The investigators will conduct a pilot cluster randomized trial of Nutri, a clinical decision support software to support collaborative diet goal setting in primary care. Nutri is designed within the Chronic Care Model framework, specifically with the intention of leveraging clinical information systems to connect clinical care with patients' lives in the community setting. Nutri is based on the Theory of Planned Behavior and uses collaborative goal setting between the patient and provider to identify a behavioral intention (i.e., diet goal) and improve goal self-efficacy by improving attitudes/outcome expectations, subjective norms/social support, and perceived behavioral control. In this pilot trial, the intervention group (N=10 primary care providers \[PCPs\], N=40 patients) receives collaborative diet goal setting via Nutri, and the control group receives usual care(N=10 PCP, N=40 patients). Before and after the appointment, patients will report food they consumed over the last 24 hours via the dietary recall tool, ASA24 and respond to surveys about behavioral intention and self-efficacy. Intervention PCPs will be alerted when the Nutri workflow is available for a patient and asked to complete it during their visit with that patient.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
DOUBLE
Enrollment
82
Receives Nutri
Lone Star Circle of Care
Austin, Texas, United States
Variance and Within-Provider Covariance of Patient Self-Reported Dietary Behavioral Intention
Patient self-report of a diet goal set during medical appointment, coded y/n
Time frame: 1-day post medical encounter
Variance and Within-Provider Covariance of Patient Self-Reported Dietary Behavior Change Self-Efficacy (Confidence in ability to change dietary behavior)
Patient self-report of self-efficacy (ie, confidence) in changing their diet after appointment, 7-point Likert scale, a higher score means a better outcome
Time frame: 1-day post medical encounter
Variance and Within-Provider Covariance of Patient Change in Diet Quality (measured via Healthy Eating Index)
Change in diet quality measured via the Healthy Eating Index (HEI) score calculated from 24-hour recall, 0-100 score range, higher score means better outcome.
Time frame: Patient pre-assessment and 7-day post medical encounter
Nutri (Intervention) Usability
System Usability Scale, 0-100 score range, higher score means better outcome
Time frame: PCP post-assessment (after 4 medical encounters), expected to be at 8 weeks after enrollment
Number and timeline of PCPs and patients recruited into the study
Recruitment of patients and providers into the study, including timeline and total number. The outcome will be used to inform pragmatic trial feasibility.
Time frame: through study completion, expected to be at 8 weeks after enrollment
Number and timeline of PCPs and patients who drop out of the study
Loss to follow up of patients and providers into the study, including timeline and total number. The outcome will be used to inform pragmatic trial feasibility.
Time frame: through study completion,expected to be at 8 weeks after enrollment
Completion of patient ASA24 survey
Patient completion of the ASA24 survey pre and post-test. The outcome will be used to inform pragmatic trial feasibility.
Time frame: patient pre-assessment & 7 days post-appointment
Impact of Nutri on Patient Self-Reported Dietary Behavioral Intention
Difference between intervention and control in the frequency of patient self-reported diet goal.
Time frame: 1 day post-medical encounter
Impact of Nutri on Patient Self-Reported Dietary Behavior Change Self-Efficacy (Confidence in ability to change dietary behavior), measured via questionnaire
The difference between intervention and control in the amount of patient self-reported self-efficacy (confidence) in changing their diet after the appointment, 7-point Likert scale, a higher score means a better outcome.
Time frame: 1 day post-medical encounter
Impact of Nutri on Patient Diet Quality (measured via Healthy Eating Index)
Difference between intervention and control in change in Healthy Eating Index (HEI) score calculated from 24-hour recall, 0-100 score range, a higher score means a better outcome.
Time frame: Patient pre-assessment and 7 days post-medical encounter
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