BACKGROUND
Adults diagnosed with cancers of the stomach, oesophagus and pancreas are at high risk of malnutrition. In many hospital-based health care settings there is a lack of systems in place to provide the early and intensive nutrition support that is required by these high-risk cancer patients. Our research team undertook a 3-arm parallel randomised controlled trial to test the provision of an early and intensive nutrition intervention to patients with UGI cancers using a synchronous telephone based delivery approach versus an asynchronous mobile application-based delivered using an iPad compared to a control group to address this issue. The novel coronavirus-19 (COVID-19) has resulted in the rapid adoption of telehealth services to enable remote delivery of healthcare to comply with physical distancing laws and to keep vulnerable patient’s safe. Thus, the impetus to understand the best way to deliver these services to enhance acceptability, engagement and improve patients’ health care outcomes has become even more urgent.
OBJECTIVE
To explore the acceptability of an early, intensive e-health nutrition intervention delivered either via a synchronous telephone based approach or an asynchronous mobile application based approach.
METHODS
Participants were recruited who were newly diagnosed with upper gastrointestinal cancer and who had consented to take part in a nutrition intervention. In depth, semi-structured qualitative interviews were conducted by telephone and transcribed verbatim. Data was analysed using deductive thematic analysis using the Theoretical Framework of Acceptability in NVivo Pro 12 Plus.
RESULTS
A total of 20 participants were interviewed, 10 from each intervention group (synchronous or asynchronous delivery). Four major themes emerged from the qualitative synthesis: 1) participant self-efficacy, low levels of burden and intervention comprehension were required for intervention effectiveness and positive affect 2) participants sought a sense of support and security through relationship building and rapport with their dietitian 3) knowledge acquisition and learning enabled empowerment through self-management 4) convenience, flexibility and bridging the gap to hard to reach individuals.
CONCLUSIONS
Features of eHealth models of nutrition care delivered via telephone and mobile application can be acceptable to those undergoing treatment for upper gastrointestinal cancer. Convenience, knowledge acquisition, improved self-management and support were key benefits for participants. Future interventions should focus on a home-based intervention delivered with simple, easy to use technology. Ideally enabling participants, the choice of and allow individual choice of intervention delivery mode (synchronous or asynchronous) that aligns to their individual values and capabilities may support improved outcomes.
CLINICALTRIAL
Trial Registration: Australian and New Zealand Clinical Trial Registry, 27th January 2017 (ACTRN12617000152325).
Nutritional Outcomes of patients Undergoing Resection for upper gastroIntestinal cancer in AuStralian Hospitals (NOURISH): protocol for a multicentre point prevalence study
