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Feasibility and acceptability of telehealth coaching to promote healthy eating in chronic kidney disease: a mixed-methods process evaluation
  1. Jaimon T Kelly1,
  2. Molly M Warner1,
  3. Marguerite Conley2,
  4. Dianne P Reidlinger1,
  5. Tammy Hoffmann3,
  6. Jonathan Craig4,5,
  7. Allison Tong5,6,
  8. Marina Reeves7,
  9. David W Johnson8,9,10,
  10. Suetonia Palmer11,
  11. Katrina L Campbell1,2
  1. 1 Faculty of Health Science and Medicine, Bond University, Robina, Queensland, Australia
  2. 2 Department of Nutrition and Dietetics, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
  3. 3 Centre for Research in Evidence Based Practice, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
  4. 4 College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
  5. 5 Sydney School of Public Health, The University of Sydney, Adelaide, South Australia, Australia
  6. 6 Centre for Kidney Research, The Children’s Hospital at Westmead, Westmead, New South Wales, Australia
  7. 7 Cancer Prevention Research Centre, School of Public Health, The University of Queensland, Herston, Queensland, Australia
  8. 8 Department of Nephrology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
  9. 9 Centre for Kidney Disease Research, University of Queensland, Brisbane, Queensland, Australia
  10. 10 Translational Research Institute, Brisbane, Queensland, Australia
  11. 11 Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand
  1. Correspondence to Dr Jaimon T Kelly; jkelly{at}


Objective To evaluate the feasibility and acceptability of a personalised telehealth intervention to support dietary self-management in adults with stage 3–4 chronic kidney disease (CKD).

Design Mixed-methods process evaluation embedded in a randomised controlled trial.

Participants People with stage 3–4 CKD (estimated glomerular filtration rate [eGFR]15–60 mL/min/1.73 m2).

Setting Participants were recruited from three hospitals in Australia and completed the intervention in ambulatory community settings.

Intervention The intervention group received one telephone call per fortnight and 2–8 tailored text messages for 3 months, and then 4–12 tailored text messages for 3 months without telephone calls. The control group received usual care for 3 months then non-tailored education-only text messages for 3 months.

Main outcome measures Feasibility (recruitment, non-participation and retention rates, intervention fidelity and participant adherence) and acceptability (questionnaire and semistructured interviews).

Statistical analyses performed Descriptive statistics and qualitative content analysis.

Results Overall, 80/230 (35%) eligible patients who were approached consented to participate (mean±SD age 61.5±12.6 years). Retention was 93% and 98% in the intervention and control groups, respectively, and 96% of all planned intervention calls were completed. All participants in the intervention arm identified the tailored text messages as useful in supporting dietary self-management. In the control group, 27 (69%) reported the non-tailored text messages were useful in supporting change. Intervention group participants reported that the telehealth programme delivery methods were practical and able to be integrated into their lifestyle. Participants viewed the intervention as an acceptable, personalised alternative to face-face clinic consultations, and were satisfied with the frequency of contact.

Conclusions This telehealth-delivered dietary coaching programme is an acceptable intervention which appears feasible for supporting dietary self-management in stage 3–4 CKD. A larger-scale randomised controlled trial is needed to evaluate the efficacy of the coaching programme on clinical and patient-reported outcomes.

Trial registration number ACTRN12616001212448; Results.

  • diet
  • telehealth
  • chronic kidney disease
  • process evaluation

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  • Patient consent for publication Not required.

  • Contributors JTK wrote the first draft of the manuscript and takes responsibility for the integrity of the data. JTK, KLC, DWJ, MR and SP assisted in the conceptualisation of the trial design. MMW and DPR were responsible for the qualitative data collection and analysis, assisted in the conceptualisation of the qualitative research methods. MMW wrote the qualitative results section of the manuscript. JTK and MC designed the intervention materials and were responsible for the management of the trial at their respective sites. TH, JC and AT provided methodological expertise and revised drafts of the manuscript. All authors contributed to revisions of the manuscript and approved the final version for submission. JTK is the guarantor and affirms that the manuscript is an honest, accurate and transparent account of the study being reported.

  • Funding This study was supported by a research support grant awarded by Kidney Health Australia via Australasian Kidney Trial Network (AKTN), and a Vice-Chancellors Research Award through Bond University.

  • Competing interests None declared.

  • Ethics approval This trial was approved by the Metro South Health Service District Human Research Ethics Committee (EC00167) and Bond University Human Research Ethics Committee (EC00357).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data available.