• Juliana Chen and Margaret Allman-Farinelli.
• The University of Sydney, Charles Perkins Centre, Discipline of Nutrition and Dietetics, School of Life and Environmental Sciences, Camperdown, Australia.
• JMIR Mhealth Uhealth. 2019 Mar 4; 7 (3): e12349.

BackgroundThe use of mobile health (mHealth) apps in dietetic practice could support the delivery of nutrition care in medical nutrition therapy. However, apps are underutilized by dietitians in patient care.ObjectiveThis study aimed to determine the feasibility of an intervention consisting of education, training, and integration of apps in improving dietitians' perceived self-efficacy with using mHealth apps.MethodsPrivate practice Accredited Practising Dietitians who were not regular users or recommenders of mHealth apps were recruited into the intervention. The intervention consisted of 2 phases: (1) a workshop that incorporated an educational lecture and skill-building activities to target self-efficacy, capability, opportunity, and motivation factors and (2) a 12-week intervention phase allowing for the integration of an app into dietetic practice via an app platform. During the 12-week intervention phase, dietitians prescribed an Australian commercial nutrition app to new (intervention) patients receiving nutrition care. Existing (control) patients were also recruited to provide a measure of patient satisfaction before the apps were introduced. New patients completed their patient satisfaction surveys at the end of the 12 weeks. Usability feedback about the app and app platform was gathered from intervention patients and dietitians.ResultsA total of 5 dietitians participated in the study. On the basis of an analysis of variance with the Tukey post hoc tests, the educational and skills training workshop component of the intervention produced immediate improvements in mean ratings for dietitians' self-efficacy with using mHealth apps compared with baseline (P=.02), particularly with regard to familiarity with apps factor (P<.001). The self-efficacy factor integration into dietetic work systems achieved significant improvements from baseline to 12 weeks (P=.03). Patient satisfaction with dietetic services did not differ significantly between intervention (n=17) and control patients (n=13). Overall, dietitians and their patients indicated that they would continue using the app platform and app, respectively, and would recommend it to others. To improve usability, enhancing patient-dietitian communication mediums in the app platform and reducing the burden of entering in meals cooked at home should be considered.ConclusionsAdministering an educational and skills training workshop in conjunction with integrating an app platform into dietetic practice was a feasible method for improving the self-efficacy of dietitians toward using mHealth apps. Further translational research will be required to determine how the broader dietetic profession responds to this intervention.©Juliana Chen, Margaret Allman-Farinelli. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 04.03.2019.

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