Abstract
To investigate the extent, quality and challenges of dietetic counselling during the pandemic. A cross-sectional online thirty-six-item Google Survey. The survey queried demographics and information on usage and perceived telemedicine quality. The survey was distributed to Israeli Dietetic Association (ATID) mailing list between 31 March and 5 May 2020. Clinical dietitians, members of ATID, who consented to participated in the survey. Three hundred dietitians (12 % of ATID members; 95 % women; mean age 4·41 (sd 10·2) years) replied to the survey. Most dietitians reported a significant ∼30 % decrease in work hours due to the pandemic. The most prevalent form of alternative nutrition counselling (ANC) was over the phone (72 %); 53·5 % used online platforms. Nearly 45 % had no former ANC experience. Both ANC formats were reported inferior to face-to-face nutritional consultation (consultation quality median scores 8 and 7, on a 1-10 scale, for online and phone, respectively). ANC difficulties on either phone or online platforms were technical (56 and 47 %, respectively), lack of anthropometric measurements (28 and 25 %, respectively) and interpersonal communication (19 and 14·6 %, respectively). Older age and former phone counselling experience were associated with higher quality scores, respectively (OR = 1·046, 95 % CI 1·01, 1·08, P = 0·005), (95 % CI 1·38, 4·52, P = 0·02). Those who continued to work full time had five-time greater odds for a higher quality score using online platforms (OR = 5·33, 95 % CI 1·091, 14·89, P = 0·001). Our findings suggest telemedicine holds considerable promise for dietary consultation; however, additional tools and training are needed to optimise remote ANC, especially in light of potential crisis-induced lockdown.
Highlights
MethodsOverall study design and plan The respondents to this cross-sectional survey were a convenience sample of registered dietitians (RD)
In a multivariate logistic regression in which the dependent variable was the total quality score of counselling using online video platforms > 8, the only significant predictor variable was workload; respondents who continued full-time work had a five-fold increase in odds for a higher quality score (OR = 5·33, 95 % CI 1·091, 14·89, P = 0·001) (Table 5)
We described the unique characteristics of nutrition consultation during the first phase of the COVID-19 pandemic in Israel
Summary
Overall study design and plan The respondents to this cross-sectional survey were a convenience sample of registered dietitians (RD). Survey development The survey included thirty-six questions, featuring a questionnaire to assess participant perceptions and experiences of telemedicine using the phone and/or online platforms[11]. The survey questions and usability of the online platform were referred to a focus group of potential participants to assess readability and clarity; minor amendments were made following their feedback. Respondents were asked to compare the quality of phone or online platforms to face-to-face counselling. Continuous data had distributions significantly deviating from normal, so they are described as median (interquartile range) Categorical variables such as the proportion of participants with a given response were described using frequency counts and expressed as n (%). Associations between socio-demographic and occupational characteristics of dietitians and the overall quality of phone and online counselling were examined using logistic regression models with stepwise variable selection. All tests are two-sided and considered significant at P < 0·05
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