Overweight and Obesity
Conditions
Keywords
dietetics, telemedicine, dietitian
Brief summary
The project aims to investigate the effect of internet-based dietetic treatment (IDT) on patients, dietitians, and society. The project will show: * If IDT is equivalent to traditional dietetic treatment with physical meetings * Patients' attitudes to, and experiences of, meeting a dietician through video calls * How the dietician's work environment and working methods are affected by IDT * If there are subgroups of patients where IDT is more or less appropriate * Health economic and environmental consequences of IDT The major shortage of dietitians leaves patients with non-communicable diseases (NCD) without qualified dietary treatment. In a pilot study, the investigators have shown that IDT has great potential to streamline healthcare and increase accessibility. In the project Dietitian online, the investigators will conduct an RCT with 400 NCD-patients allocated to either IDT or standard dietetic treatment to see if IDT affect treatment outcome and whether IDT is appropriate for everyone. Even though internet-based treatment (IT) increases rapidly in society, there is little knowledge about the patients' experiences and how healthcare personnel incorporates IT in their daily work. The investigators will conduct qualitative studies to meet this knowledge gap. General assumptions are that IT is beneficial for society, both economically and environmentally, but very few studies have been done. The project will incorporate a full health-economic evaluation, including environmental impact.
Interventions
OTHERInternet-based dietetic treatment with video calls
The dietitian meets the patient through video calls, no physical meetings
OTHERTraditional dietetic treatment
The dietitian meets the patient through physical meetings
Sponsors
Västerbotten County Council, Sweden
Forte
Umeå University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* seeking/being referred to a dietitian for the treatment of obesity (BMI≥25) or obesity in combination with: * type 2 diabetes (HbA1c\>48mmol/mol) and/or * elevated blood lipids (total cholesterol \>4,5 mmol/l and/or LDL \>2,5 mmol/l and/or triglycerides \>2,0 mmol/l) and/or * high blood pressure (\>140/90 hg)
Exclusion criteria
* other diagnoses requiring/might require nutritional treatment (eg cancer, COPD) * dementia * severe impairment of sight, hearing, or other disability where internet-based dietetic treatment is deemed difficult * pregnancy * need for interpreter
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in dietary intake | Change from baseline to three, six and twelve months after first treatment session | Dietary intake will be assessed using the Swedish National Food Administrations Food Index (minimum value 0, maximum value 12, higher score indicates a healthier diet). Intake of fruit and vegetables in grams, as well as intake of discretionary calories (sweets, snacks, fast food, sugary drinks, pastries), will also be assessed. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in participant alliance to dietitian | Change from baseline to three and six months after first treatment session | Alliance between patient and dietitian, measured with Working Alliance Inventory - Short (WAI-S, minimum value 12, maximum value 84, higher score indicates higher alliance to dietitian) |
| Change in participant activation | Change from baseline to six months after first treatment session | Patient activation (readiness to behavioral change), measured with Patient Activation Measure (PAM, (minimum value 0, maximum value 100, higher score indicates a higher activation (better)). |
| Change in participant motivation | Change from baseline to three. six and twelve months after first treatment session | Patient motivation (personal motivation to behavioral change), measured with VAS-scale 0-100, where higher score indicates higher motivation to behavioral change. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Change in physical activity | Change from baseline to three, six and twelve months after first treatment session | Physical activity, measured as average physical activity level (PAL) at work and at leisure time using a validated two-question questionnaire. PAL-levels from the questionnaire range between 1.4 - 2.3, where a higher score indicates higher physical activity |
| Change in health-related quality of life | Change from baseline to six months after first treatment session | Health-related quality of life, measured with EQ-5D (minimum value 0, maximum value 1 where a higher value indicates higher quality of life |
| Change in body weight | Change from baseline to three, six and twelve months after first treatment session | Self reported body weight |
Contacts
Primary ContactPetra M Rydén, PhD
Backup ContactSarah Persson, BSc
Outcome results
None listed