# Identifying Clinic Barriers and Facilitators Affecting the Implementation of a Mobile App-Based Treatment for Disorders of Gut-Brain Interaction in Children.

> **NIH NIH R03** · BAYLOR COLLEGE OF MEDICINE · 2024 · $120,375

## Abstract

PROJECT SUMMARY/ABSTARCT
Disorders of gut-brain interaction (DGBI; formerly known as functional abdominal pain disorders) like irritable
bowel syndrome are highly prevalent worldwide in children and adults. They are associated with significant
morbidity and incur substantial healthcare costs. The etiology of DGBI is multifactorial as described by the
biopsychosocial model. Psychological distress, including anxiety and depression, is highly associated with DGBI,
and cognitive behavioral therapy and its variant guided imagery therapy (GIT) are efficacious first-line treatments
per experts and clinical guidelines. Unfortunately, individual and systemic barriers often impede regular in-person
therapy visits. Alternatively, researchers have demonstrated that remotely delivered CBT and GIT via compact
discs and websites are efficacious, which led to the development of a K23-supported, patient-centered guided
imagery therapy mobile application (GIT App). However, our current K23 research nor the medical literature
inform best practices for implementing such a therapeutic App in pediatric clinics. Further, our preliminary data
shows that our clinicians infrequently refer children with DGBI to any psychological therapy. This proposal aims
to identify our clinic personnel’s perceived implementation determinants (i.e., barriers and facilitators) for rolling
out the GIT App within our pediatric clinics. To address this known barrier and discover unforeseen barriers and
inherent facilitators possibly affecting the implementation process, this proposal will solicit our clinic personnel’s
perspectives of these factors to inform a future GIT App implementation strategy that can guide clinic personnel
activities necessary to promote the implementation of the GIT App in this setting. Guided by the theory of
Organizational Readiness for Change and the Consolidated Framework for Implementation Research, we will
use qualitative and quantitative research methods to (1) assess our clinicians' perspectives about the infrequent
referral of patients with DGBI to psychological therapy and (2) identify perceived barriers and facilitators to the
implementation of the GIT App intervention in our pediatric clinics. Aim 1 will involve qualitative interviews with
clinicians to better understand their views on barriers to referral. For Aim 2, we will use mixed-methods research
by first quantitatively assessing clinic personnel’s organizational readiness for implementing the GIT App
intervention within our pediatrics clinics by using the validated Organizational Readiness to Change Assessment
(ORCA) instrument. Then we will conduct qualitative interviews with the same clinic personnel who have highest
and lowest ORCA readiness scores and capture their respective perspectives about perceived barriers and
facilitators affecting GIT App intervention implementation. The combined results of Aims 1 and 2 will inform a
GIT App implementation strategy for our pediatric clinics that can be...

## Key facts

- **NIH application ID:** 10889493
- **Project number:** 1R03DK134789-01A1
- **Recipient organization:** BAYLOR COLLEGE OF MEDICINE
- **Principal Investigator:** John M Hollier
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $120,375
- **Award type:** 1
- **Project period:** 2024-04-01 → 2026-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10889493

## Citation

> US National Institutes of Health, RePORTER application 10889493, Identifying Clinic Barriers and Facilitators Affecting the Implementation of a Mobile App-Based Treatment for Disorders of Gut-Brain Interaction in Children. (1R03DK134789-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10889493. Licensed CC0.

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