Mayr Hannah L, Hayes Lisa, Wang William Y S, Murray Eryn, Kelly Jaimon T, Palmer Michelle, Hickman Ingrid J
Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, QLD 4102, Australia.
Centre for Functioning and Health Research, Metro South Hospital and Health Service, Brisbane, QLD 4102, Australia.
Healthcare (Basel). 2025 Feb 26;13(5):506. doi: 10.3390/healthcare13050506.
: A Mediterranean-style dietary pattern (MDP) is embedded across coronary heart disease (CHD) and type 2 diabetes (T2D) clinical guidelines. However, MDP evidence has not consistently been translated into practice. This study aimed to develop, integrate and evaluate implementation strategies to support clinicians in translating MDP evidence into routine care for CHD and T2D in the local context of a public health service. : This study documents the implementation and evaluation phases of a broader knowledge translation project guided by the Knowledge-to-Action cycle. Multi-disciplinary clinicians in the cardiology and diabetes services of two large metropolitan hospitals and a post-acute community service were targeted. Strategies were prioritised utilising theory and stakeholder engagement and included facilitation, building a coalition, the engagement of clinical champions and local opinion leaders, educational meetings, consensus discussions, sharing local knowledge, consumer consultation, and the development and distribution of education materials. Surveys were conducted with clinicians and patients of targeted services to evaluate the reach, acceptability, feasibility, adoption and perceived sustainability of MDP in practice. : In total, 57 clinicians (7 dietitians, 29 nurses/diabetes educators, 15 doctors and 6 other allied health professionals) and 55 patients completed post-implementation evaluation surveys. The majority of clinicians agreed an MDP is appropriate to recommend in their clinical setting (95%), and most of the time/always their advice (85%) aligns. Education sessions were attended by 65% of clinicians, of which the majority indicated improved knowledge (100%) and change in practice (86%). Factors deemed most important to maintaining an MDP approach in practice were hard-copy education materials (85%) and access to a dietitian (62%). Of the patients who had received care from a dietitian of targeted services (n = 32, 58%), 100% recalled having discussed ≥1 MDP topic and 89% received education material. Of the patients who had received dietary advice from non-dietetic clinicians (n = 33, 60%), 67% recalled having discussed ≥1 MDP topic and 70% received education material. : Targeted and theory-informed implementation reached the majority of surveyed clinicians and patients, and positively influenced the adoption, acceptability and feasibility of an MDP approach in routine care. Ongoing sustainability strategies are crucial with rotating clinician roles.
地中海式饮食模式（MDP）已纳入冠心病（CHD）和2型糖尿病（T2D）的临床指南。然而，MDP的相关证据并未始终转化为实际行动。本研究旨在制定、整合并评估实施策略，以支持临床医生将MDP证据转化为公共卫生服务当地环境中针对CHD和T2D的常规护理。：本研究记录了以知识到行动循环为指导的更广泛知识转化项目的实施和评估阶段。目标人群为两家大型都市医院的心脏病学和糖尿病服务部门以及一家急性后社区服务机构的多学科临床医生。利用理论和利益相关者参与对策略进行了优先排序，包括促进、建立联盟、临床倡导者和当地意见领袖的参与、教育会议、共识讨论、分享当地知识、消费者咨询以及教育材料的开发和分发。对目标服务的临床医生和患者进行了调查，以评估MDP在实践中的覆盖范围、可接受性、可行性、采用情况和感知可持续性。：共有57名临床医生（7名营养师、29名护士/糖尿病教育工作者、15名医生和6名其他 allied health professionals）和55名患者完成了实施后评估调查。大多数临床医生同意在其临床环境中推荐MDP（95%），并且大多数时候/总是他们的建议（85%）是一致的。65%的临床医生参加了教育课程，其中大多数表示知识有所提高（100%）且实践有改变（86%）。在实践中维持MDP方法被认为最重要的因素是纸质教育材料（85%）和获得营养师的帮助（62%）。在接受了目标服务营养师护理的患者中（n = 32，58%）,100%回忆起讨论过≥1个MDP主题，89%收到了教育材料。在接受非营养师临床医生饮食建议的患者中（n = 33，60%），67%回忆起讨论过≥1个MDP主题，70%收到了教育材料。：有针对性的、基于理论的实施覆盖了大多数接受调查的临床医生和患者，并对MDP方法在常规护理中的采用、可接受性和可行性产生了积极影响。随着临床医生角色的轮换，持续的可持续性策略至关重要。
