TY - JOUR

T1 - Theory-driven development of an educative nutritional intervention (ENI) supporting older hospital patients to eat sufficiently, assisted by an eHealth solution

T2 - an intervention mapping approach

AU - Terp, Rikke

AU - Lindhardt, Tove

AU - Kayser, Lars

N1 - Publisher Copyright: © 2022, The Author(s).

PY - 2022

Y1 - 2022

N2 - Background:: Insufficient protein and energy intake is a prevalent and serious problem in older hospital patients. Here, we describe the development of a program consisting of 1) an educative nutritional intervention (ENI) to support older hospital patients to participate in their own nutritional care using the eHealth solution Food’n’Go, and 2) a plan for education and support of healthcare professionals, enabling them to conduct the ENI. Further, we describe the evaluation of the acceptability of the program as perceived by nursing staff and dieticians. Methods:: The Intervention Mapping (IM) framework was used to design and develop the ENI through six steps: 1) a logic model of the problem was developed; 2) performance objectives and related change objectives were defined for patients, relatives, and healthcare professionals; 3) the intervention was designed using relevant theory-based change methods; 4) program materials were produced; and finally, 5) implementation and maintenance were planned and 6) evaluation of the program was planned. End users (patients, relatives, and healthcare professionals) were involved in the design and development of the ENI. Results:: Based on the logic model, the personal determinants (knowledge, skills, self-efficacy, outcome expectation, social support, attitude, and awareness) related to the patients and their relatives were addressed in the ENI, and those related to the healthcare professionals were addressed in the plan for their education and support. Theories of behavioral change, technology acceptance, and nutritional management for older persons were applied. A plan for evaluation of the effectiveness (intake of energy and protein) and feasibility of the ENI was conducted. The feasibility measurements were the behaviors and determinants related to the intervention outcome that were identified in the logic model of change. The ENI was perceived as acceptable by the nursing staff and dieticians. Conclusion:: We developed a theory- and evidence-based intervention guided by the IM framework and a sociotechnical approach, which was perceived as acceptable and ready for use to support older hospital patients to eat sufficiently assisted by eHealth.

AB - Background:: Insufficient protein and energy intake is a prevalent and serious problem in older hospital patients. Here, we describe the development of a program consisting of 1) an educative nutritional intervention (ENI) to support older hospital patients to participate in their own nutritional care using the eHealth solution Food’n’Go, and 2) a plan for education and support of healthcare professionals, enabling them to conduct the ENI. Further, we describe the evaluation of the acceptability of the program as perceived by nursing staff and dieticians. Methods:: The Intervention Mapping (IM) framework was used to design and develop the ENI through six steps: 1) a logic model of the problem was developed; 2) performance objectives and related change objectives were defined for patients, relatives, and healthcare professionals; 3) the intervention was designed using relevant theory-based change methods; 4) program materials were produced; and finally, 5) implementation and maintenance were planned and 6) evaluation of the program was planned. End users (patients, relatives, and healthcare professionals) were involved in the design and development of the ENI. Results:: Based on the logic model, the personal determinants (knowledge, skills, self-efficacy, outcome expectation, social support, attitude, and awareness) related to the patients and their relatives were addressed in the ENI, and those related to the healthcare professionals were addressed in the plan for their education and support. Theories of behavioral change, technology acceptance, and nutritional management for older persons were applied. A plan for evaluation of the effectiveness (intake of energy and protein) and feasibility of the ENI was conducted. The feasibility measurements were the behaviors and determinants related to the intervention outcome that were identified in the logic model of change. The ENI was perceived as acceptable by the nursing staff and dieticians. Conclusion:: We developed a theory- and evidence-based intervention guided by the IM framework and a sociotechnical approach, which was perceived as acceptable and ready for use to support older hospital patients to eat sufficiently assisted by eHealth.

KW - Educative nutritional intervention

KW - eHealth

KW - eHealth literacy

KW - Intervention mapping

KW - Malnutrition

KW - Older patients

KW - Patient participation

KW - Self-management

U2 - 10.1186/s12913-022-08679-8

DO - 10.1186/s12913-022-08679-8

M3 - Journal article

C2 - 36443804

AN - SCOPUS:85142805990

VL - 22

JO - BMC Health Services Research

JF - BMC Health Services Research

SN - 1472-6963

IS - 1

M1 - 1435

ER -