The Impact of a Digital Digestive Health Program and Telehealth Visits in Socially Vulnerable Populations: Cohort Evaluation.

Background: Socially vulnerable populations have less access to quality gastrointestinal (GI) care. Digital telehealth services provided by GI-focused registered dietitian nutritionists (RDNs) and digestive health coaches (HCs) may improve digestive health outcomes by facilitating access to GI care and thereby reduce health care disparities among vulnerable populations.

Objective: The objectives of this study were to (1) evaluate the impact of a digital digestive health program on reducing GI symptoms among socially vulnerable populations and (2) assess whether telehealth visits with digital app use provide additional benefits in symptom reduction compared to digital app use alone among socially vulnerable populations.

Methods: A comprehensive digital digestive care program with optional telehealth visits with RDNs and HCs was provided to US employees of participating companies via their employee benefits. We enrolled participants in the program between 2022 and 2023 who tracked digestive symptoms multiple times at baseline and then over 90 days. We measured changes in GI symptoms from baseline to up to 3 months, comparing those who opted for telehealth visits with those who used the app only. We stratified participants by the median Social Vulnerability Index (SVI) to evaluate symptom improvement across socially vulnerable populations. Multivariable regressions adjusted for age, gender, race, BMI, and preexisting GI conditions.

Results: A total of 1656 participants met the inclusion criteria, of which 1362 (82%) scheduled at least one telehealth visit and 294 (18%) used only app-based resources. The majority (n=1417 86%) of participants saw GI symptom improvement, with an average reduction of 60% in symptom burden (P<.001). Participants who used telehealth services and the app had a reduction in symptoms 16% greater than that of app-only users (P=.01). High-SVI participants (ie, those with an SVI score above the median of 0.4, indicating greater social vulnerability) had a 22% greater reduction in GI symptom severity score than app-only high-SVI participants (P=.04).

Conclusions: Digital health solutions may be an important resource in advancing equitable access to quality GI care and addressing disparities among populations with high social vulnerability. Virtual telehealth visits with RDNs and HCs appear to be particularly beneficial in improving digestive symptoms in such populations.