Abstract
BackgroundThe long-term management of chronic diseases requires adoption of complex dietary recommendations, which can be facilitated by regular coaching to support sustained behaviour change. Telehealth interventions can overcome patient-centred barriers to accessing face-to-face programs and provide feasible delivery methods, ubiquitous and accessible regardless of geographic location. The protocol for this systematic review explains the methods that will be utilised to answer the review question of whether telehealth interventions are effective at promoting change in dietary intake and improving diet quality in people with chronic disease.Methods/designA structured search of Medline, EMBASE, CINAHL, and PsychINFO, from their inception, will be conducted. We will consider randomised controlled trials which evaluate complex dietary interventions in adults with chronic disease. Studies must provide diet education in an intervention longer than 4 weeks in duration, and at least half of the intervention contact must be delivered via telehealth. Comparisons will be made against usual care or a non-telehealth intervention. The primary outcome of interest is dietary change with secondary outcomes relating to clinical markers pre-specified in the methodology. The process for selecting studies, extracting data, and resolving conflicts will follow a set protocol. Two authors will independently appraise the studies and extract the data, using specified methods. Meta-analyses will be conducted where appropriate, with parameters for determining statistical heterogeneity pre-specified. The GRADE tool will be used for determining the quality of evidence for analysed outcomes.DiscussionTo date, there has been a considerable variability in the strategies used to deliver dietary education, and the overall effectiveness of telehealth dietary interventions for facilitating dietary change has not been reviewed systematically in adults with chronic disease. A systematic synthesis of telehealth strategies will inform the development of evidence-based telehealth programs that can be tailored to deliver dietary interventions specific to chronic disease conditions.Systematic review registrationPROSPERO CRD42015026398Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-015-0170-8) contains supplementary material, which is available to authorized users.
Highlights
The long-term management of chronic diseases requires adoption of complex dietary recommendations, which can be facilitated by regular coaching to support sustained behaviour change
To date, there has been a considerable variability in the strategies used to deliver dietary education, and the overall effectiveness of telehealth dietary interventions for facilitating dietary change has not been reviewed systematically in adults with chronic disease
A systematic synthesis of telehealth strategies will inform the development of evidencebased telehealth programs that can be tailored to deliver dietary interventions specific to chronic disease conditions
Summary
This protocol for a systematic review of available evidence will establish whether telehealth is an effective strategy to deliver multifactorial dietary interventions in adults with chronic disease, which has not been previously evaluated or reviewed systematically. If telehealth is found to be effective in establishing multifactorial dietary change, this may inform a change in current clinical and public health practice by restructuring funding and resources for future chronic disease dietary management in healthcare. Additional file 1 presents the MEDLINE search strategy which will be used to identify potential studies. (PDF 153 kb) Additional file 2: PRISMA-P checklist. Additional file 2 presents the PRISMA-P checklist. JK assisted in the conceptualisation of the review and drafted the study protocol. KC conceived the review and revised manuscript drafts. DR assisted in the conceptualisation of the review and reviewed all drafts of the manuscript.
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