Development, Implementation, and Process Evaluation of a Theory-Based Nutrition Education Programme for Adults Living With HIV in Abeokuta, Nigeria

Abstract

Introduction: Healthy diets play a role in the management and care for adults living with HIV/AIDS (ALH). Appropriate nutrition education (NE) is necessary to equip ALH with relevant knowledge and skills for healthy eating. A needs assessment identified the need for a nutrition education programme (NEP) as part of the nutrition service for ALH in Abeokuta, Nigeria. The aim of this study was to design a theory-based NEP and to evaluate the implementation process among ALH attending selected federal and state hospitals in Abeokuta as out-patients.Materials and Methods: An exploratory descriptive needs assessment in the qualitative and quantitative domains was conducted among a convenient sample of ALH (N = 243) at the selected hospitals. The quantitative needs assessment identified needs for improvement in the primary outcome [quality of life (QoL)] and the secondary outcomes [quality of dietary intake, nutrition knowledge, attitudes, and practice (KAP), and anthropometric status]. Participants' perceptions of the NEP were obtained using an interviewer administered questionnaire among 70 ALH who attended the implementation of the NEP and process evaluation thereof at the intervention hospital.Results: The qualitative results identified a lack of knowledge on planning varied meals with limited resources. The identified needs, existing guidelines and literature were integrated with appropriate constructs of the Social Cognitive Theory (SCT) and the Health Belief Model (HBM) into the NEP. The NE manual, participant's work book, flipcharts, and the brochure were tailored to address the identified challenges.Discussion: The process evaluation showed that the NEP was implemented as planned and that the participants' perceptions were positive. The use of the NE manual, participant's work book, flipcharts, and brochure demonstrated the practicality of incorporating behavioral theories in NE for ALH.

Process evaluation of a national elderly nutrition care program in Iran: Perspectives of clients and providers

“…The follow-up sessions, number and duration of nutrition education and physical activity sessions, and vitamin or mineral supplementation did not go on as had been planned. In disagreement of current study, the process evaluation of two studies in Nigeria and USA has shown the delivery rate of 100% (42,43). Several factors may have contributed to low level of delivery in current study; most of the providers reported that they had not enough time to dedicate on EINCP as they had other tasks in the health care centers.…”

“…77.5% of the clients had exposure to the program. Clients' satisfaction rate was varied from 4.2 to 34.7% with various available services, but 42.8% of the clients had high satisfaction with overall parts of the EINCP. The program also suffered from some external contexts such as the lack of financial support of program providers.…”

<p>Process Evaluation of a National Elderly Nutrition–Care Program in Iran: Perspectives of Clients and Providers</p>

“…In contrast to the current study, process evaluations in Nigeria and the US have shown a delivery rate of 100%. 30,31 In the current study, several factors may have contributed to the low level of delivery, including insufficient time on the part of the providers and lack of attention to providers' specialties. It is speculated that poor delivery of the program components might have resulted in diminished EINCP effects, as confirmed by another study.…”

A nutrition education programme improves quality of life but not anthropometric status of adults living with HIV in Abeokuta, Nigeria

“…Approximately 1400 ALH at each hospital received free ART which they collected on a monthly basis. A needs assessment, conducted prior to the current study to determine the NE needs of the ALH at the two hospitals, showed the ALH attending the two hospitals to have similar demographic and anthropometric characteristics ( P > 0·05) ( 17 ) .…”

“…Convenience sampling was used to recruit 200 ALH who met the inclusion criteria and consented to participate in the study. The sample size was determined from the results of the prior needs assessment ( 17 ) where 169 of the 243 participants answered all the Short Form (SF)-36 QoL questions with a mean of 65 ( sd 14·7) %.…”