Feasibility of a mHealth Approach to Nutrition Counseling in an Appalachian State

Abstract

West Virginia is a rural state with an aging population that may experience barriers to accessing nutritional and lifestyle counseling. This study examined feasibility of an online personalized nutrition tracking application, Good Measures (GM), with patients at seven health care clinics throughout the state. Fourteen healthcare providers and 64 patients 18 years or older with a Body Mass Index (BMI) greater than or equal to 30 and access to the Internet were recruited for this 12-week feasibility study. Patient participants logged meals and exercise into the GM application via smart phone, tablet, or computer and virtually engaged with a Registered Dietitian Nutritionist (RDN) in one-on-one sessions. The primary endpoint was to examine feasibility of the program by usage of the application and feedback questions regarding the benefits and challenges of the application. Participants were predominately white (92%) and female (76%). Minimal improvements in weight and systolic blood pressure were found. Participant attitude survey data declined from 4-weeks to 12-weeks of the intervention. Interestingly though, patients in a rural clinic had lesser declines in attitudes than peri-urban participants. Qualitative feedback data identified participants predominately had a positive overall feeling toward the approach. Participants expressed favorability of RDN access, the variety of foods, but did give suggestions for in-person meetings and more updating of the application. Implementing a technology approach to nutrition in rural areas of West Virginia using a mobile application with RDN access may be one strategy to address public health issues such as obesity.

Is the uptake, engagement, and effectiveness of exclusively mobile interventions for the promotion of weight‐related behaviors equal for all? A systematic review

“…Finally, the present review focused on exclusively mobile interventions only, which is why only a small number of studies were identified. While mobile interventions often include non‐mobile components (e.g., an accompanying website, counseling via telephone or in face‐to‐face consultations 69,106,107 ), exclusively mobile interventions become increasingly common. For instance, the German Digital Healthcare act allows medical professionals to prescribe digital interventions as they would prescribe medication 10 .…”

“…Studies were conducted in the USA (n = 6), [56][57][58][59][60][61] the UK (n = 3), [62][63][64] India (n = 1), 65 Japan (n = 1), 66 Germany (n = 1), 67 and Saudi Arabia (n = 1). 68 The included studies were randomized controlled trials (n = 10), [56][57][58][59][61][62][63][64][65]68 quasi-experimental nonrandomized longitudinal designs (n = 2), 60,66 single group studies (n = 2), 67,69 a mixed-method study (n = 1) 70 and a retrospective cohort study (n = 1). 71 The number of participants included in the studies ranged between 48 and 251,718.…”

Feasibility and Perception of a Diet and Exercise Intervention Delivered via Telehealth to Firefighters

“…To the best of our knowledge, there are no other studies that have assessed perceptions of telehealth in firefighters with an exercise and diet intervention. In 2019, Olfert et al (2019) reported positive effects of personalized mobile health diet counseling in a group of overweight patients. In their study, they measured perception with a 32-question behavior and attitude survey administered at baseline, mid-intervention, and post-intervention.…”

Is the uptake, engagement and effectiveness of exclusively mobile interventions for the promotion of weight-related behaviours equal for all? A systematic review

“…Studies were conducted in United States 60, 62-64, 66, 67 , the United Kingdom 54,55,59 , India 61 , Japan 57 , Germany 58 , and Saudi Arabia 52 . The included studies were randomised controlled trials 52,54,55,[59][60][61][62][63][64]67 , quasi-experimental nonrandomised longitudinal designs 57,66 , single group studies 58,68 and a retrospective cohort study 56 .…”

“…Finally, the present review focused on exclusively mobile interventions only, which is why only a small number of studies were identified. While mobile interventions often include non-mobile components (e.g., an accompanying website, counselling via telephone or in face-to-face consultations 68,103,104 ), exclusively mobile interventions become increasingly common. For instance, the German Digital Health Care act allows medical professionals to prescribe digital interventions as they would prescribe medication 105 .…”