Publication date: May 19, 2025

Mind Over Matter: Healthy Bowels, Healthy Bladder (Mind Over Matter) is a small-group behavioral management program with proven effectiveness to improve continence in women 50 years and older when implemented in person. To preserve access to the program during the COVID-19 pandemic, community organizations shifted to virtual implementation without evidence to support its effectiveness in that format. This study aimed to characterize participants reached by virtual versus in-person implementation of Mind Over Matter and to compare their symptom improvement and program satisfaction. We performed a retrospective analysis of pretest and posttest evaluation surveys completed by program participants between April 2019 and December 2021. Data were available for 708 participants (481 in-person, 227 virtual), most of whom identified as non-Hispanic White, with a mean age of 74 +/- 9 years. Virtual participants were younger (73 vs 75 years, P = 0. 031) and were more likely to live alone (66% vs 54%, P = 0. 011), have a bachelor’s or graduate degree (53% vs 44%, P = 0. 006), and have help around the house (93% vs 85%, P = 0. 007). Urinary incontinence improved in both virtual and in-person participants; virtual participants also had a significant improvement in fecal incontinence. Overall program satisfaction was high, but virtual participants were less likely (55% vs 63%, P = 0. 031) to feel completely satisfied. Virtual implementation of Mind Over Matter achieved similar symptom improvement and program satisfaction to in-person implementation. However, those without some college and those who do not identify as non-Hispanic White were unlikely to be reached by either format.

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