Designing an eHealth delivered nutrition education and dietary assessment programme for the PREDITION Trial (PRotEin DIet SatisfacTION)

Abstract

Background: Overconsumption of red meat has been associated with poor health consequences, likely contributing to the growing number of young New Zealand (NZ) adults eating less meat. However, emerging literature suggests a meat-free diet is not necessarily a healthy one. The Protein Diet Satisfaction (PREDITION) trial consists of four studies (i.e., Objectives) investigating the effects of moderate lean red meat consumption as part of a balanced diet; Objective 4 of the PREDITION trial is a ten-week randomised control trial where young adults (20-35 years) will follow a diet containing pasture-fed red meat or plant-based meat analogues. It is crucial to ensure participants adhere to a well-controlled diet and record their dietary intake to uphold the validity of this trial. A promising avenue to reach this target population is through electronic health (eHealth). Objectives: Develop a feasible eHealth programme for implementation in Objective 4 that aims to increase young adults’ adherence to (i) recording dietary intake, (ii) a healthy diet, and (iii) the dietary intervention. Design and Methods: Step 1 to 6 in the Nine Principles framework were followed to develop the Healthy Eating for Young Adults (HEYA) programme. Using a mixed-methods approach to data collection, the Nine Principles framework and implementation recommendations were underpinned by published literature and multiple focus groups. Results: Young NZ adults engage in multiple undesirable dietary behaviours including low consumption of fruit, vegetables and wholegrains, high intake of fast-food and sugar-sweetened beverages, irregular meals, and frequent snacking. Using the theory of planned behaviour, key barriers to target were identfied (e.g. apathy, lack of time, skills and knowledge). Thematically analysed data from an online survey of the target audience (n=47) provided the basis for first HEYA programme draft. Further qualitative data from expert focus groups (n=7) informed a second draft. This draft was then assessed by focus groups of young adults (n=8), producing a final draft HEYA programme. Conclusion: The HEYA programme components include text messages, Zoom calls, an in-person meeting, social media, emails and supporting resources. User-centred design, literature and theoretical models were used in the development of the programme to increase its efficacy. It is recommended the HEYA programme be piloted prior to implementation in Objective 4.