Digital Vaccine Initiative for Inflammatory Bowel Disease Patients Using the Consolidated Framework for Implementation Research.

Background and Aims: Digital health interventions may improve preventive care for patients with inflammatory bowel disease, but implementation barriers can limit effectiveness. We evaluated a multisite digital vaccine outreach initiative and identified implementation barriers and facilitators using the Consolidated Framework for Implementation Research. Methods: We conducted a qualitative case study across 3 academic medical centers from 2022 to 2024. Survey responses from clinical coordinators and principal investigators were coded within Consolidated Framework for Implementation Research domains. The intervention used automated text messages with links to patient education and interactive health assessments. Results: Patient engagement was limited at all sites. Pre-existing vaccination programs facilitated integration, whereas sites without established infrastructure faced greater difficulty. Institutional constraints, including institutional review board restrictions that excluded two-thirds of patients at one site, limited enrollment. Many patients distrusted unsolicited automated messages and perceived embedded links as phishing attempts. Weekly staff time varied substantially, and turnover disrupted implementation continuity. Despite limited platform engagement, the initiative increased provider attention to vaccination. Conclusion: Digital vaccine initiatives require more than technology deployment. Successful implementation should include early assessment of institutional capacity, patient-centered design addressing trust and communication preferences, baseline needs assessment, structured implementation support, and clear gastroenterology-primary care workflows. Hybrid approaches combining digital outreach with communication from known clinicians or nurses may be more effective than fully automated messaging for preventive care in inflammatory bowel disease.