Technology Use by Registered Dietitians for Patient Care in an Outpatient Setting

Background Technology use in digital health tools has increased significantly since the COVID-19 pandemic disrupted many in-office patient care services. Although healthcare practices have adopted several technologies, they remain surrounded by a saturated increase in consumer-based wearables and smartphone applications. As a result, attitudes and acceptability toward integrating these technologies for patient care are evolving. Digital health tools is an umbrella term including several technologies utilized among health care providers for the purpose of patient care. The inclusion of digital health tools by Registered Dietitian Nutritionists’ (RDNs) in practice provides a more robust and personalized approach to patients and their health needs. Reasons for decisions about incorporating digital health tools into the RDN practice setting are limited in the professional literature. Methods An exploratory cross-sectional survey design was used. Professionals working as Registered Dietitian Nutritionists (RDNs) were recruited utilizing a snowball sampling approach among several practice settings. Survey compilation included a literature review, identifying and utilizing two surveys otherwise used for different purposes and target audiences. Data collection consists of a 2-step process with a survey pilot test and distribution of a final survey administered via Qualtrics. Data analysis was conducted using SPSS v27.0. Results Sixteen of 20 professionals completed the survey in its entirety: 2 working in employee wellness, 13 in a hospital-based system, and 1 in both employee wellness and community/public health. Quantitative analysis depicted the highest usage of tele-visits/virtual visits and less appreciation for technology in eating disorders. Additionally, RDNs reported heightened chances of adopting a tool if the technology is the standard of care. Qualitative analysis indicated that professionals working in a setting for diabetes had a positive attitude towards wearable or smartphone nutrition applications. Moreover, other practice settings such as dialysis and post-liver transplant, eating disorders, or employee wellness produced either a neutral or negative attitude. Conclusions Registered dietitian nutritionists are highly interested in using digital health tools for patient care. However, it is difficult to conclude the current use of technology in outpatient practice. RDNs understand the potential of technology, such as wearables, in offering patients care concerning their illness or diagnosis. Although RDNs utilize telehealth, other technologies such as wearables and smartphone nutrition apps have yet to be widely adopted. The use of technology among RDNs who practice in an outpatient setting is highly variable, and therefore a presumption cannot be made. Therefore, future research is warranted, focusing on patients with various health conditions and diverse samples

A review of dietary monitoring applications and eating disorder/disordered eating symptomatology

Eating disorders are among the deadliest mental illnesses in the United States. Given their high prevalence and low treatment rates, mitigating risk exposure is necessary for prevention. Dietary monitoring applications are highly popular self-monitoring tools that can inform dietary patterns and improve weight loss efficacy. However, they can also serve as a means for those with body preoccupation to restrict and possibly exacerbate disordered symptomatology. A literature search was conducted to identify research regarding the usage of dietary monitoring applications and eating disorder/disordered eating symptomatology. Twelve articles met inclusion criteria and are discussed in the review. An association between the use of apps to self-monitor dietary intake and disordered eating behaviors were consistently reported in observational studies. No impact on the use of these apps and validated assessments of eating disorder/disordered eating symptomatology were indicated in experimental studies on low-risk populations. However, both limitations and qualitative analysis suggest that continued research with improved methodology is necessary. Some principal issues within methodology include sampling issues, minimal risk exposure, and unrealistic use case scenarios. With eating disorder prevalence and dietary monitoring app use rising, future research to investigate the associations and any temporal effects on eating disorder/disordered eating symptomatology is imperative to inform researchers and clinicians

Mobile Health Technology Development: Adaptations for Children and Adolescents with Autism

Mobile health technology is a growing health resource that is usually designed for the general population. The existing literature on children and adolescents with autism suggests that their experience with mobile health technology may differ from the general population due to the coexisting conditions and social determinants of health related to autism. These differences can impact the anticipated effectiveness of mobile health technology. The goal of this qualitative study was to learn more about the experience of children and adolescents with autism with mobile health technology by interviewing health care providers, individuals who have autism, and parents of children with autism. The existing literature along with the personal experiences and recommendations discussed during these interviews provide a variety of considerations for mobile health technology developers. By incorporating these findings into new and existing mobile health technology, these resources can be more accessible and beneficial for children and adolescents with autism

Feasibility of a mHealth Approach to Nutrition Counseling in an Appalachian State

Abstract: West Virginia is a rural state with an aging population that may experience barriers to accessing nutritional and lifestyle counseling. This study examined feasibility of an online personalized nutrition tracking application, Good Measures (GM), with patients at seven health care clinics throughout the state. Fourteen healthcare providers and 64 patients 18 years or older with a Body Mass Index (BMI) greater than or equal to 30 and access to the Internet were recruited for this 12-week feasibility study. Patient participants logged meals and exercise into the GM application via smart phone, tablet, or computer and virtually engaged with a Registered Dietitian Nutritionist (RDN) in one-on-one sessions. The primary endpoint was to examine feasibility of the program by usage of the application and feedback questions regarding the benefits and challenges of the application. Participants were predominately white (92%) and female (76%). Minimal improvements in weight and systolic blood pressure were found. Participant attitude survey data declined from 4-weeks to 12-weeks of the intervention. Interestingly though, patients in a rural clinic had lesser declines in attitudes than peri-urban participants. Qualitative feedback data identified participants predominately had a positive overall feeling toward the approach. Participants expressed favorability of RDN access, the variety of foods, but did give suggestions for in-person meetings and more updating of the application. Implementing a technology approach to nutrition in rural areas of West Virginia using a mobile application with RDN access may be one strategy to address public health issues such as obesity

The app caused me to cancel - Understanding mobile health app dissatisfaction: An affordance perspective

The use of mobile health (mHealth) applications to easily track calorie intake and exercise behavior becomes more and more popular. However, research showed that mHealth apps could only be effective in supporting people in their weight loss if used regularly over a long period. Despite a significant amount of work examining the decision to continue to use mHealth apps, less is known about sources of negative user experiences that can act as barriers to long-term use. Drawing upon affordance theory, this study aims to fill this research gap by qualitatively analyzing app reviews from five popular weight loss apps. Our findings reveal nine causes of dissatisfaction that can have adverse effects regarding long-term mHealth app use for weight management. The results contribute to research and practice by shedding light on the barriers to the continued use of mHealth applications for weight management and how designers and developers can overcome these shortcomings

The factors influencing the adoption of mental health applications

Dissertation presented as the partial requirement for obtaining a Master's degree in Information Management, specialization in Marketing IntelligenceMental illnesses are a growing issue nowadays. According to the World Health Organization, the gap between the need for treatment for mental disorders and the accessibility of treatment is widening. One potential solution to making treatment more accessible is mental health apps. In recent years, mental health apps have been essential tools for providing healthcare services at an affordable cost. Despite the effectiveness and benefits of new technologies, the uptake of these apps remains a challenge, especially in Europe compared to the US. This study aims to investigate the factors that influence the adoption of mental health apps. To this end, a conceptual framework based on the UTAUT2 and the HBM was developed, which was tested using a quantitative study. For operationalization, 309 participants aged between 18 and 70 years old were collected through an online questionnaire. The results show that all of the tested factors impact behavioral intention. The determinants that stand out are performance expectancy, social influence, hedonic motivation, and cues to action, which significantly affect the behavioral choice to use a mental health application. The findings lead to implications for promoting and developing greater adoption of mental health apps

It\u27s All Lateral Violence : How Sexual Minority Men Cope With Appearance Discrimination

Sexual minority men experience higher rates of body dissatisfaction (BD) than heterosexual men (Frederick & Essayli, 2016). BD is associated with negative health outcomes in this population, including eating disorders (Yean et al., 2013), depression (Blashill et al., 2016), suicidality (Grunewald, Calzo, et al., 2021), and risky sexual behavior (Goedel et al., 2017). Sexual minority men who use dating apps may be at greater risk of experiencing BD via exposure to appearance-based discrimination (Tran et al., 2020), sexual objectification, and weight stigma (Filice et al., 2019). Little is known about sexual minority men’s experiences of appearance discrimination on dating apps and how they cope with these negative experiences. This experiential qualitative study addressed this gap in the literature using reflexive thematic analysis (Braun & Clarke, 2006; Braun & Clarke, 2022). Fourteen sexual minority men shared their lived experiences with appearance discrimination on dating apps in semi-structured individual interviews. Findings were organized into four categories (context, type, coping strategies, and reflections) that collectively told a compelling story about how sexual minority men experience and cope with appearance discrimination on dating apps. The interviewees noted that appearance discrimination often focused on specific physical attributes like body hair, race and skin tone, and body weight and shape. Appearance discrimination evoked psychological distress and worsened their body image, but men felt that certain contextual factors like intention for dating app use, mental health struggles, and lived experience with minority stressors, influenced their perceptions, experiences, and coping. While some coping strategies (i.e., avoidance) were ultimately unhelpful, other strategies like boundary setting, positive reappraisal, social support seeking, and problem solving, were critical to supporting their psychological well-being and facilitate reflection. Implications for future research, psychotherapy, and community-based intervention are discussed. In particular, clinicians should assist their clients in developing healthy, adaptive ways of coping such as setting firm boundaries, confronting perpetrators, taking breaks from dating apps when needed, and seeking social support. Clinicians should also help SMM clients find healthy and supportive activities within the gay male community that de-emphasize appearance and status