Using novel telehealth strategies to change the delivery of nutrition care in community living older adults with malnutrition
This PhD project aims to determine whether personalised dietetic interventions delivered via telehealth are effective for improving dietary intake (including energy and protein intake), nutritional outcomes (including weight, BMI and hand grip strength), as well as measures of sarcopenia and quality of life.
The problem of malnutrition in older adults has been well established. Prevalence rates of 30-50% in hospitalised patients and 5-10% in community living older adults continue to exist despite the implementation of a range of nutrition interventions. The outcomes of malnutrition are concerning for individuals and for the broader health system, where the condition leads to poorer health outcomes (including higher mortality), increased rates of readmission and length of stay. The majority of dietetic intervention is delivered in the hospital setting, with limited community health follow up. As such, patients develop a nutrition care plan in conjunction with a dietitian preceding discharge with little support provided for its implementation.
Telehealth-based strategies offer great promise for management of malnutrition because they can improve integration of care across the healthcare spectrum, support patient self-management and empowerment, improve clinician decision-making and patient-practitioner communication, and increase access to health care services. In malnourished community-dwelling older adults significant improvements following telephone delivered care versus in person/no intervention have been identified in protein intake and quality of life. However, many older adults have difficulty using existing telehealth tools due to lack of familiarity. Voice-Controlled Intelligent Personal Assistants (VIPAs; e.g. Amazon Alexa), embedded in speaker and display units, allow for natural language conversations which may be more acceptable for older adults.
Working with an industry partner, we have developed innovative web-based software which allows dietitians to deliver individually-tailored nutritional information via VIPAs in patients’ homes. Dietitians can use this software to provide evidence-based instructions consistent with the patient’s discharge nutrition care plan, and these instructions are scheduled for broadcasting (using images, video and audio) by the VIPA at specified times. Importantly, dietitians can also schedule the broadcasting of follow-up questions which patients can respond to using natural language; these patient responses are recorded in a secure database. Dietitians can review them at any time, and can then provide further instruction or modify their nutrition advice accordingly.
Prerequisites: Applicants must hold an undergraduate degree with first class honours (or equivalent) in a relevant field including nutrition, dietetics or health sciences. Interested students must meet Deakin University’s PhD entry requirements and be eligible to apply for an Australian Post Graduate Award or equivalent. The supervision team will work with suitably qualified applicants to apply for scholarship funding.
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