JMIR Publications

ABSTRACT

Background:

Use of mobile health (mHealth) applications (apps) in dietetic practice could support delivery of nutrition care in medical nutrition therapy. However, apps are underutilized by dietitians in patient care.

Objective:

This study aimed to determine the feasibility of an intervention, comprising of education, training and integration of apps, in improving dietitians’ perceived self-efficacy with using mHealth apps.

Methods:

Private practice Accredited Practising Dietitians who were not regular users or recommenders of mHealth apps were recruited into the intervention. The intervention consisted of two phases: 1) a workshop that incorporated an educational lecture and skill building activities to target self-efficacy, capability, opportunity and motivation factors; 2) 12-week intervention phase allowing for the integration of an app into dietetic practice via an app platform. During the 12-week intervention phase, dietitians prescribed an Australian commercial nutrition app to new (intervention) patients receiving nutrition care. Existing (control) patients were also recruited to provide a measure of patient satisfaction before the apps were introduced. New patients completed their patient satisfaction surveys at the end of the 12 weeks. Usability feedback about the app and app platform were gathered from intervention patients and dietitians.

Results:

Five dietitians participated in the study. The educational and skills training workshop component of the intervention produced immediate significant improvements in dietitians’ mHealth app self-efficacy compared to baseline (P=.02), particularly with regards to ‘familiarity with apps’ factor (P<.001). The self-efficacy factor ‘integration into dietetic work systems’ achieved significant improvements from baseline to 12 weeks (P=.03). Patient satisfaction with dietetic services did not differ significantly between intervention (n=17) and control patients (n=13). Overall, dietitians and their patients indicated they would continue using the app platform and app respectively, and would recommend it to others. To improve usability, enhancing patient-dietitian communication mediums in the app platform and reducing the burden of entering in meals cooked at home should be considered.

Conclusions:

Administering an educational and skills training workshop in conjunction with integrating an app platform into dietetic practice were feasible methods for improving the self-efficacy of dietitians towards using mHealth apps. Further translational research will be required to determine how the broader dietetic profession respond to this intervention.