Nutri的试点试验，数字化干预糖尿病个性化饮食管理的安全网初级保健。

IF 2.3 3区医学 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

Journal of Nutrition Education and Behavior Pub Date : 2025-07-01 DOI:10.1016/j.jneb.2025.03.015

Marissa Burgermaster PhD , Madalyn Rosenthal BS , Brandon S. Altillo MD, MPH , Mariana Rendon Flores MS, RD , Eesha Nayak BS , Dagny N. Larson MS, RD , James Custer MS , Lola Okunade MD , William M. Tierney MD , Steven Andrews PhD , Grant Daniels BS , Paul J. Rathouz PhD

{"title":"Nutri的试点试验，数字化干预糖尿病个性化饮食管理的安全网初级保健。","authors":"Marissa Burgermaster PhD , Madalyn Rosenthal BS , Brandon S. Altillo MD, MPH , Mariana Rendon Flores MS, RD , Eesha Nayak BS , Dagny N. Larson MS, RD , James Custer MS , Lola Okunade MD , William M. Tierney MD , Steven Andrews PhD , Grant Daniels BS , Paul J. Rathouz PhD","doi":"10.1016/j.jneb.2025.03.015","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>Feasibility evaluation of Nutri, a clinical decision support software for brief diet counseling by primary care providers (PCPs).</div></div><div><h3>Design</h3><div>Cluster-randomized controlled trial.</div></div><div><h3>Setting</h3><div>Primary care practices in a large network of federally qualified health centers.</div></div><div><h3>Participants</h3><div>Sixteen PCPs block randomized to Nutri (n = 8) or control (n =8) and 30 of their adult diabetes/prediabetes patients (Nutri, n = 17; control, n=13).</div></div><div><h3>Intervention(s)</h3><div>After patients completed the automated self-administered 24-hour dietary assessment tool, Nutri synthesized diet data to prioritize dietary problems and guide PCPs through collaborative diet goal setting during a regularly scheduled appointment. Control PCPs provided usual care.</div></div><div><h3>Main Outcome Measure(s)</h3><div>Completion rates (trial feasibility); Nutri usage, usability (intervention feasibility); patient-reported goal setting, self-efficacy, diet quality; PCP-reported diet counseling self-efficacy, attitudes, and competence.</div></div><div><h3>Analysis</h3><div>Summary of trial and intervention feasibility; intent-to-treat comparisons with Bayesian mixed effects models (patient outcomes accounting for PCP-level clustering), ordinary least squares regression (PCP outcomes).</div></div><div><h3>Results</h3><div>All PCPs and patients matriculated into the trial were followed through posttest. Nutri PCPs used Nutri in all study appointments; 81% of Nutri patients reported goal setting, and 57% initiated their goal. PCP-reported diet counseling self-efficacy and competence improved.</div></div><div><h3>Conclusions and Implications</h3><div>Nutri was useful to PCPs for collaborative diet goal setting with the potential to improve diabetes management in safety-net clinics.</div></div>","PeriodicalId":50107,"journal":{"name":"Journal of Nutrition Education and Behavior","volume":"57 7","pages":"Pages 614-626"},"PeriodicalIF":2.3000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Pilot Trial of Nutri, a Digital Intervention for Personalized Dietary Management of Diabetes in Safety-Net Primary Care\",\"authors\":\"Marissa Burgermaster PhD , Madalyn Rosenthal BS , Brandon S. Altillo MD, MPH , Mariana Rendon Flores MS, RD , Eesha Nayak BS , Dagny N. Larson MS, RD , James Custer MS , Lola Okunade MD , William M. Tierney MD , Steven Andrews PhD , Grant Daniels BS , Paul J. Rathouz PhD\",\"doi\":\"10.1016/j.jneb.2025.03.015\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><div>Feasibility evaluation of Nutri, a clinical decision support software for brief diet counseling by primary care providers (PCPs).</div></div><div><h3>Design</h3><div>Cluster-randomized controlled trial.</div></div><div><h3>Setting</h3><div>Primary care practices in a large network of federally qualified health centers.</div></div><div><h3>Participants</h3><div>Sixteen PCPs block randomized to Nutri (n = 8) or control (n =8) and 30 of their adult diabetes/prediabetes patients (Nutri, n = 17; control, n=13).</div></div><div><h3>Intervention(s)</h3><div>After patients completed the automated self-administered 24-hour dietary assessment tool, Nutri synthesized diet data to prioritize dietary problems and guide PCPs through collaborative diet goal setting during a regularly scheduled appointment. Control PCPs provided usual care.</div></div><div><h3>Main Outcome Measure(s)</h3><div>Completion rates (trial feasibility); Nutri usage, usability (intervention feasibility); patient-reported goal setting, self-efficacy, diet quality; PCP-reported diet counseling self-efficacy, attitudes, and competence.</div></div><div><h3>Analysis</h3><div>Summary of trial and intervention feasibility; intent-to-treat comparisons with Bayesian mixed effects models (patient outcomes accounting for PCP-level clustering), ordinary least squares regression (PCP outcomes).</div></div><div><h3>Results</h3><div>All PCPs and patients matriculated into the trial were followed through posttest. Nutri PCPs used Nutri in all study appointments; 81% of Nutri patients reported goal setting, and 57% initiated their goal. PCP-reported diet counseling self-efficacy and competence improved.</div></div><div><h3>Conclusions and Implications</h3><div>Nutri was useful to PCPs for collaborative diet goal setting with the potential to improve diabetes management in safety-net clinics.</div></div>\",\"PeriodicalId\":50107,\"journal\":{\"name\":\"Journal of Nutrition Education and Behavior\",\"volume\":\"57 7\",\"pages\":\"Pages 614-626\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Nutrition Education and Behavior\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1499404625000958\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"EDUCATION, SCIENTIFIC DISCIPLINES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Nutrition Education and Behavior","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1499404625000958","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"EDUCATION, SCIENTIFIC DISCIPLINES","Score":null,"Total":0}

引用次数: 0

摘要

目的：评价Nutri临床决策支持软件用于初级保健医生（pcp）简短饮食咨询的可行性。设计：成组随机对照试验。环境：初级保健实践在一个大型网络的联邦合格的健康中心。参与者：16名pcp组随机分为Nutri组（n =8）或对照组（n =8）和30名成年糖尿病/前驱糖尿病患者(Nutri组，n = 17；干预：在患者完成自动自我管理的24小时饮食评估工具后，Nutri在定期预约期间合成饮食数据，优先考虑饮食问题，并通过协作制定饮食目标来指导pcp。对照pcp提供常规护理。主要结局指标：完成率（试验可行性）；营养的使用、可用性（干预的可行性）；患者报告的目标设定、自我效能、饮食质量；pcp报告的饮食咨询自我效能、态度和能力。分析：试验及干预可行性总结；使用贝叶斯混合效应模型（患者结果占PCP水平聚类），普通最小二乘回归（PCP结果）进行意向治疗比较。结果：所有纳入试验的pcp和患者均通过后测随访。Nutri pcp在所有的研究预约中都使用Nutri；81%的Nutri患者报告了目标设定，57%的患者开始了他们的目标。pcp报告的饮食咨询自我效能和能力提高。结论和意义：Nutri对pcp合作制定饮食目标有用，有可能改善安全网诊所的糖尿病管理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Pilot Trial of Nutri, a Digital Intervention for Personalized Dietary Management of Diabetes in Safety-Net Primary Care

Objective

Feasibility evaluation of Nutri, a clinical decision support software for brief diet counseling by primary care providers (PCPs).

Design

Cluster-randomized controlled trial.

Setting

Primary care practices in a large network of federally qualified health centers.

Participants

Sixteen PCPs block randomized to Nutri (n = 8) or control (n =8) and 30 of their adult diabetes/prediabetes patients (Nutri, n = 17; control, n=13).

Intervention(s)

After patients completed the automated self-administered 24-hour dietary assessment tool, Nutri synthesized diet data to prioritize dietary problems and guide PCPs through collaborative diet goal setting during a regularly scheduled appointment. Control PCPs provided usual care.

Main Outcome Measure(s)

Completion rates (trial feasibility); Nutri usage, usability (intervention feasibility); patient-reported goal setting, self-efficacy, diet quality; PCP-reported diet counseling self-efficacy, attitudes, and competence.

Analysis

Summary of trial and intervention feasibility; intent-to-treat comparisons with Bayesian mixed effects models (patient outcomes accounting for PCP-level clustering), ordinary least squares regression (PCP outcomes).

Results

All PCPs and patients matriculated into the trial were followed through posttest. Nutri PCPs used Nutri in all study appointments; 81% of Nutri patients reported goal setting, and 57% initiated their goal. PCP-reported diet counseling self-efficacy and competence improved.

Conclusions and Implications

Nutri was useful to PCPs for collaborative diet goal setting with the potential to improve diabetes management in safety-net clinics.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Journal of Nutrition Education and Behavior 医学-学科教育

CiteScore

4.20

自引率

11.50%

发文量

379

审稿时长

44 days

期刊介绍： The Journal of Nutrition Education and Behavior (JNEB), the official journal of the Society for Nutrition Education and Behavior, is a refereed, scientific periodical that serves as a global resource for all professionals with an interest in nutrition education; nutrition and physical activity behavior theories and intervention outcomes; complementary and alternative medicine related to nutrition behaviors; food environment; food, nutrition, and physical activity communication strategies including technology; nutrition-related economics; food safety education; and scholarship of learning related to these areas. The purpose of JNEB is to document and disseminate original research and emerging issues and practices relevant to these areas worldwide. The Journal of Nutrition Education and Behavior welcomes evidence-based manuscripts that provide new insights and useful findings related to nutrition education research, practice and policy. The content areas of JNEB reflect the diverse interests in nutrition and physical activity related to public health, nutritional sciences, education, behavioral economics, family and consumer sciences, and eHealth, including the interests of community-based nutrition-practitioners. As the Society''s official journal, JNEB also includes policy statements, issue perspectives, position papers, and member communications.