Technology Assisted Dietary Assessment and Advice (TADAA) Feasibility Study

The study will be a non-randomised, single-arm, open-label feasibility trial to test the feasibility of technology-assisted dietary assessment and advice to improve overall diet quality in cardiac surgery patients. Participants will be required to record all food and beverage intake over four consecutive days (including one weekend day) at baseline (T0 pre-surgery) and at 4 weeks after baseline (T4 pre-surgery) both before surgery, and at 6 weeks after surgery (T6 post-surgery) using a mobile food record (mFR trademark) app. Participants will also be asked to record all food and beverage intake over a 24-hour period using the mFR trademark app at 2 weeks after baseline (T2 pre-surgery) and every 4 weeks after T4 prior to until surgery. Participants will be on varying wait periods for surgery and therefore the intervention will be standardised for the first four weeks. Participants will be asked to label vegetables on their images to be aware and conscious of increasing intake as a strategy to improve overall diet quality. Within 7 days of recording food and beverage intake, participants will receive tailored dietary advice based on their dietary assessment with the aim of increasing vegetables and improving overall diet quality consistent with the National Heart Foundation Dietary Position Statement on Heart Healthy Eating Patterns. A research dietitian with tertiary dietetic qualifications will deliver the intervention. Additional training will be completed for the analysis of image-based food records and behaviour change interview techniques for improving diet quality. Dietary advice will be provided via a one-hour dietetic telehealth consultation at baseline and 15 min dietetic check-in appointments at 2 and 4 weeks after baseline (before surgery) and at 6 weeks after surgery. A dietary summary designed by the dietitian will be emailed to participants after the initial consultation and supportive SMS messages will be provided after each dietetic check-in appointment (e.g., look for pre-made salads or veggie bowls at your grocery store or local deli). A purposefully sampled group of participants (approx. 10-15) will be invited to take part in a semi-structured in-depth online or telephone interview, to further explore acceptability of the image-assisted mFR trademark method and features (e.g., labelling). Participants will be deemed adherent if they have completed at least 75% of the prescribed food and beverage recording days (i.e., four days) using the mFR trademark app at baseline and 4 weeks after baseline (before surgery) and at 6 weeks after surgery. Complete recording days will be defined as at least one meal recorded in a day.