Feasibility and acceptability of telehealth coaching to promote healthy eating in chronic kidney disease: A mixed-methods process evaluation

Jaimon T. Kelly, Molly M. Warner, Marguerite Conley, Dianne P. Reidlinger, Tammy Hoffmann, Jonathan Craig, Allison Tong, Marina Reeves, David W. Johnson, Suetonia Palmer, Katrina L. Campbell

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Abstract

Objective To evaluate the feasibility and acceptability of a personalised telehealth intervention to support dietary self-management in adults with stage 3-4 chronic kidney disease (CKD).

Design Mixed-methods process evaluation embedded in a randomised controlled trial.

Participants People with stage 3-4 CKD (estimated glomerular filtration rate [eGFR] 15-60 mL/min/1.73 m(2)).

Setting Participants were recruited from three hospitals in Australia and completed the intervention in ambulatory community settings.

Intervention The intervention group received one telephone call per fortnight and 2-8 tailored text messages for 3 months, and then 4-12 tailored text messages for 3 months without telephone calls. The control group received usual care for 3 months then non-tailored education-only text messages for 3 months.

Main outcome measures Feasibility (recruitment, nonparticipation and retention rates, intervention fidelity and participant adherence) and acceptability (questionnaire and semistructured interviews).

Statistical analyses performed Descriptive statistics and qualitative content analysis.

Results Overall, 80/230 (35%) eligible patients who were approached consented to participate (mean +/- SD age 61.5 +/- 12.6 years). Retention was 93% and 98% in the intervention and control groups, respectively, and 96% of all planned intervention calls were completed. All participants in the intervention arm identified the tailored text messages as useful in supporting dietary selfmanagement. In the control group, 27 (69%) reported the non-tailored text messages were useful in supporting change. Intervention group participants reported that the telehealth programme delivery methods were practical and able to be integrated into their lifestyle. Participants viewed the intervention as an acceptable, personalised alternative to face-face clinic consultations, and were satisfied with the frequency of contact.

Conclusions This telehealth-delivered dietary coaching programme is an acceptable intervention which appears feasible for supporting dietary self-management in stage 3-4 CKD. A larger-scale randomised controlled trial is needed to evaluate the efficacy of the coaching programme on clinical and patient-reported outcomes.

Original languageEnglish
Article numbere024551
Number of pages12
JournalBMJ Open
Volume9
Issue number1
DOIs
Publication statusPublished - Jun 2019

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Text Messaging
Telemedicine
Chronic Renal Insufficiency
Self Care
Telephone
Control Groups
Randomized Controlled Trials
Glomerular Filtration Rate
Life Style
Arm
Referral and Consultation
Outcome Assessment (Health Care)
Mentoring
Healthy Diet
Interviews
Education

Cite this

Kelly, Jaimon T. ; Warner, Molly M. ; Conley, Marguerite ; Reidlinger, Dianne P. ; Hoffmann, Tammy ; Craig, Jonathan ; Tong, Allison ; Reeves, Marina ; Johnson, David W. ; Palmer, Suetonia ; Campbell, Katrina L. / Feasibility and acceptability of telehealth coaching to promote healthy eating in chronic kidney disease : A mixed-methods process evaluation. In: BMJ Open. 2019 ; Vol. 9, No. 1.
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abstract = "Objective To evaluate the feasibility and acceptability of a personalised telehealth intervention to support dietary self-management in adults with stage 3-4 chronic kidney disease (CKD).Design Mixed-methods process evaluation embedded in a randomised controlled trial.Participants People with stage 3-4 CKD (estimated glomerular filtration rate [eGFR] 15-60 mL/min/1.73 m(2)).Setting Participants were recruited from three hospitals in Australia and completed the intervention in ambulatory community settings.Intervention The intervention group received one telephone call per fortnight and 2-8 tailored text messages for 3 months, and then 4-12 tailored text messages for 3 months without telephone calls. The control group received usual care for 3 months then non-tailored education-only text messages for 3 months.Main outcome measures Feasibility (recruitment, nonparticipation and retention rates, intervention fidelity and participant adherence) and acceptability (questionnaire and semistructured interviews).Statistical analyses performed Descriptive statistics and qualitative content analysis.Results Overall, 80/230 (35{\%}) eligible patients who were approached consented to participate (mean +/- SD age 61.5 +/- 12.6 years). Retention was 93{\%} and 98{\%} in the intervention and control groups, respectively, and 96{\%} of all planned intervention calls were completed. All participants in the intervention arm identified the tailored text messages as useful in supporting dietary selfmanagement. In the control group, 27 (69{\%}) reported the non-tailored text messages were useful in supporting change. Intervention group participants reported that the telehealth programme delivery methods were practical and able to be integrated into their lifestyle. Participants viewed the intervention as an acceptable, personalised alternative to face-face clinic consultations, and were satisfied with the frequency of contact.Conclusions This telehealth-delivered dietary coaching programme is an acceptable intervention which appears feasible for supporting dietary self-management in stage 3-4 CKD. A larger-scale randomised controlled trial is needed to evaluate the efficacy of the coaching programme on clinical and patient-reported outcomes.",
author = "Kelly, {Jaimon T.} and Warner, {Molly M.} and Marguerite Conley and Reidlinger, {Dianne P.} and Tammy Hoffmann and Jonathan Craig and Allison Tong and Marina Reeves and Johnson, {David W.} and Suetonia Palmer and Campbell, {Katrina L.}",
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Feasibility and acceptability of telehealth coaching to promote healthy eating in chronic kidney disease : A mixed-methods process evaluation. / Kelly, Jaimon T.; Warner, Molly M.; Conley, Marguerite; Reidlinger, Dianne P.; Hoffmann, Tammy; Craig, Jonathan; Tong, Allison; Reeves, Marina; Johnson, David W.; Palmer, Suetonia; Campbell, Katrina L.

In: BMJ Open, Vol. 9, No. 1, e024551, 06.2019.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Feasibility and acceptability of telehealth coaching to promote healthy eating in chronic kidney disease

T2 - A mixed-methods process evaluation

AU - Kelly, Jaimon T.

AU - Warner, Molly M.

AU - Conley, Marguerite

AU - Reidlinger, Dianne P.

AU - Hoffmann, Tammy

AU - Craig, Jonathan

AU - Tong, Allison

AU - Reeves, Marina

AU - Johnson, David W.

AU - Palmer, Suetonia

AU - Campbell, Katrina L.

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N2 - Objective To evaluate the feasibility and acceptability of a personalised telehealth intervention to support dietary self-management in adults with stage 3-4 chronic kidney disease (CKD).Design Mixed-methods process evaluation embedded in a randomised controlled trial.Participants People with stage 3-4 CKD (estimated glomerular filtration rate [eGFR] 15-60 mL/min/1.73 m(2)).Setting Participants were recruited from three hospitals in Australia and completed the intervention in ambulatory community settings.Intervention The intervention group received one telephone call per fortnight and 2-8 tailored text messages for 3 months, and then 4-12 tailored text messages for 3 months without telephone calls. The control group received usual care for 3 months then non-tailored education-only text messages for 3 months.Main outcome measures Feasibility (recruitment, nonparticipation and retention rates, intervention fidelity and participant adherence) and acceptability (questionnaire and semistructured interviews).Statistical analyses performed Descriptive statistics and qualitative content analysis.Results Overall, 80/230 (35%) eligible patients who were approached consented to participate (mean +/- SD age 61.5 +/- 12.6 years). Retention was 93% and 98% in the intervention and control groups, respectively, and 96% of all planned intervention calls were completed. All participants in the intervention arm identified the tailored text messages as useful in supporting dietary selfmanagement. In the control group, 27 (69%) reported the non-tailored text messages were useful in supporting change. Intervention group participants reported that the telehealth programme delivery methods were practical and able to be integrated into their lifestyle. Participants viewed the intervention as an acceptable, personalised alternative to face-face clinic consultations, and were satisfied with the frequency of contact.Conclusions This telehealth-delivered dietary coaching programme is an acceptable intervention which appears feasible for supporting dietary self-management in stage 3-4 CKD. A larger-scale randomised controlled trial is needed to evaluate the efficacy of the coaching programme on clinical and patient-reported outcomes.

AB - Objective To evaluate the feasibility and acceptability of a personalised telehealth intervention to support dietary self-management in adults with stage 3-4 chronic kidney disease (CKD).Design Mixed-methods process evaluation embedded in a randomised controlled trial.Participants People with stage 3-4 CKD (estimated glomerular filtration rate [eGFR] 15-60 mL/min/1.73 m(2)).Setting Participants were recruited from three hospitals in Australia and completed the intervention in ambulatory community settings.Intervention The intervention group received one telephone call per fortnight and 2-8 tailored text messages for 3 months, and then 4-12 tailored text messages for 3 months without telephone calls. The control group received usual care for 3 months then non-tailored education-only text messages for 3 months.Main outcome measures Feasibility (recruitment, nonparticipation and retention rates, intervention fidelity and participant adherence) and acceptability (questionnaire and semistructured interviews).Statistical analyses performed Descriptive statistics and qualitative content analysis.Results Overall, 80/230 (35%) eligible patients who were approached consented to participate (mean +/- SD age 61.5 +/- 12.6 years). Retention was 93% and 98% in the intervention and control groups, respectively, and 96% of all planned intervention calls were completed. All participants in the intervention arm identified the tailored text messages as useful in supporting dietary selfmanagement. In the control group, 27 (69%) reported the non-tailored text messages were useful in supporting change. Intervention group participants reported that the telehealth programme delivery methods were practical and able to be integrated into their lifestyle. Participants viewed the intervention as an acceptable, personalised alternative to face-face clinic consultations, and were satisfied with the frequency of contact.Conclusions This telehealth-delivered dietary coaching programme is an acceptable intervention which appears feasible for supporting dietary self-management in stage 3-4 CKD. A larger-scale randomised controlled trial is needed to evaluate the efficacy of the coaching programme on clinical and patient-reported outcomes.

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DO - 10.1136/bmjopen-2018-024551

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