Development of Telenutrition Education and Counseling Protocol to Improve Diet Quality in Individuals With Spinal...

Cardiometabolic disease (CMD) is a leading cause of death for individuals living with chronic spinal cord injury (SCI), with a mortality rate due to CMD being higher than individuals without SCI. Telenutrition (TN) interventions tailored to health and accessibility needs of individuals with SCI may mitigate cardiometabolic risks.

To describe the development and validation of a telehealth-based medical nutrition therapy (MNT) within a clinical trial investigating the effectiveness of modifying diets to improve cardiometabolic health in persons with chronic SCI.

The adaptive module-based MNT education content was developed in 3 phases by a multidisciplinary team. The first phase entailed a literature review of SCI-specific clinical practice guidelines for CMD prevention for setting dietary goals. Phase 2 included the development of a framework for presenting the intervention components. The third phase focused on validating the readability and quality of the materials. The intervention and education content were designed to be delivered as part of an ongoing prospective, 1:1 block randomized, wait-list controlled clinical trial among individuals with SCI living in the community. The TN counseling was designed to be delivered over a 3-month period, on a bimonthly basis through videoconferencing by a dietitian specialized in SCI. Diet quality across assessments is measured by the Healthy Eating Index, and dietary changes will be assessed at the conclusion of the ongoing clinical trial.

The developed education content from this SCI-specific, evidence-based MNT intervention can be readily adapted in other research and clinical settings.