Wageningen University & Research, Division of Human Nutrition, PO Box 17, 6700 AAWageningen, The Netherlands.
Meditecnologia, Barcelona, Spain.
Public Health Nutr. 2019 Feb;22(2):363-374. doi: 10.1017/S1368980018002185. Epub 2018 Sep 3.
The present study aimed to conduct a process evaluation of a multicomponent nutritional telemonitoring intervention implemented among Dutch community-dwelling older adults.
A mixed-methods approach was employed, guided by the process evaluation framework of the Medical Research Council and the Unified Theory of Acceptance and Use of Technology. The process indicators reach, dose, fidelity and acceptability were measured at several time points within the 6-month intervention among participants and/or nurses.
The intervention was implemented in the context of two care organisations in the Netherlands.
In total, ninety-seven participants (average age 78 years) participated in the intervention and eight nurses were involved in implementation.
About 80 % of participants completed the intervention. Dropouts were significantly older, had worse cognitive and physical functioning, and were more care-dependent. The intervention was largely implemented as intended and received well by participants (satisfaction score 4·1, scale 1-5), but less well by nurses (satisfaction score 3·5, scale 1-5). Participants adhered better to weight telemonitoring than to telemonitoring by means of questionnaires, for which half the participants needed help. Intention to use the intervention was predicted by performance expectancy (β=0·40; 95 % CI 0·13, 0·67) and social influence (β=0·17; 95 % CI 0·00, 0·34). No association between process indicators and intervention outcomes was found.
This process evaluation showed that nutritional telemonitoring among older adults is feasible and accepted by older adults, but nurses' satisfaction should be improved. The study provided relevant insights for future development and implementation of eHealth interventions among older adults.
本研究旨在对荷兰社区居住的老年人群中实施的多组分营养远程监测干预进行过程评估。
采用混合方法，以医学研究委员会和接受和使用技术的统一理论的过程评估框架为指导。在 6 个月的干预期内，在参与者和/或护士中，在几个时间点测量了可达性、剂量、保真度和可接受性等过程指标。
干预在荷兰的两个护理组织中实施。
共有 97 名参与者（平均年龄 78 岁）参加了干预，8 名护士参与了实施。
约 80%的参与者完成了干预。辍学者年龄较大，认知和身体功能更差，更依赖护理。干预基本按照预期进行，参与者接受度较高（满意度评分 4.1，1-5 分制），但护士接受度较低（满意度评分 3.5，1-5 分制）。与通过问卷进行的远程监测相比，参与者更遵守体重远程监测，因为有一半的参与者需要帮助。干预意向由绩效预期（β=0.40；95%CI 0.13，0.67）和社会影响（β=0.17；95%CI 0.00，0.34）预测。过程指标与干预结果之间没有关联。
本过程评估表明，老年人的营养远程监测是可行的，也被老年人接受，但护士的满意度有待提高。该研究为未来老年人的电子健康干预的开发和实施提供了相关见解。
