U:DECIDE Study: Utilising technology for Diet & Exercise Change In complex chronic conditions across Diverse Environments

The objective of this research is to determine whether health technologies can be utilised in specialist chronic disease clinics to deliver lifestyle interventions to improve the management of cardiometabolic risk in individuals with complex chronic conditions. There will be two groups; an intervention group and a control group randomised to a 1:1 ratio. Intervention: - Participants will undergo education for increasing physical activity in line with Australian National Guidelines (30minutes daily, up to 150minutes per week of aerobic and resistance activity) and aligning with heart healthy dietary eating patterns. The Healthy heart dietary education will focus on increasing intake of fruit/veg/wholegrains/healthy proteins, reduction of foods with added salt/sugars and promotion of healthy fat choices such as nuts and olive oil). Education is focused on food choice and dietary pattern with no specific education around weight reduction even though weight loss may occur as a result of dietary change. The intervention will last for 26 weeks. All intervention participants will receive a one-on-one baseline dietary assessment and education session with an accredited practicing dietitian. The first session will be one-on-one for the health professional to determine any individual specific needs, but all remaining appointments will be group base and delivered via telehealth or technology assisted contact such as online information or text messages. Participants will receive an information booklet and then can choose a range of review strategies including group video 1hr dietitian review (offered monthly), group video 1hr exercise sessions (offered weekly), text message support with frequency from 1 - 3 per week to reinforce advice, information, motivation and support to improve diet and physical activity behaviours support. This booklet has been designed specifically for the study and is not publicly available at this stage. Participants will also be provided with a fitbit wearable device to track physical activity patterns and intensity. Participants will have access to online dietary education videos, recipes and information via a private web platform and/or mobile app. Monitoring of individual access to the online material will not be tracked, but rather whole group de-identified access of app will be observed with web analytics. Fidelity of the service delivery will be assessed by regular supervision of the intervention appointments by principal investigators and professional support and case discussions at weekly team meetings. It will be up to the participant to decide the frequency of which they would like this additional support. Adherence and compliance with the model of care will be assessed at each session by the health professional. Log books to record exercise sessions and diet tracking checklists will assist in recording adherence to recommendations for diet and exercise. The intervention will be delivered via the Queensland Health Portal whereby participants will log in online from their personal device (computer/laptop/ipad/smart phone) with the health professional located centrally at the Princess Alexandra Hospital or University of Queensland and multiple participants logging in to each appointment for a group session. There will be no web analytic analysis of individuals accessing the portal.