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Law L, Kelly JT, Savill H, Wallen MP, Hickman IJ, Erku D, Mayr HL. Cost-effectiveness of telehealth-delivered diet and exercise interventions: A systematic review. J Telemed Telecare 2024; 30:420-437. [PMID: 35108135 DOI: 10.1177/1357633x211070721] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Telehealth is a promising tool for delivering lifestyle interventions for the management of health conditions. However, limited evidence exists regarding the cost-effectiveness of these interventions. This systematic review aimed to evaluate the current literature reporting on the cost-effectiveness of telehealth-delivered diet and/or exercise interventions. METHODS Four electronic databases (PubMed, CENTRAL, CINAHL and Embase) were searched for published literature from database inception to November 2020. This review adhered to the preferred reporting items for systematic reviews and meta-analyses guidelines and the ISPOR Criteria for Cost-Effectiveness Review Outcomes Checklist. The quality of reporting was assessed using the Consolidated Health Economic Evaluation Reporting Standards checklist. The extracted data were grouped into subcategories according to telehealth modality, organised into tables and reported narratively. RESULTS Twenty-four studies of controlled trials (11 combined diet and exercise, 9 exercise-only and 4 diet-only telehealth-delivered interventions) were included for data extraction and quality assessment. Interventions were reported as cost-effective in 12 studies (50%), five studies (21%) reported inconclusive results, and seven studies (29%) reported that the interventions were not cost-effective. Telephone interventions were applied in eight studies (33%), seven studies (29%) used internet interventions, six studies (25%) used a combination of internet and telephone interventions, and three studies (13%) evaluated mHealth interventions. Quality of study reporting varied with between 54% and 92% of Consolidated Health Economic Evaluation Reporting Standards items reported. CONCLUSIONS This review suggests that telehealth-delivered lifestyle interventions can be cost-effective compared to traditional care. There is a need for further investigations that employ rigorous methodology and economic reporting, including appropriate decision analytical models and longer timeframes.
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Affiliation(s)
- Lynette Law
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Jaimon T Kelly
- Centre for Online Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Holly Savill
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Matthew P Wallen
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
- Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
- School of Science, Psychology and Sport, Federation University Australia, Mount Helen, Victoria, Australia
| | - Ingrid J Hickman
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Queensland, Australia
- School of Clinical Medicine, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Daniel Erku
- Centre for Applied Health Economics, Griffith University, Nathan, Queensland, Australia
| | - Hannah L Mayr
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Queensland, Australia
- School of Clinical Medicine, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Centre for Functioning and Health Research, Metro South Health, Queensland, Australia
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Herbert J, Schumacher T, Brown LJ, Collins CE. Developing a telehealth medical nutrition therapy (MNT) service for adults living in rural Australia at risk of cardiovascular disease: An intervention development study. J Hum Nutr Diet 2023; 36:1782-1794. [PMID: 37344944 PMCID: PMC10947187 DOI: 10.1111/jhn.13193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 05/26/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND Receiving medical nutrition therapy (MNT) from an accredited practising dietitian (APD) can reduce diet-related cardiovascular disease (CVD) risk factors. However, people living in rural areas of Australia experience barriers to accessing dietitians because of their remote location. Telehealth has the potential to improve dietetic access in rural areas; however, there is limited research into the development and delivery of telehealth MNT interventions specific to these areas. The present study describes the development of the Healthy Rural Hearts (HealthyRHearts) telehealth MNT intervention, which was developed as a part of the HealthyRHearts randomised control trial, set in primary care practices in rural areas of the Hunter New England and Central Coast Primary Health Network. The aim of HealthyRHearts is to improve diet-related risk factors for CVD in rural adults at moderate to high CVD risk using a telehealth MNT intervention delivered by an APD. METHODS The study describes the development of the HealthyRHearts telehealth MNT intervention, using the 14-item GUIDance for rEporting of intervention Development (GUIDED) checklist and the Template for Intervention Description and Replication (TIDieR) framework to guide description. RESULTS HealthyRHearts is a complex intervention that aims to translate a telehealth MNT intervention for CVD prevention into rural and remote primary care settings. The intervention is designed to be implemented across multiple sites of varying characteristics and needs, with the ability to accommodate individual complexities within the rural context and target population. Participants are adults aged 45-75 years who are assessed as moderate to high risk of CVD by their general practitioner (GP). Consenting participants are referred to the intervention by their GPs and receive five telehealth MNT consultations with an APD over 6-months. APDs are trained in the intervention protocol including intervention materials, resources and behaviour change counselling strategies. CONCLUSION Using the GUIDED and TIDieR frameworks to guide description of the HealthyRHearts intervention development process facilitates detailed description of decision-making pathways for each element of the intervention design. The comprehensive description of the intervention development process for HealthyRHearts is intended to facilitate replication, iteration and optimisation of the intervention for rural contexts.
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Affiliation(s)
- Jaimee Herbert
- School of Health Sciences (Nutrition and Dietetics), University of Newcastle, Callaghan, NSW, Australia
- Department of Rural Health, University of Newcastle, North Tamworth, NSW, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, Callaghan, NSW, Australia
| | - Tracy Schumacher
- Department of Rural Health, University of Newcastle, North Tamworth, NSW, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, Callaghan, NSW, Australia
| | - Leanne J Brown
- Department of Rural Health, University of Newcastle, North Tamworth, NSW, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, Callaghan, NSW, Australia
| | - Clare E Collins
- School of Health Sciences (Nutrition and Dietetics), University of Newcastle, Callaghan, NSW, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, Callaghan, NSW, Australia
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Herbert J, Schumacher T, Brown LJ, Clarke ED, Collins CE. Delivery of telehealth nutrition and physical activity interventions to adults living in rural areas: a scoping review. Int J Behav Nutr Phys Act 2023; 20:110. [PMID: 37715234 PMCID: PMC10504780 DOI: 10.1186/s12966-023-01505-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 08/20/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND Lifestyle behaviours related to smoking, alcohol, nutrition, and physical activity are leading risk factors for the development of chronic disease. For people in rural areas, access to individualised lifestyle services targeting behaviour change may be improved by using telehealth. However, the scope of literature investigating telehealth lifestyle behaviour change interventions for rural populations is unknown, making it difficult to ascertain whether telehealth interventions require adaptation for rural context via a systematic review. This scoping review aimed to address this gap, by mapping existing literature describing telehealth lifestyle interventions delivered to rural populations to determine if there is scope for systematic review of intervention effectiveness in this research topic. METHODS The PRISMA extension for scoping review checklist guided the processes of this scoping review. A search of eight electronic databases reported in English language until June 2023 was conducted. Eligible studies included adults (18 years and over), who lived in rural areas of high-income countries and undertook at least one synchronous (video or phone consultation) telehealth intervention that addressed either addictive (smoking or alcohol), or non-addictive lifestyle behaviours (nutrition or physical activity). Studies targeting addictive and non-addictive behaviours were separated after full text screening to account for the involvement of addictive substances in smoking and alcohol studies that may impact behaviour change interventions described. Studies targeting nutrition and/or physical activity interventions are presented here. RESULTS The search strategy identified 17179 citations across eight databases, with 7440 unique citations once duplicates were removed. Full texts for 492 citations were retrieved and screened for inclusion with 85 publications reporting on 73 studies eligible for data extraction and analysis. Of this, addictive behaviours were comprised of 15 publications from 13 studies. Non-addictive behaviours included 70 publications from 58 studies and are reported here. Most interventions were delivered within the United States of America (n = 43, 74.1%). The most common study design reported was Randomised Control Trial (n = 27, 46.6%). Included studies involved synchronous telehealth interventions targeting nutrition (11, 18.9%), physical activity (5, 8.6%) or nutrition and physical activity (41, 70.7%) and were delivered predominately via videoconference (n = 17, 29.3%). CONCLUSIONS Despite differences in intervention characteristics, the number of randomised control trials published suggests sufficient scope for future systematic reviews to determine intervention effectiveness related to nutrition and physical activity telehealth interventions for rural populations. TRIAL REGISTRATION The scoping review protocol was not pre-registered.
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Affiliation(s)
- Jaimee Herbert
- School of Health Sciences (Nutrition and Dietetics), Department of Rural Health, University of Newcastle, 114/148 Johnston St, North Tamworth, NSW, 2340, Australia
| | - Tracy Schumacher
- School of Health Sciences (Nutrition and Dietetics), Department of Rural Health, University of Newcastle, 114/148 Johnston St, North Tamworth, NSW, 2340, Australia
| | - Leanne J Brown
- School of Health Sciences (Nutrition and Dietetics), Department of Rural Health, University of Newcastle, 114/148 Johnston St, North Tamworth, NSW, 2340, Australia
| | - Erin D Clarke
- School of Health Sciences (Nutrition and Dietetics), University of Newcastle, ATC 205, ATC Building, University Drive Callaghan, Newcastle, NSW, 2308, Australia
| | - Clare E Collins
- School of Health Sciences (Nutrition and Dietetics), University of Newcastle, ATC 310, ATC Building, University Drive Callaghan, Newcastle, NSW, 2308, Australia.
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Liu SH, Wu YR, Chen W, Su CH, Chin CL. Using Ballistocardiogram and Impedance Plethysmogram for Minimal Contact Measurement of Blood Pressure Based on a Body Weight-Fat Scale. SENSORS (BASEL, SWITZERLAND) 2023; 23:2318. [PMID: 36850917 PMCID: PMC9966183 DOI: 10.3390/s23042318] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/14/2023] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
Electronic health (eHealth) is a strategy to improve the physical and mental condition of a human, collecting daily physiological data and information from digital apparatuses. Body weight and blood pressure (BP) are the most popular and important physiological data. The goal of this study is to develop a minimal contact BP measurement method based on a commercial body weight-fat scale, capturing biometrics when users stand on it. The pulse transit time (PTT) is extracted from the ballistocardiogram (BCG) and impedance plethysmogram (IPG), measured by four strain gauges and four footpads of a commercial body weight-fat scale. Cuffless BP measurement using the electrocardiogram (ECG) and photoplethysmogram (PPG) serves as the reference method. The BP measured by a commercial BP monitor is considered the ground truth. Twenty subjects participated in this study. By the proposed model, the root-mean-square errors and correlation coefficients (r2s) of estimated systolic blood pressure and diastolic blood pressure are 7.3 ± 2.1 mmHg and 4.5 ± 1.8 mmHg, and 0.570 ± 0.205 and 0.284 ± 0.166, respectively. This accuracy level achieves the C grade of the corresponding IEEE standard. Thus, the proposed method has the potential benefit for eHealth monitoring in daily application.
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Affiliation(s)
- Shing-Hong Liu
- Department of Computer Science and Information Engineering, Chaoyang University of Technology, Taichung City 41349, Taiwan
| | - Yan-Rong Wu
- Department of Computer Science and Information Engineering, Chaoyang University of Technology, Taichung City 41349, Taiwan
| | - Wenxi Chen
- Biomedical Information Engineering Laboratory, The University of Aizu, Aizu-Wakamatsu City 965-8580, Japan
| | - Chun-Hung Su
- Institute of Medicine, School of Medicine, Chung-Shan Medical University, Taichung City 40201, Taiwan
- Department of Internal Medicine, Chung-Shan Medical University Hospital, Taichung City 40201, Taiwan
| | - Chiun-Li Chin
- Department of Medical Informatics, Chung-Shan Medical University, Taichung City 40201, Taiwan
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Zheng Q, Shi L, Zhu L, Jiao N, Chong YS, Chan SWC, Chan YH, Luo N, Wang W, He H. Cost-effectiveness of Web-Based and Home-Based Postnatal Psychoeducational Interventions for First-time Mothers: Economic Evaluation Alongside Randomized Controlled Trial. J Med Internet Res 2022; 24:e25821. [PMID: 35275078 PMCID: PMC8956997 DOI: 10.2196/25821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 05/12/2021] [Accepted: 11/18/2021] [Indexed: 11/17/2022] Open
Abstract
Background The cost-effectiveness of interventions has attracted increasing interest among researchers. Although web-based and home-based psychoeducational interventions have been developed to improve first-time mothers’ postnatal health outcomes, very limited studies have reported their cost-effectiveness. Objective The aim of this study was to evaluate the cost-effectiveness of web-based and home-based postnatal psychoeducational interventions for first-time mothers during the early postpartum period. Methods A randomized controlled 3-group pretest and posttest design was adopted, and cost-effectiveness analysis from the health care’s perspective was conducted. A total of 204 primiparas were recruited from a public tertiary hospital in Singapore from October 2016 to August 2017 who were randomly allocated to the web-based intervention (n=68), home-based intervention (n=68), or control (n=68) groups. Outcomes of maternal parental self-efficacy, social support, postnatal depression, anxiety, and health care resource utilization were measured using valid and reliable instruments at baseline and at 1 month, 3 months, and 6 months after childbirth. The generalized linear regression models on effectiveness and cost were used to assess the incremental cost-effectiveness ratios of the web-based and home-based intervention programs compared to routine care. Projections of cumulative cost over 5 years incurred by the 3 programs at various coverage levels (ie, 10%, 50%, and 100%) were also estimated. Results The web-based intervention program dominated the other 2 programs (home-based program and routine care) with the least cost (adjusted costs of SGD 376.50, SGD 457.60, and SGD 417.90 for web-based, home-based, and control group, respectively; SGD 1=USD 0.75) and the best improvements in self-efficacy, social support, and psychological well-being. When considering the implementation of study programs over the next 5 years by multiplying the average cost per first-time mother by the estimated average number of first-time mothers in Singapore during the 5-year projection period, the web-based program was the least costly program at all 3 coverage levels. Based on the 100% coverage, the reduced total cost reached nearly SGD 7.1 million and SGD 11.3 million when compared to control and home-based programs at the end of the fifth year, respectively. Conclusions The web-based approach was promisingly cost-effective to deliver the postnatal psychoeducational intervention to first-time mothers and could be adopted by hospitals as postnatal care support. Trial Registration ISRCTN registry ISRCTN45202278; https://www.isrctn.com/ISRCTN45202278
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Affiliation(s)
- Qishi Zheng
- Epidemiology, Singapore Clinical Research Institute, Singapore, Singapore.,Cochrane Singapore, Singapore, Singapore
| | - Luming Shi
- Epidemiology, Singapore Clinical Research Institute, Singapore, Singapore.,Cochrane Singapore, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore
| | - Lixia Zhu
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,National University Health System, Singapore, Singapore
| | - Nana Jiao
- Edson College of Nursing and Health Innovation, Arizona State University, Arizona, AZ, United States
| | - Yap Seng Chong
- Division of Maternal Fetal Medicine, Department of Obstetrics & Gynaecology, National University Hospital, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | | | - Yiong Huak Chan
- Biostatistics Unit, National University of Singapore, Singapore, Singapore
| | - Nan Luo
- National University Health System, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,National University Health System, Singapore, Singapore
| | - Honggu He
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,National University Health System, Singapore, Singapore
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Chwyl C, Wright N, M Turner-McGrievy G, L Butryn M, M Forman E. Beyond Calorie Tracking: A Pilot Trial of a Remotely Delivered Behavioral Weight Loss Intervention Using an Ad Libitum Plant-Based Diet (Preprint). JMIR Form Res 2022; 6:e37414. [PMID: 35737443 PMCID: PMC9264123 DOI: 10.2196/37414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 11/17/2022] Open
Abstract
Background Many traditional lifestyle interventions use calorie prescriptions, but most individuals have difficulty sustaining calorie tracking and thus weight loss. In contrast, whole food plant-based diets (WFPBDs) have previously shown significant weight loss without this issue. However, most WFPBD interventions are face-to-face and time-intensive, and do not leverage gold standard behavioral strategies for health behavior change. Objective This open pilot trial was the first to evaluate the feasibility of a fully featured, remotely delivered behavioral weight loss intervention using an ad libitum WFPBD. Methods Over 12 weeks, participants (N=15) with overweight or obesity received a newly designed program that integrated behavioral weight loss and a WFPBD prescription via weekly web-based modules and brief phone coaching calls. Assessments were performed at baseline, midtreatment (6 weeks), and after treatment (12 weeks). Results The intervention was rated as highly acceptable (mean 4.40 out of 5, SE 0.18), and attrition was low (6.7%). In all, intention-to-treat analyses revealed that 69% (10.4/15) of the participants lost 5% of their weight (mean –5.89, SE 0.68 kg). Predefined benchmarks for quality of life were met. Conclusions A pilot digital behavioral weight loss intervention with a non–energy-restricted WFPBD was feasible, and the mean acceptability was high. Minimal contact time (80-150 minutes of study interventionist time per participant over 12 weeks) led to clinically relevant weight loss and dietary adherence for most participants (10.4/15, 69% and 11.8/15, 79%, respectively), and quality of life improvements (reliable change indices >1.53). We hope that this work will serve as a springboard for future larger scale randomized controlled studies evaluating the efficacy of such programs for weight loss, dietary change, and quality of life. Trial Registration ClinicalTrials.gov NCT04892030; https://clinicaltrials.gov/ct2/show/NCT04892030
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Affiliation(s)
- Christina Chwyl
- Center for Weight, Eating, and Lifestyle Sciences, Drexel University, Philadelphia, PA, United States
| | - Nicholas Wright
- Royal New Zealand College of General Practitioners, Wellington, New Zealand
| | - Gabrielle M Turner-McGrievy
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, Columbia, SC, United States
| | - Meghan L Butryn
- Center for Weight, Eating, and Lifestyle Sciences, Drexel University, Philadelphia, PA, United States
| | - Evan M Forman
- Center for Weight, Eating, and Lifestyle Sciences, Drexel University, Philadelphia, PA, United States
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Ali L, Wallström S, Ekman I, Swedberg K, Fors A. Effects of person-centred care via telephone on self-efficacy in patients with chronic obstructive pulmonary disease: Subgroup analysis of a randomized controlled trial. Nurs Open 2021; 8:927-935. [PMID: 33570304 PMCID: PMC7877134 DOI: 10.1002/nop2.701] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 11/04/2020] [Indexed: 01/20/2023] Open
Abstract
AIM To evaluate the effects of PCC in the form of structured telephone support on self-reported cardiac self-efficacy in patients with COPD. METHODS We enrolled 105 patients, aged ≥50 years, admitted to hospital and diagnosed with COPD from January 2015 to November 2016. The patients received usual care or PCC via telephone added to usual care. The Swedish Cardiac Self-Efficacy Scale comprising three dimensions (control symptoms, control illness and maintain functioning) was used as outcome measure. Data was collected at baseline, and at 3- and 6-month follow-ups. RESULTS At both the 3- and 6-month follow-ups, the intervention group improved significantly more than the control group in the control illness dimension (p = .012 and p = .032, respectively). No differences were found in the other two dimensions. CONCLUSIONS PCC in the form of structured telephone support increases patients' confidence in managing their illness and may be a feasible strategy to support patients in their homes.
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Affiliation(s)
- Lilas Ali
- Institute of Health and Care SciencesSahlgrenska AcademyUniversity of GothenburgGothenburgSweden
- Centre for Person‐Centred Care (GPCC)University of GothenburgGothenburgSweden
- Psychiatric DepartmentSahlgrenska University HospitalGothenburgSweden
| | - Sara Wallström
- Institute of Health and Care SciencesSahlgrenska AcademyUniversity of GothenburgGothenburgSweden
- Centre for Person‐Centred Care (GPCC)University of GothenburgGothenburgSweden
| | - Inger Ekman
- Institute of Health and Care SciencesSahlgrenska AcademyUniversity of GothenburgGothenburgSweden
- Centre for Person‐Centred Care (GPCC)University of GothenburgGothenburgSweden
| | - Karl Swedberg
- Institute of Health and Care SciencesSahlgrenska AcademyUniversity of GothenburgGothenburgSweden
- Centre for Person‐Centred Care (GPCC)University of GothenburgGothenburgSweden
- Department of Molecular and Clinical MedicineSahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Andreas Fors
- Institute of Health and Care SciencesSahlgrenska AcademyUniversity of GothenburgGothenburgSweden
- Centre for Person‐Centred Care (GPCC)University of GothenburgGothenburgSweden
- Research and Development Primary Health CareRegion Västra GötalandGothenburgSweden
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Hickman IJ, Hannigan AK, Johnston HE, Elvin-Walsh L, Mayr HL, Staudacher HM, Barnett A, Stoney R, Salisbury C, Jarrett M, Reeves MM, Coombes JS, Campbell KL, Keating SE, Macdonald GA. Telehealth-delivered, Cardioprotective Diet and Exercise Program for Liver Transplant Recipients: A Randomized Feasibility Study. Transplant Direct 2021; 7:e667. [PMID: 33564717 PMCID: PMC7861655 DOI: 10.1097/txd.0000000000001118] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 11/24/2020] [Indexed: 12/14/2022] Open
Abstract
Rapid excess weight gain and metabolic complications contribute to poor outcomes following liver transplant care. Providing specialist lifestyle intervention with equitable access is a challenge for posttransplant service delivery. METHODS This study investigated the feasibility of a 12-wk telehealth delivered lifestyle intervention for liver transplant recipients (randomized controlled trial with a delayed intervention control group). The intervention included 14 group sessions facilitated by nutrition and exercise specialists via video streaming telehealth and participants used their own devices. Feasibility was assessed across session attendance, the adequacy, acceptability, and confidence with the telehealth technology and adherence to diet (Mediterranean Diet Adherence Score). Secondary pooled analysis of effectiveness was determined from changes in quality of life and metabolic syndrome severity score. RESULTS Of the 35 participants randomized, dropout was 22.8% (n = 8) and overall session attendance rate was 60%. Confidence with and adequacy of home technology was rated high in 96% and 91% of sessions, respectively. Participants randomized to the intervention significantly improved Mediterranean Diet Adherence Score (2-point increase [95% confidence interval, 1.5-3.4] versus control 0 point change [95% confidence interval, -1.4 to 1.2]; P = 0.004). Intervention (within group) analysis found the intervention significantly decreased the metabolic syndrome severity score (-0.4 [95% confidence interval, -0.6 to -0.1] P = 0.01), and improved mental health-related quality of life (2.5 [95% confidence interval, 0.4-4.6] P = 0.03). CONCLUSIONS A cardioprotective lifestyle intervention delivered via telehealth is feasible for liver transplant recipients and may improve access to specialist care to support metabolic health and wellness after transplant.
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Affiliation(s)
- Ingrid J. Hickman
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, QLD, Australia
- Mater Research Institute, University of Queensland, Brisbane, QLD, Australia
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Amy K. Hannigan
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Heidi E. Johnston
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Louise Elvin-Walsh
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Hannah L. Mayr
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, QLD, Australia
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
| | - Heidi M. Staudacher
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Amandine Barnett
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, QLD, Australia
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
| | - Rachel Stoney
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Chloe Salisbury
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Maree Jarrett
- Queensland Liver Transplant Service, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Marina M. Reeves
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Jeff S. Coombes
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Katrina L. Campbell
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, QLD, Australia
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
- Centre for Applied Health Economics, Menzies Health Institute, Griffith University, Brisbane, QLD, Australia
| | - Shelley E. Keating
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Graeme A. Macdonald
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
- Queensland Liver Transplant Service, Princess Alexandra Hospital, Brisbane, QLD, Australia
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, QLD, Australia
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9
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van den Helder J, Verlaan S, Tieland M, Scholten J, Mehra S, Visser B, Kröse BJA, Engelbert RHH, Weijs PJM. Digitally Supported Dietary Protein Counseling Changes Dietary Protein Intake, Sources and Distribution in Community-Dwelling Older Adults. Nutrients 2021; 13:nu13020502. [PMID: 33546451 PMCID: PMC7913661 DOI: 10.3390/nu13020502] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/26/2021] [Accepted: 01/29/2021] [Indexed: 01/14/2023] Open
Abstract
Digitally supported dietary counselling may be helpful in increasing the protein intake in combined exercise and nutritional interventions in community-dwelling older adults. To study the effect of this approach, 212 older adults (72.2 ± 6.3 years) were randomised in three groups: control, exercise, or exercise plus dietary counselling. The dietary counselling during the 6-month intervention was a blended approach of face-to-face contacts and videoconferencing, and it was discontinued for a 6-month follow-up. Dietary protein intake, sources, product groups, resulting amino acid intake, and intake per eating occasion were assessed by a 3-day dietary record. The dietary counselling group was able to increase the protein intake by 32% at 6 months, and the intake remained 16% increased at 12 months. Protein intake mainly consisted of animal protein sources: dairy products, followed by fish and meat. This resulted in significantly more intake of essential amino acids, including leucine. The protein intake was distributed evenly over the day, resulting in more meals that reached the protein and leucine targets. Digitally supported dietary counselling was effective in increasing protein intake both per meal and per day in a lifestyle intervention in community-dwelling older adults. This was predominantly achieved by consuming more animal protein sources, particularly dairy products, and especially during breakfast and lunch.
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Affiliation(s)
- Jantine van den Helder
- Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, 1067 SM Amsterdam, The Netherlands; (M.T.); (J.S.); (S.M.); (B.V.); (B.J.A.K.); (R.H.H.E.)
- Correspondence: (J.v.d.H.); (P.J.M.W.); Tel.: +31-(62)-1155919 (J.v.d.H.)
| | - Sjors Verlaan
- FrieslandCampina, 3818 LE Amersfoort, The Netherlands; or
- Department of Rehabilitation Medicine, Amsterdam University Medical Centers, Vrije Universiteit, 1081 HV Amsterdam, The Netherlands
| | - Michael Tieland
- Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, 1067 SM Amsterdam, The Netherlands; (M.T.); (J.S.); (S.M.); (B.V.); (B.J.A.K.); (R.H.H.E.)
| | - Jorinde Scholten
- Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, 1067 SM Amsterdam, The Netherlands; (M.T.); (J.S.); (S.M.); (B.V.); (B.J.A.K.); (R.H.H.E.)
| | - Sumit Mehra
- Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, 1067 SM Amsterdam, The Netherlands; (M.T.); (J.S.); (S.M.); (B.V.); (B.J.A.K.); (R.H.H.E.)
- CREATE-IT Applied Research, Amsterdam University of Applied Sciences, 1091 GC Amsterdam, The Netherlands
| | - Bart Visser
- Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, 1067 SM Amsterdam, The Netherlands; (M.T.); (J.S.); (S.M.); (B.V.); (B.J.A.K.); (R.H.H.E.)
| | - Ben J. A. Kröse
- Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, 1067 SM Amsterdam, The Netherlands; (M.T.); (J.S.); (S.M.); (B.V.); (B.J.A.K.); (R.H.H.E.)
- Informatics Institute, University of Amsterdam, 1090 GH Amsterdam, The Netherlands
| | - Raoul H. H. Engelbert
- Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, 1067 SM Amsterdam, The Netherlands; (M.T.); (J.S.); (S.M.); (B.V.); (B.J.A.K.); (R.H.H.E.)
- Department of Rehabilitation, Amsterdam University Medical Centers, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
| | - Peter J. M. Weijs
- Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, 1067 SM Amsterdam, The Netherlands; (M.T.); (J.S.); (S.M.); (B.V.); (B.J.A.K.); (R.H.H.E.)
- Department of Nutrition and Dietetics, Amsterdam University Medical Centers, VU University, 1081 HV Amsterdam, The Netherlands
- Correspondence: (J.v.d.H.); (P.J.M.W.); Tel.: +31-(62)-1155919 (J.v.d.H.)
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10
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Cliffe M, Di Battista E, Bishop S. Can you see me? Participant experience of accessing a weight management programme via group videoconference to overcome barriers to engagement. Health Expect 2020; 24:66-76. [PMID: 33089630 PMCID: PMC7879542 DOI: 10.1111/hex.13148] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 09/21/2020] [Accepted: 10/03/2020] [Indexed: 01/09/2023] Open
Abstract
Background Engagement with conventional weight management group programmes is low. Objective To understand participant experience of accessing an adapted programme via videoconference. Participants Adults with obesity (BMI ≥ 35kg/m2), referred to an NHS Dietetics service in Wales, were offered a group videoconference weight management programme as an optional alternative to in‐person groups. Thirteen participants (mean age 48.5 ± 20.2 years, 8 female) recruited to two videoconference groups were interviewed. Study design A Registered Dietitian delivered a behavioural programme using Skype for Business in 10 sessions over 6 months. Participants joined the groups from any Internet‐connected device with a webcam. Participant perspectives were audiorecorded in one‐to‐one, semi‐structured interviews. Interviews were transcribed verbatim and thematically analysed using self‐determination theory as a theoretical framework. Results Ten themes were identified, three relating to service engagement and seven relating to behaviour change facilitation. Key themes in engagement included ‘reduced burden’, described as saving time and travel and ‘reduced threat’ as participants perceived joining a group from home as less daunting compared to attending in‐person. Despite reporting some initial technical difficulties with establishing video and audio connection, participants described beneficial peer support although not physically with other group members. Conclusion Accessing a group weight management programme via videoconference may be the preferred option for some participants, overcoming some of the barriers to access to standard in‐person programmes, particularly in rural areas. Participants are able to experience peer support via videoconference. During the COVID‐19 pandemic, weight management programmes could utilize videoconference groups to continue to provide support.
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Affiliation(s)
- Marion Cliffe
- Betsi Cadwaladr University Health Board, Bangor, Wales, UK
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11
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Shoneye CL, Mullan B, Begley A, Pollard CM, Jancey J, Kerr DA. Design and Development of a Digital Weight Management Intervention (ToDAy): Qualitative Study. JMIR Mhealth Uhealth 2020; 8:e17919. [PMID: 32641284 PMCID: PMC7511863 DOI: 10.2196/17919] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 06/15/2020] [Accepted: 07/07/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The Tailored Diet and Activity (ToDAy) study aims to build on the campaign by adding a digital intervention with the potential to provide wide-reaching, cost-effective weight management support. OBJECTIVE The ToDAy study aims to build a tailored intervention using mobile technology to improve diet and physical activity behaviours in adults with overweight and obesity. The main objectives were to identify behavior change techniques for diet and physical activity (PA) change for weight loss and explore preferences for digital intervention features that would be effective in changing diet and PA behaviors. METHODS This qualitative study uses the principles of a person-based approach to intervention development; the behavioral intervention technology framework; and the capability, opportunity, motivation, and behavior (COM-B) framework. Focus groups and telephone interviews were conducted with 56 adults in Western Australia. Open-ended questions and example intervention features were used to explore the usability and acceptability of the self-monitoring tools, knowledge about effective weight-loss strategies, and acceptability of tailored feedback. Findings from the focus groups and interviews were analyzed using thematic analysis. RESULTS Qualitative findings revealed an awareness of key public health messages but a lack of confidence in how to perform these behaviors to help manage their weight. A total of 4 major themes were identified and mapped to the domains of the COM-B framework: (1) misinformation, (2) environmental support, (3) social norms, and (4) confidence. CONCLUSIONS This study explores users' capability, opportunity, and motivation to perform the target behaviors for weight loss. The findings suggested that a digital weight management intervention using a mobile food record and activity trackers to inform tailored feedback may be acceptable and feasible. Participants expressed a preference for simple expert advice, digital self-monitoring tools, and visual feedback. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/12782.
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Affiliation(s)
- Charlene L Shoneye
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Barbara Mullan
- Health Psychology & Behavioural Medicine Research Group, School of Psychology, Curtin University, Perth, Western Australia, Australia
| | - Andrea Begley
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Christina M Pollard
- School of Public Health, Curtin University, Perth, Western Australia, Australia.,East Metropolitan Health Service, Perth, Western Australia, Australia
| | - Jonine Jancey
- Collaboration for Evidence Research & Impact in Public Health, School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Deborah A Kerr
- School of Public Health, Curtin University, Perth, Western Australia, Australia
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12
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Plow M, Packer T, Mathiowetz VG, Preissner K, Ghahari S, Sattar A, Bethoux F, Finlayson M. REFRESH protocol: a non-inferiority randomised clinical trial comparing internet and teleconference to in-person 'Managing Fatigue' interventions on the impact of fatigue among persons with multiple sclerosis. BMJ Open 2020; 10:e035470. [PMID: 32801193 PMCID: PMC7430436 DOI: 10.1136/bmjopen-2019-035470] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Multiple sclerosis (MS) is an immune-mediated disease of the central nervous system. It is considered a major cause of non-traumatic disability in young adults. One of the most common and disabling symptoms of MS is fatigue. MS fatigue can impact all aspects of quality of life, including physical, mental and social function. Fortunately, fatigue self-management interventions, such as 'Managing Fatigue: A 6 week energy conservation course', can decrease the impact of fatigue and improve health-related quality of life. The purpose of this study is to compare three modes of delivering the Managing Fatigue intervention-two remote delivery formats (teleconference and internet) and one in-person format-on perceptions of fatigue and its impact on physical, mental and social function. METHODS AND ANALYSIS A non-inferiority randomised clinical trial is being conducted to compare the three delivery formats (1:1:1 allocation ratio) among 582 participants with MS living in the Midwestern and Northeastern United States. The hypothesis is that teleconference and internet versions of the intervention are non-inferior to the traditional mode of clinical service delivery (ie, one to one, in person) in terms of the primary outcome of self-reported fatigue impact (ie, Fatigue Impact Scale) and the secondary outcome of health-related quality of life (ie, Multiple Sclerosis Impact Scale). Outcomes are being measured at baseline, 2 months, 3 months and 6 months. The primary analysis tool will be linear mixed effects model. The prespecified inferiority margin for the primary outcome is 10 points. We will also examine whether baseline characteristics (eg, sociodemographic) moderate outcomes of the Managing Fatigue intervention and whether changes in self-efficacy and fatigue self-management behaviours mediate changes in outcomes. ETHICS AND DISSEMINATION The protocol is approved centrally by the institutional review board at Case Western Reserve University. Eligible participants give consent before being enrolled and randomised into the study. The study results will be disseminated through relevant advocacy organisations, newsletters to participants, publication in peer-reviewed journals and presentations at scientific conferences. TRIAL REGISTRATION NUMBER NCT03550170; Pre-results.
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Affiliation(s)
- Matthew Plow
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA
| | - Tanya Packer
- School of Occupational Therapy and School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Virgil G Mathiowetz
- Program in Occupational Therapy, University of Minnesota, Minneapolis, Minnesota, USA
| | - Kathy Preissner
- Department of Occupational Therapy, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Setareh Ghahari
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
| | - Abdus Sattar
- School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Francois Bethoux
- Department of Physical Medicine and Rehabilitation, Cleveland Clinic, Cleveland, Ohio, USA
| | - Marcia Finlayson
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
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13
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Fakih El Khoury C, Crutzen R, Schols JMGA, Halfens RJG, Karavetian M. A Dietary Mobile App for Patients Undergoing Hemodialysis: Prospective Pilot Study to Improve Dietary Intakes. J Med Internet Res 2020; 22:e17817. [PMID: 32706698 PMCID: PMC7399958 DOI: 10.2196/17817] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 05/05/2020] [Accepted: 06/03/2020] [Indexed: 01/26/2023] Open
Abstract
Background Mobile technology has an impact on the health care sector, also within dietetics. Mobile health (mHealth) apps may be used for dietary assessment and self-monitoring, allowing for real-time reporting of food intakes. Changing eating behaviors is quite challenging, and patients undergoing hemodialysis, particularly, struggle to meet the target intakes set by dietary guidelines. Usage of mobile apps that are developed in a person-centered approach and in line with recommendations may support both patients and health care practitioners. Objective This study is a pilot that aims at estimating the potential efficacy of a dietary intervention using a theory-based, person-centered smartphone app. Results will be used to improve both the app and a planned large-scale trial intended to assess app efficacy thoroughly. Methods A prospective pilot study was performed at the hemodialysis unit of Al Qassimi Hospital (The Emirate of Sharjah). All patients that fulfilled the study inclusion criteria were considered eligible to be enrolled in the pilot study. Upon successful installation of the app, users met with a dietitian once a week. Outcomes were measured at baseline (T0) and 2 weeks post app usage (T1). This pilot is reported as per guidelines for nonrandomized pilot and feasibility studies and in line with the CONSORT 2010 checklist for reporting pilot or feasibility trials. Results A total of 23 patients completed the pilot intervention. Mean energy intakes increased from 24.4 kcal/kg/day (SD 8.0) to 29.1 kcal/kg/day (SD 7.8) with a medium effect size (d=0.6, 95% CI 0.0-1.2). Mean protein intakes increased from 0.9 g/kg/day (SD 0.3) to 1.3 g/kg/day (SD 0.5) with a large effect size (d=1.0, 95% CI 0.4-1.6); mean intake of high biological value (%HBV) proteins also increased from 58.6% (SD 10.1) to 70.1% (SD 10.7) with a large effect size (d=1.1, 95% CI 0.5-1.7). Dietary intakes of minerals did not change, apart from sodium which decreased from a mean intake of 2218.8 mg/day (SD 631.6) to 1895.3 mg/day (SD 581.0) with a medium effect size (d=0.5, 95% CI 0.1-1.1). Mean serum phosphorus, potassium, and albumin levels did not change relevantly. Mean serum iron increased from 7.9 mg/dL (SD 2.8) to 11.5 mg/dL (SD 7.9) postintervention with a medium effect size (d=0.6, 95% CI 0.0-1.2). Conclusions This pilot study showed that the KELA.AE app has the potential to improve dietary intakes. Processes related to procedure, resources, tools, and app improvement for a future trial were assessed. A more extended intervention using a randomized controlled trial is required to estimate parameters concerning app efficacy accurately.
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Affiliation(s)
- Cosette Fakih El Khoury
- Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Rik Crutzen
- Department of Health Promotion, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Jos M G A Schols
- Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.,Department of Family Medicine, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Ruud J G Halfens
- Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Mirey Karavetian
- Department of Health Sciences, Zayed University, Dubai, United Arab Emirates
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14
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Kelly JT, Allman-Farinelli M, Chen J, Partridge SR, Collins C, Rollo M, Haslam R, Diversi T, Campbell KL. Dietitians Australia position statement on telehealth. Nutr Diet 2020; 77:406-415. [PMID: 32596950 PMCID: PMC7540717 DOI: 10.1111/1747-0080.12619] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/11/2020] [Accepted: 05/12/2020] [Indexed: 12/21/2022]
Abstract
It is the position of Dietitians Australia that clients can receive high‐quality and effective dietetic services such as Medical Nutrition Therapy (MNT) delivered via telehealth. Outcomes of telehealth‐delivered dietetic consultations are comparable to those delivered in‐person, without requiring higher levels of additional training nor compromising quality of service provision. Dietitians Australia recommends that policy makers and healthcare funders broaden the recognition for telehealth‐delivered dietetic consultations as a responsive and cost‐effective alternative or complement to traditional in‐person delivery of dietetic services. The successful implementation of telehealth can help to address health and service inequalities, improve access to effective nutrition services, and support people with chronic disease to optimise their diet‐related health and well‐being, regardless of their location, income or literacy level, thereby addressing current inequities.
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Affiliation(s)
- Jaimon T Kelly
- Menzies Health Institute Queensland, Faculty of Medicine, Griffith University, Gold Coast, Australia
| | - Margaret Allman-Farinelli
- Charles Perkins Centre, Discipline of Nutrition and Dietetics, School of Life and Environmental Sciences, The University of Sydney, Sydney, Australia
| | - Juliana Chen
- Charles Perkins Centre, Discipline of Nutrition and Dietetics, School of Life and Environmental Sciences, The University of Sydney, Sydney, Australia
| | - Stephanie R Partridge
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Clare Collins
- Priority Research Centre in Physical Activity & Nutrition and School of Health Sciences, Faculty of Health and Medicine , The University of Newcastle, Callaghan, Australia
| | - Megan Rollo
- Priority Research Centre in Physical Activity & Nutrition and School of Health Sciences, Faculty of Health and Medicine , The University of Newcastle, Callaghan, Australia
| | - Rebecca Haslam
- Priority Research Centre in Physical Activity & Nutrition and School of Health Sciences, Faculty of Health and Medicine , The University of Newcastle, Callaghan, Australia
| | | | - Katrina L Campbell
- Menzies Health Institute Queensland, Faculty of Medicine, Griffith University, Gold Coast, Australia
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15
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Pelly FE, Wiesmayr-Freeman T, Tweedie J. Student placement adaptability during COVID-19: Lessons learnt in 2020. Nutr Diet 2020; 77:481-483. [PMID: 32578370 PMCID: PMC7361821 DOI: 10.1111/1747-0080.12625] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/11/2020] [Accepted: 05/13/2020] [Indexed: 12/04/2022]
Affiliation(s)
- Fiona E Pelly
- School of Health and Sport Sciences, University of the Sunshine Coast, Brisbane, Queensland, Australia
| | - Tania Wiesmayr-Freeman
- School of Health and Sport Sciences, University of the Sunshine Coast, Brisbane, Queensland, Australia
| | - Judith Tweedie
- School of Health and Sport Sciences, University of the Sunshine Coast, Brisbane, Queensland, Australia
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16
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Olfert MD, Barr ML, Hagedorn RL, Wattick RA, Zhou W, Horacek TM, Mathews AE, Kattelmann KK, Kidd T, White AA, Brown ON, Morrell JS, Franzen-Castle L, Shelnutt KP, Byrd-Bredbenner C, Tolar-Peterson T, Greene GW, Colby SE. eB4CAST Approach Improves Science Communication With Stakeholders in a College-Based Health Program. Front Public Health 2020; 8:158. [PMID: 32457864 PMCID: PMC7223159 DOI: 10.3389/fpubh.2020.00158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 04/14/2020] [Indexed: 11/13/2022] Open
Abstract
Communicating scientific results with community partners is often lacking in intervention programs, thus eB4CAST was developed to facilitate impact sharing. This article investigated using the eB4CAST dissemination tool to communicate impact from a campus-based obesity prevention program. Data from Get Fruved RCT university sites collected at baseline were used to generate eB4CAST reports. Experts (n = 13) and RCT sites (n = 15) were asked to provide feedback on eB4CAST reports based on appeal, understanding, and clarity. On all Likert items, participants rated above 7 on each (out of 10). Positive responses from open-ended questions included eB4CAST reports being clear, visually appealing, and aid in program understanding. Overall, eB4CAST was successful in relaying data and information for the Get Fruved program, thus a means for science communication that could be used in interventions. Utilizing infographics to report data and information is a feasible way to disseminate and communicate in a cost-effective, timely manner.
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Affiliation(s)
- Melissa D. Olfert
- Division of Animal and Nutritional Sciences, West Virginia University, Morgantown, WV, United States
| | - Makenzie L. Barr
- Division of Animal and Nutritional Sciences, West Virginia University, Morgantown, WV, United States
| | - Rebecca L. Hagedorn
- Division of Animal and Nutritional Sciences, West Virginia University, Morgantown, WV, United States
| | - Rachel A. Wattick
- Division of Animal and Nutritional Sciences, West Virginia University, Morgantown, WV, United States
| | - Wenjun Zhou
- Business Analytics and Statistics, University of Tennessee, Knoxville, Knoxville, TN, United States
| | - Tanya M. Horacek
- Department of Public Health, Food Studies, and Nutrition, Syracuse University, Syracuse, NY, United States
| | - Anne E. Mathews
- Food Science and Human Nutrition Department, University of Florida, Gainesville, FL, United States
| | | | - Tandalayo Kidd
- Department of Food, Nutrition, Dietetics and Health, Kansas State University, Manhattan, KS, United States
| | - Adrienne A. White
- School of Food and Agriculture, University of Maine, Orono, ME, United States
| | - Onikia N. Brown
- Department of Nutrition, Dietetics, and Hospitality Management, Auburn University, Auburn, AL, United States
| | - Jesse Stabile Morrell
- Department of Agriculture, Nutrition, and Food Systems, University of New Hampshire, Durham, NH, United States
| | - Lisa Franzen-Castle
- Nutrition and Health Sciences Department, University of Nebraska–Lincoln, Lincoln, NE, United States
| | - Karla P. Shelnutt
- Department of Family, Youth and Community Sciences, University of Florida, Gainesville, FL, United States
| | - Carol Byrd-Bredbenner
- Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ, United States
| | - Terezie Tolar-Peterson
- Department of Food Science, Nutrition and Health Promotion, Mississippi State University, Starkville, MS, United States
| | - Geoffrey W. Greene
- Department of Nutrition and Food Science, University of Rhode Island, Kingston, RI, United States
| | - Sarah E. Colby
- Department of Nutrition, University of Tennessee, Knoxville, Knoxville, TN, United States
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17
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Barnett A, Campbell KL, Mayr HL, Keating SE, Macdonald GA, Hickman IJ. Liver transplant recipients' experiences and perspectives of a telehealth-delivered lifestyle programme: A qualitative study. J Telemed Telecare 2020; 27:590-598. [PMID: 31986966 DOI: 10.1177/1357633x19900459] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Dietary modification and exercise are encouraged to address cardiometabolic risk factors after solid organ transplantation. However, the lived experience of attempting positive lifestyle changes for liver transplant recipients is not known. The aim of this study was to explore the experiences of liver transplant recipients and their perspectives of a 12-week telehealth lifestyle programme and assess the feasibility of this innovative health service. METHODS Focus groups and one-on-one interviews were conducted with participants who had completed a 12-week, group-based, telehealth-delivered diet and exercise programme and thematic qualitative analysis was used to code and theme the data. RESULTS In total, 19 liver transplant recipients participated in the study (25-68 years, median time since transplant 4.4 years, 63% male). Overarching themes included: (a) 'broad telehealth advantages' which highlighted that telehealth reduced the perceived burdens of face-to-face care; (b) 'impact of employment' which identified employment as a competing priority and appeared to effect involvement with the programme; (c) 'adapting Mediterranean eating pattern to meet individual needs' which identified the adaptability of the Mediterranean diet supported by sessions with the dietitian; (d) 'increasing exercise confidence' which recognised that a tailored approach facilitated confidence and acceptability of the exercise component of the programme. DISCUSSION A telehealth lifestyle programme delivered by dietitians and exercise physiologists is an acceptable alternative to face-to-face care that can meet the needs of liver transplant recipients. There is a need to further innovate and broaden the scope of routine service delivery beyond face-to-face consultations.
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Affiliation(s)
- Amandine Barnett
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Australia.,Bond University Nutrition and Dietetics Research Group, Bond University, Australia
| | - Katrina L Campbell
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Australia.,Bond University Nutrition and Dietetics Research Group, Bond University, Australia.,Translational Research Institute, Australia
| | - Hannah L Mayr
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Australia.,Bond University Nutrition and Dietetics Research Group, Bond University, Australia
| | - Shelley E Keating
- School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
| | - Graeme A Macdonald
- Translational Research Institute, Australia.,Queensland Liver Transplant Service, Princess Alexandra Hospital, Australia.,Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Australia
| | - Ingrid J Hickman
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Australia.,Translational Research Institute, Australia.,Mater Research Institute, The University of Queensland, Australia
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18
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Challenges and Perspectives in Nutritional Counselling and Nursing: A Narrative Review. J Clin Med 2019; 8:jcm8091489. [PMID: 31540531 PMCID: PMC6780101 DOI: 10.3390/jcm8091489] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 09/07/2019] [Accepted: 09/12/2019] [Indexed: 12/20/2022] Open
Abstract
Nutritional counselling has been recognised as the first line approach in the management of numerous chronic diseases. Though usually carried out by dietitians, nutritional counselling may be used by nurses, or other healthcare professionals to improve nutritional status and meet healthcare goals. Healthcare professionals require training and education to facilitate a patient centred approach to effective counselling. Advances in digital technology have the potential to improve access to nutritional counselling for some patients such as those in primary care. However, caution is required to ensure that valuable interpersonal relationships are not lost, as these form the cornerstone of effective nutritional counselling. The aim of this narrative review is to explore aspects of effective nutritional counselling, including advances in e-counselling and areas where nursing input in nutritional counselling might enhance overall nutritional care.
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19
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Flood VM. Food, nutrition and ageing in the twenty-first century. Nutr Diet 2018; 75:3-5. [DOI: 10.1111/1747-0080.12410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Victoria M. Flood
- Professor of Allied Health, Faculty of Health Sciences; University of Sydney and Western Sydney Local Health District; Sydney New South Wales Australia
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20
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Vincze L, Rollo ME, Hutchesson MJ, Callister R, Thompson DI, Collins CE. Postpartum Women's Perspectives of Engaging with a Dietitian and Exercise Physiologist via Video Consultations for Weight Management: A Qualitative Evaluation. Healthcare (Basel) 2018; 6:E8. [PMID: 29351233 PMCID: PMC5872215 DOI: 10.3390/healthcare6010008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 01/15/2018] [Accepted: 01/17/2018] [Indexed: 01/01/2023] Open
Abstract
Optimising weight status after childbirth is important. Video consultations are an unexplored opportunity to deliver real-time support to postpartum women to improve lifestyle behaviours. This study aims to provide insight into postpartum women's perspectives of engaging with a dietitian and exercise physiologist through video consultations for tailored nutrition and exercise care. A qualitative study using individual telephone interviews (13-36 min) was undertaken. 21 women (body mass index (BMI): 28.1 ± 3.8 kg/m²; age: 32.3 ± 3.0 years; parity: 1.6 ± 0.9 children) who had completed the 8 week "Video-coaching to assist lifestyle (VITAL) change for mums" intervention participation included up to five video consultations with a dietitian and exercise physiologist. The interviews were audiorecorded and transcribed. Thematic data analysis was conducted by an independent researcher using NVIVO11. Themes relating to the video consultation experience included feeling that they did not differ from other consultations, they were convenient, and the length of time and flexible options were appropriate; however there was a desire for increased contact frequency. The dietitian and exercise physiologist were perceived to increase the participants' knowledge and confidence to improve health behaviours. The approach to setting realistic and tailored goals was well received. Tailored advice from a dietitian and exercise physiologist received via video consultations is acceptable for postpartum women and offers a viable alternative to in-person care.
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Affiliation(s)
- Lisa Vincze
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia.
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia.
| | - Megan E Rollo
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia.
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia.
| | - Melinda J Hutchesson
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia.
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia.
| | - Robin Callister
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia.
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia.
| | - Debbe I Thompson
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA.
| | - Clare E Collins
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia.
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia.
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