal Cancer Risk in Ulcerative Colitis?","volume":"78","author":"Eaden","year":"2002","journal-title":"Postgrad. Med. J."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"1508","DOI":"10.1111\/jocn.13436","article-title":"Assessment of Disease-related Knowledge and Possible Factors Associated with the Knowledge Level among Chilean Patients with Inflammatory Bowel Disease","volume":"26","author":"Simian","year":"2017","journal-title":"J. Clin. Nurs."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1186\/s13063-015-0962-0","article-title":"Faecal Incontinence Intervention Study (FINS): Self-Management Booklet Information with or without Nurse Support to Improve Continence in People with Inflammatory Bowel Disease: Study Protocol for a Randomized Controlled Trial","volume":"16","author":"Norton","year":"2015","journal-title":"Trials"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"e41092","DOI":"10.2196\/41092","article-title":"Video-Based Educational Interventions for Patients with Chronic Illnesses: Systematic Review","volume":"25","author":"Deshpande","year":"2023","journal-title":"J. Med. Internet Res."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1093\/jcag\/gwad029","article-title":"Identification and Evaluation of Mobile Applications for Self-Management of Diet and Lifestyle for Patients with Inflammatory Bowel Disease","volume":"6","author":"Gold","year":"2023","journal-title":"J. Can. Assoc. Gastroenterol."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1093\/ibd\/izx073","article-title":"IBD-INFO Questionnaire: A Multicenter French Up-to-Date Survey of Patient Knowledge in Inflammatory Bowel Disease","volume":"24","author":"Danion","year":"2018","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.cct.2015.03.006","article-title":"TELEmedicine for Patients with Inflammatory Bowel Disease (TELE-IBD): Design and Implementation of Randomized Clinical Trial","volume":"42","author":"Cross","year":"2015","journal-title":"Contemp. Clin. Trials"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"e13","DOI":"10.2196\/mhealth.4874","article-title":"Mobile Phone Apps for Inflammatory Bowel Disease Self-Management: A Systematic Assessment of Content and Tools","volume":"4","author":"Con","year":"2016","journal-title":"JMIR mHealth uHealth"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"e42921","DOI":"10.2196\/42921","article-title":"Web-Based Video Education to Improve Uptake of Influenza Vaccination and Other Preventive Health Recommendations in Adults with Inflammatory Bowel Disease: Randomized Controlled Trial of Project PREVENT","volume":"25","author":"Long","year":"2023","journal-title":"J. Med. Internet Res."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"6001","DOI":"10.3748\/wjg.v21.i19.6001","article-title":"Assessment of Disease Specific Knowledge and Health-Related Quality of Life among United States Military Veterans with Inflammatory Bowel Disease","volume":"21","author":"Hou","year":"2015","journal-title":"World J. Gastroenterol."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"17562848251319807","DOI":"10.1177\/17562848251319807","article-title":"\u201cSimpleness\u201d: A Qualitative Description Study Exploring Patient Perspectives on the Barriers and Facilitators of Using Digital Health Tools to Self-Manage Inflammatory Bowel Disease","volume":"18","author":"Ajibulu","year":"2025","journal-title":"Ther. Adv. Gastroenterol."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"e70186","DOI":"10.1002\/hsr2.70186","article-title":"Designing the Essential Informational Needs of a Smartphone Application for Self-Management of Patients with Inflammatory Bowel Disease","volume":"7","author":"Asadi","year":"2024","journal-title":"Health Sci. Rep."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1097\/00054725-200207000-00005","article-title":"Providing Disease-Related Information Worsens Health-Related Quality of Life in Inflammatory Bowel Disease","volume":"8","author":"Borgaonkar","year":"2002","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"1272","DOI":"10.1111\/imj.15840","article-title":"Development of Inflammatory Bowel Disease Patient Education and Medical Information Sheets: Serving an Unmet Need","volume":"52","author":"Garg","year":"2022","journal-title":"Intern. Med. J."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.1093\/ibd\/izae201","article-title":"Communicating Information Regarding IBD Remission to Patients: Evidence from a Survey of Adult Patients in the United States","volume":"31","author":"Wood","year":"2025","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1002\/ibd.21363","article-title":"Information Needs and Preferences of Recently Diagnosed Patients with Inflammatory Bowel Disease","volume":"17","author":"Bernstein","year":"2011","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"1","DOI":"10.9734\/BJMMR\/2016\/21884","article-title":"Unmet Communication and Information Needs for Patients with IBD: Implications for Mobile Health Technology","volume":"12","author":"Khan","year":"2016","journal-title":"Br. J. Med. Med. Res."},{"key":"ref_104","doi-asserted-by":"crossref","unstructured":"He, S., Xiao, T., and Xia, Y. (2024). Life Changes, Self-Prevention, Knowledge and Mental Health among Inflammatory Bowel Disease Patients during COVID-19 Pandemic: A Cross-Sectional Study. Front. Public Health, 12.","DOI":"10.3389\/fpubh.2024.1416880"},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"2306","DOI":"10.1093\/ibd\/izae009","article-title":"Physical Activity and IBD: State of Art and Knowledge, Patients and Healthcare Professionals Points of View, A French Multicenter Cross Sectional Study","volume":"30","author":"Derbey","year":"2024","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"4246","DOI":"10.3748\/wjg.v25.i30.4246","article-title":"Inflammatory Bowel Disease Patient Profiles Are Related to Specific Information Needs: A Nationwide Survey","volume":"25","author":"Daher","year":"2019","journal-title":"World J. Gastroenterol."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1111\/jnu.12189","article-title":"A Systematic Review of Self-Management Interventions for Inflammatory Bowel Disease","volume":"48","author":"Conley","year":"2016","journal-title":"J. Nurs. Scholarsh."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"211","DOI":"10.34172\/mejdd.2024.394","article-title":"Developing Mobile Health Applications for Inflammatory Bowel Disease: A Systematic Review of Features and Technologies","volume":"16","author":"Akbarian","year":"2024","journal-title":"Middle East J. Dig. Dis."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1186\/s41687-021-00366-2","article-title":"Patient Perspectives on Digital Patient Reported Outcomes in Routine Care of Inflammatory Bowel Disease","volume":"5","author":"Nielsen","year":"2021","journal-title":"J. Patient-Rep. Outcomes"},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"1910","DOI":"10.1093\/ibd\/izy113","article-title":"Current Landscape of Telemedicine Practice in Inflammatory Bowel Disease","volume":"24","author":"Patil","year":"2018","journal-title":"Inflamm. Bowel Dis."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/23\/8577\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T16:39:01Z","timestamp":1765211941000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/23\/8577"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,3]]},"references-count":110,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["jcm14238577"],"URL":"https:\/\/doi.org\/10.3390\/jcm14238577","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,3]]}}}