Implementation of a multicomponent telemonitoring intervention to improve nutritional status of community-dwelling older adults: a process evaluation.
OBJECTIVE
The present study aimed to conduct a process evaluation of a multicomponent nutritional telemonitoring intervention implemented among Dutch community-dwelling older adults.


DESIGN
A mixed-methods approach was employed, guided by the process evaluation framework of the Medical Research Council and the Unified Theory of Acceptance and Use of Technology. The process indicators reach, dose, fidelity and acceptability were measured at several time points within the 6-month intervention among participants and/or nurses.


SETTING
The intervention was implemented in the context of two care organisations in the Netherlands.


SUBJECTS
In total, ninety-seven participants (average age 78 years) participated in the intervention and eight nurses were involved in implementation.


RESULTS
About 80 % of participants completed the intervention. Dropouts were significantly older, had worse cognitive and physical functioning, and were more care-dependent. The intervention was largely implemented as intended and received well by participants (satisfaction score 4·1, scale 1-5), but less well by nurses (satisfaction score 3·5, scale 1-5). Participants adhered better to weight telemonitoring than to telemonitoring by means of questionnaires, for which half the participants needed help. Intention to use the intervention was predicted by performance expectancy (β=0·40; 95 % CI 0·13, 0·67) and social influence (β=0·17; 95 % CI 0·00, 0·34). No association between process indicators and intervention outcomes was found.


CONCLUSIONS
This process evaluation showed that nutritional telemonitoring among older adults is feasible and accepted by older adults, but nurses' satisfaction should be improved. The study provided relevant insights for future development and implementation of eHealth interventions among older adults.
['van Doorn-van Atten|Marije N|MN|', 'de Groot|Lisette Cpgm|LC|', 'Romea|Albert Collet|AC|', 'Schwartz|Simon|S|', 'de Vries|Jeanne Hm|JH|', 'Haveman-Nies|Annemien|A|']
D000368:Aged D000072001:Diet, Healthy D005240:Feasibility Studies D005260:Female D006266:Health Education D006284:Health Plan Implementation D006801:Humans D057187:Independent Living D008297:Male D009426:Netherlands D015596:Nutrition Assessment D009752:Nutritional Status D017064:Process Assessment, Health Care D017216:Telemedicine
Telemonitoring Older adults Implementation research Undernutrition