JMIR Publications

ABSTRACT

Background:

People of low socioeconomic position (SEP) are disproportionately affected by Type 2 Diabetes (T2D), partly due to unhealthy eating patterns that contribute to poor disease self-management and prognosis. Digital technologies have the potential to provide a practical medium to facilitate diabetes education, support self-management, and address some of the barriers to healthy eating, such as lack of nutritional knowledge, or of shopping or cooking skills, among this target group.

Objective:

This study aims to test the feasibility, appeal, and potential effectiveness of EatSmart, a 12-week, evidence-based, theoretically grounded web- and mobile-phone delivered healthy eating behaviour change program, to help disadvantaged people living with T2D to eat healthily on a budget in order to better manage their condition.

Methods:

EatSmart is a mixed methods (quantitative and qualitative) pre-post design pilot study. Sixty socioeconomically disadvantaged people with T2D aged 18 to 75 years will be recruited. Participants will complete baseline assessments of their basic demographic and clinical data, dietary intake, dietary self-efficacy and barriers to healthy eating. They will be provided with log-in access to the EatSmart web-program, which includes six progressive skill-based modules covering healthy eating planning; smart food budgeting and shopping; time-saving meal strategies; healthy cooking methods; modifying recipes; and a final reinforcement and summary module. Over the three-month intervention, participants will also receive three text messages weekly, of encouragement to review goals, continue to engage with different components of the EatSmart web program and eat healthily. Participants will undertake follow-up assessments directly following the intervention at three months post-baseline, and also after a six-month post-intervention follow-up period (9 months post-baseline). Feasibility will be evaluated with measures of the numbers of participants recruited and retained, and objective indicators of engagement with the website. Program appeal and potential effects on primary and secondary outcomes will be assessed via the same surveys at baseline, with additional questions asking about experience with and perceptions of the program. In-depth qualitative interviews will also be conducted 6 months post intervention to provide deeper insight into experiences with EatSmart, as well as a more comprehensive description of the program appeal.

Results:

The EatSmart website has been developed, and the first modules have been viewed by all participants as of mid-March 2020. Results are expected to be submitted for publication in December 2020.

Conclusions:

This study will provide data to address the currently limited evidence regarding whether disadvantaged populations with T2D may benefit from digitally delivered behaviour change programs to eat healthily on a budget. Clinical Trial: The Australian New Zealand Clinical Trials Registry (ANZCTR) Number for this study is ACTRN 12619001111167.