Downloaded from http://journals.lww.com/jpgn by BhDMf5ePHKbH4TTImqenVOi5Xq/Qs+jzS5N67S1+PkzeiueW+GvQZ4Yvi0CFs1CE on 08/17/2020 Copyright © ESPGHAN and NASPGHAN. All rights reserved. The Effect of the Inflammatory Bowel Disease Classroom in Nature on the Quality of Life of Patients With Inflammatory Bowel Disease y Vı ´ctor M. Navas-Lo ´pez, z Laura Camacho Martel,  Rafael Martı ´n-Masot, § Marı ´a Navalo ´n Rubio, z Natalia Ruiz Santana,  Marta Herrador Lo ´pez,  Almudena Frı ´as Arjona, jj Vı ´ctor M. Merino Valero, ô Vero ´nica Ortega Doltz, # Sara N. Ramos-Co ´zar, and z Guillermo Alcaı ´n Martı ´nez ABSTRACT ‘‘The IBD Classroom in Nature’’ is an initiative that combines training and leisure activities in an ideal environment where families and patients can interact with each other. The objective of the present study was to quantify the effect that ‘‘The IBD Classroom in Nature’’ had on the health-related quality-of-life of patients with Inflammatory bowel disease (IBD). We conducted a prospective, analytical study with a pre-post design to demon- strate the impact on health-related quality-of-life (measured with the IMPACT-III questionnaire) of 3 days together in the context of The IBD Classroom in Nature. The study included 13 patients with IBD with a mean age of 12.3 years (interquartile range 11.9–14.5). After ‘‘The IBD Class- room in Nature’’ there was an improvement in the IMPACT-III score with significant improvements in the emotional functioning and body image domains. The present study objectively shows the beneficial effect of group activities focused on the most diverse aspects of their disease. Key Words: camp, Crohn disease, health-related quality-of-life, pediatric, ulcerative colitis (JPGN 2020;71: 243–245) P atients with inflammatory bowel disease (IBD) usually have poor control of their disease and feel more vulnerable and different from their peers (1). Symptoms of IBD, such as abdominal pain, diarrhea, fatigue, and tenesmus, can compound apathy and fear of rejection leading to decreased social and leisure (2,3). All this can result in fewer opportunities to experience rewarding activities, increases the likelihood of isolation, and significantly decreases quality of life. ‘‘The IBD Classroom in Nature’’ is an initiative that combines training (face-to-face sessions for parents, patients, or both on the most relevant aspects of IBD) and leisure activities (rafting, paintball, nature trek, zip line, rock climbing, forest climbing park, water games, and costume party) in an ideal environment where families and patients can interact with each other over the entire weekend and with the specialists who are part of the multidisciplinary team responsible for follow-up in IBD units. The activities take place in summer, and 5 annual sessions have already been conducted. The objective of the present study was to quantify the effect that ‘‘The IBD Classroom in Nature’’ had on the health-related quality-of-life (HRQOL) of patients with IBD. MATERIALS AND METHODS We conducted a prospective, analytical study with a pre-post design to demonstrate the impact on HRQOL (measured with the IMPACT-III questionnaire (4)) of 3 days together in the context of The IBD Classroom in Nature. All patients were in remission (measured by the Paediatric Ulcerative Colitis Activity Index (5) or the weighted Paediatric Crohn Disease Activity Index (6)). The IMPACT-III is an HRQOL questionnaire that has been validated and is specific for patients with IBD between the ages of 9 and 17 years. The questionnaire consists of 6 domains: intestinal symptoms (7 What Is Known  Inflammatory bowel disease is a chronic disease that entails numerous challenges.  Inflammatory bowel disease mainly affects children and adolescents but can also affect their parents who are responsible for providing the necessary care and are main source of support. What Is New  Initiatives such as ‘‘Inflammatory bowel disease Class- room in Nature’’ objectively improve the health- related quality-of-life of patients with inflammatory bowel disease.  With these types of activities, not only do the patients benefit but also the parents’ perception changes when they see how controlling the disease helps their children successfully perform the same activities as their peers. Received March 4, 2020; accepted April 5, 2020. From the  Paediatric Gastroenterology and Nutrition Section, Regional University Hospital of Ma ´laga, the y IBIMA, Biomedical Research Institute of Malaga, the z Inflammatory Bowel Disease Unit, University Hospital Virgen de la Victoria Malaga, Malaga, the § Paediatric Gastro- enterology and Nutrition Unit, University Hospital Virgen de la Arrixaca Murcia, Murcia, the jj Degree in Sports and Physical Activity Sciences, University of Malaga, the ô Department of Gynaecology, Regional Hospital of Marbella, and the # Medical Unit of the Disability Assess- ment Team (UMEVI), Malaga, Spain. Address correspondence and reprint requests to Vı ´ctor M. Navas-Lo ´pez, PhD, Paediatric Gastroenterology and Nutrition Section, Regional University Hospital of Ma ´laga, Avda Arroyo de los A ´ ngeles s/n 29011, Ma ´laga, Spain (e-mail: victorm.navas.sspa@juntadeandalucia.es). The authors report no conflicts of interest. Copyright # 2020 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition DOI: 10.1097/MPG.0000000000002746 SHORT COMMUNICATION:GASTROENTEROLOGY:INFLAMMATORY BOWEL DISEASE JPGN  Volume 71, Number 2, August 2020 243