Telenutrition

TN: Telenutrition Interventions by Registered Dietitians (2012)

Telenutrition and Effectiveness of Registered Dietitian Interventions

• Assessment
  Are RDs more effective than other healthcare professionals in providing nutrition education, nutrition counseling and coaching services (non-MNT) via non-face-to-face methods (to include phone, Internet, e-mail, videoconferencing, etc.)?

  • Conclusion

    Limited evidence reported comparable improvement among subjects and showed no significant differences in effectiveness by interventionists in the provision of non-MNT telenutrition services. Further research designed to study the comparative effectiveness is needed.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: Are RDs more effective than other healthcare professionals in providing nutrition education, nutrition counseling and coaching services (non-MNT) via non-face-to-face methods (to include phone, Internet, e-mail, videoconferencing, etc.)?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Glasgow RE, Toobert DJ, Hampson SE, Strycker LA. Implementation, generalization, and long-term results of the "choosing well" diabetes self-management intervention. Patient Education and Counseling. 2002; 48: 115-122.
  • Search Plan and Results: TN: Comparative Effectiveness of non-MNT by Provider 2011
     
  What is the effectiveness of telenutrition interventions and counseling provided by an RD when part of a healthcare team?

  • Conclusion

    Strong and consistent evidence reports that telenutrition interventions and counseling, when provided by a registered dietitian as part of a healthcare team, resulted in significant improvements in weight, BMI, A1C, blood pressure and serum lipids. Additional research on each of these outcomes is needed.

  • Grade: I
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the effectiveness of telenutrition interventions and counseling provided by an RD when part of a healthcare team?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Clawson B, Selden M, Lacks M, Deaton AV, Hall B, Bach R. Complex pediatric feeding disorders: using teleconferencing technology to improve access to a treatment program. Pediatr Nurs. 2008; 34 (3): 213-216.
      • Davis RM, Hitch AD, Salaam MM, Herman WH, Zimmer-Galler IE, Mayer-Davis EJ. TeleHealth improves diabetes self-management in an underserved community. Diabetes Care 2010; 33: 1,712-1,717.
      • Homenko DR, Morin PC, Eimicke JP, Teresi JA, Weinstock RS. Food insecurity and food choices in rural older adults with diabetes receiving nutrition education via telemedicine. J Nutr Educ Behav. 2010; 42(6): 404-409.
      • Huston JL, Burton DC. Patient satisfaction with multispecialty interactive consultations. J Telemed Telecare. 1997; 3 (4): 205-208.
      • Izquierdo R, Lagua CT, Meyer S, Ploutz-Snyder RJ, Palmas W, Eimicke JP, Kong J, Teresi JA, Shea S, Weinstock RS. Telemedicine intervention effects on waist circumference and body mass index in the IDEATel project. Diabetes Technol Ther. 2010; 12 (3): 213-220.
      • Izquierdo RE, Knudson PE, Meyer S, Kearns J, Ploutz-Snyder R, Weinstock RS. A comparison of diabetes education administered through telemedicine versus in person. Diabetes Care, 2003; 26 (4): 1,002-1,007.
      • Kris-Etherton PM, Taylor DS, Smiciklas-Wright H, Mitchell DC, Bekhuis TC, Olson BH, Slonim AB. High-soluble-fiber foods in conjunction with a telephone-based, personalized behavior change support service result in favorable changes in lipids and lifestyles after 7 weeks. J Am Diet Assoc. 2002; 102 (4): 503-510.
      • Saqui O, Chang A, McGonigle S, Purdy B, Fairholm L, Baun M, Yeung M, Rossos P, Allard J. Telehealth videoconferencing: improving home parenteral nutrition patient care to rural areas of Ontario, Canada. J Parenter Enteral Nutr. 2007; 31 (3): 234-239.
      • Trief PM, Sandberg J, Izquierdo R, Morin PC, Shea S, Brittain R, Feldhousen EB, Weinstock RS. Diabetes management assisted by telemedicine: patient perspectives. Telemed J E Health. 2008; 14 (7): 647-655.
      • Vale MJ, Jelinek MV, Best JD, Dart AM, Grigg LE, Hare DL, Ho BP, Newman RW, McNeil JJ, COACH Study Group. Coaching patients On Achieving Cardiovascular Health (COACH): a multicenter randomized trial in patients with coronary heart disease. Arch Intern Med. 2003; 163 (22): 2,775-2,783.
      • West SP, Lagua C, Trief PM, Izquierdo R, Weinstock RS. Goal setting using telemedicine in rural underserved older adults with diabetes: experiences from the Informatics for Diabetes Education and Telemedicine Project. Telemed J E Health. 2010; 16 (4): 405-416.
      • Wylie-Rosett J, Swencionis C, Ginsberg M, Cimino C, Wassertheil-Smoller S, Caban A, Segal-Isaacson CJ, Martin T, Lewis J. Computerized weight loss intervention optimizes staff time: The clinical and cost results of a controlled clinical trial conducted in a managed care setting. J Am Diet Assoc 2001; 101: 1,155-1,162.
  • Search Plan and Results: TN: Effectiveness of Telenutrition when RD on Team 2011
     
  What is the effectiveness of telenutrition interventions and counseling provided by an RD?

  • Conclusion

    Consistent evidence reports that telenutrition interventions and counseling provided by a registered dietitian resulted in significant improvements in weight, BMI, A1C, and/or serum lipids. Additional research on each of these outcomes is needed.

     

     

  • Grade: I
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the effectiveness of telenutrition interventions and counseling provided by an RD?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Baer JT. Improved plasma cholesterol levels in men after a nutrition education program at the worksite. J Am Diet Assoc. 1993; 93 (6): 658-663.
      • Beasley JM, Schenk JM, Ludman E, Lampe JW, Reed SD, Grothaus L, Newton KM. Brief telephone intervention increases soy intake in peri- and postmenopausal US women: the Herbal Alternatives Trial (HALT). J Am Diet Assoc. 2010; 110 (8): 1,189-1,197.
      • Djuric Z, Mirasolo J, Kimbrough L, Brown DR, Heilbrun LK, Canar L, Venkatranamamoorthy R, Simon MS. A pilot trial of spirituality counseling for weight loss maintenance in African American breast cancer survivors. J Natl Med Assoc. 2009; 101(6): 552-564.
      • Djuric Z, Vanloon G, Radakovich K, Dilaura NM, Heilbrun LK, Sen A. Design of a Mediterranean exchange list diet implemented by telephone counseling. J Am Diet Assoc 2008; 108: 2,059-2,065.
      • Haugen HA, Tran ZV, Wyatt HR, Barry MJ, Hill JO. Using telehealth to increase participation in weight management programs. Obesity (Silver Spring). 2007; 15(12): 3067-3077.
      • Rossi MC, Perozzi C, Consorti C, Almonti T, Foglini P, Giostra N, Nanni P, Talevi S, Bartolomei D, Vespasiani G. An interactive diary for diet management (DAI): A new telemedicine system able to promote body weight reduction, nutritional education, and consumption of fresh local produce. Diabetes Technol Ther 2010; 12 (8): 641-647.
      • Ten Hoedt AE, Hollak CE, Boelen CC, van der Herberg-van de Wetering NA, Ter Horst NM, Jonkers CF, Wijburg FA, Bosch AM. "MY PKU": increasing self-management in patients with phenylketonuria. A randomized controlled trial. Orphanet J Rare Dis. 2011; 6: 48.
      • Timmerberg BD, Wurst J, Patterson J, Spaulding RJ, Belz NE. Feasibility of using videoconferencing to provide diabetes education: a pilot study. J Telemed Telecare. 2009; 15 (2): 95-97.
      • Touger-Decker R, Denmark R, Bruno M, O'Sullivan-Maillet J, Lasser N. Workplace weight loss program; comparing live and internet methods. J Occup Environ Med. 2010; 52(11): 1112-1118.
  • Search Plan and Results: TN: Effectiveness of Telenutrition Provided by RD 2011
     
  What is the cost-effectiveness, cost benefit or economic savings of telenutrition interventions and counseling provided by an RD?

  • Conclusion

    There were no cost-effectiveness analyses identified, however limited evidence reports varying differences in costs between telehealth and traditional interventions, depending on the components included. Studies also report significant reductions in travel-related costs for patients and their families living in distant locations. Research is needed on the cost-effectiveness, cost benefit and/or economic savings of telenutrition interventions and counseling.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the cost-effectiveness, cost benefit or economic savings of telenutrition interventions and counseling provided by an RD?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Clawson B, Selden M, Lacks M, Deaton AV, Hall B, Bach R. Complex pediatric feeding disorders: using teleconferencing technology to improve access to a treatment program. Pediatr Nurs. 2008; 34 (3): 213-216.
      • Haugen HA, Tran ZV, Wyatt HR, Barry MJ, Hill JO. Using telehealth to increase participation in weight management programs. Obesity (Silver Spring). 2007; 15(12): 3067-3077.
      • Izquierdo RE, Knudson PE, Meyer S, Kearns J, Ploutz-Snyder R, Weinstock RS. A comparison of diabetes education administered through telemedicine versus in person. Diabetes Care, 2003; 26 (4): 1,002-1,007.
      • Rossi MC, Perozzi C, Consorti C, Almonti T, Foglini P, Giostra N, Nanni P, Talevi S, Bartolomei D, Vespasiani G. An interactive diary for diet management (DAI): A new telemedicine system able to promote body weight reduction, nutritional education, and consumption of fresh local produce. Diabetes Technol Ther 2010; 12 (8): 641-647.
      • Saqui O, Chang A, McGonigle S, Purdy B, Fairholm L, Baun M, Yeung M, Rossos P, Allard J. Telehealth videoconferencing: improving home parenteral nutrition patient care to rural areas of Ontario, Canada. J Parenter Enteral Nutr. 2007; 31 (3): 234-239.
      • Wylie-Rosett J, Swencionis C, Ginsberg M, Cimino C, Wassertheil-Smoller S, Caban A, Segal-Isaacson CJ, Martin T, Lewis J. Computerized weight loss intervention optimizes staff time: The clinical and cost results of a controlled clinical trial conducted in a managed care setting. J Am Diet Assoc 2001; 101: 1,155-1,162.
  • Search Plan and Results: TN: Cost-Effectiveness of Telenutrition by RD (Alone or Team) 2011