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Exploring the Feasibility of a Digital Service to Improve Nutrition and Hydration Status of Older Adults

Not Applicable
Recruiting
Conditions
Healthy Aging
Malnutrition
Dehydration
Interventions
Device: Keep-on-Keep-Up Nutrition (KOKU-Nut)
Registration Number
NCT05943366
Lead Sponsor
Chloe French
Brief Summary

Trial Design: This is a feasibility randomised controlled trial.

Aim: The study aims to assess the feasibility of conducting a randomised controlled trial using a digital health tool (Keep-On-Keep-Up Nutrition, KOKU-Nut) to improve dietary intake in community-dwelling older adults.

Objectives:

1. Is it feasible and practical to run KOKU-Nut study as a powered randomised controlled trial.

2. Adherence to the intervention, motivations, barriers and facilitators of engaging with KOKU-Nut

Study population:

Community-dwelling adults aged 65 and older

Intervention:

Participants in the intervention group will be asked to engage with KOKU-Nut at least 3 times a week throughout the 12-week period. A crib sheet and contact details for the research team will be available if participants require additional support to help with technical issues.

Control:

Participants will continue with usual care and receive a leaflet developed by Age UK about the importance of a healthy lifestyle.

Timing and duration 3 month intervention with interviews carried out approximately one week after the intervention period

Detailed Description

Background:

Dietary patterns can play an important role in health in older age. Apps that encourage dietary change are available and commonly used in younger populations, however; few are designed for the nutritional and technical requirements of older adults. Keep-On-Keep-Up Nutrition (KOKU-Nut) is the latest development of the digital tool and includes nutritional games based on the Eatwell guide to nudge older adults to improve their diet with a specific focus on protein, fibre and fluid. The innovation process has brought together researchers, clinicians, software designers and older users to co-develop the digital tool.

In this study, researchers will test the practicality of KOKU-Nut as an intervention before further larger studies are conducted to assess it's effectiveness.

The aim of this study is to assess the feasibility of conducting a randomised controlled trial using this digital health tool (KOKU-Nut) to improve dietary intake in community-dwelling older adults. Participants will be randomised to receive usual care and an information booklet about living a healthy lifestyle or to the intervention group and asked to engage with KOKU-Nut 3 times a week for 12 weeks.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
30
Inclusion Criteria
  • Aged 65 years or older
  • Living independently in the community
  • Have access to the internet (to complete online dietary assessment)
  • Willing to use an iPad or tablet (their own or one provided) for the duration of the study
Exclusion Criteria
  • Unable to communicate in English
  • Have a known cognitive impairment

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
KOKU-NutKeep-on-Keep-Up Nutrition (KOKU-Nut)Participants will be helped to download KOKU-Nut onto their ipad or tablet during the baseline visit and will receive training. In cases where participants do not have the necessary devices or data to join the intervention, a tablet with KOKU-Nut installed will be provided for the duration of the intervention. Participants will be asked to engage with KOKU-Nut at least 3 times a week throughout the 12-week period.
Primary Outcome Measures
NameTimeMethod
Acceptability of the intervention12 weeks

A questionnaire developed by the research team along with the 11-item, 7-point modified treatment evaluation inventory. Higher scores indicate higher acceptability, with a score of 44 indicating moderate acceptability

Retention rates12 weeks

Calculated as the number of participants who completed the study divided by the number of participants randomised

Usability of the intervention12 weeks

Participants in intervention group will complete the 10-item system usability scale (SUS) to assess perceived usability of the intervention. Responses are measured on a 5-point Likert scale ranging from one (strongly disagree) to five (strongly agree). A score \>68 is considered above average usability and \>80 is considered high usability.

Recruitment rates6 months

Cumulative recruitment against target rate each month

Self-reported use of KOKU12 weeks

Participants asked about their engagement with KOKU as part of the follow up case report. Participants respond with the option that suits their use best from the following options: every day; 3-4 times a week; 1-2 times a week; once or twice a month

Acceptability of the intervention and study design12-16 weeks

This will be assessed qualitatively through semi-structured one-to-one interviews with a subset of participants

Secondary Outcome Measures
NameTimeMethod
Change in physical functionBaseline, 12 weeks

Grip strength (kg) will be assessed on a Jamar hydraulic dynamometer three times on each hand with the best score used for analysis

Change in dietary intakeBaseline, 12 weeks

Intake of food groups will be generated from a 3-day food diary inputted onto Intake24 software to identify adherence to the Eatwell guide.

Change in frailty statusBaseline, 12 weeks

Researcher will assess frailty of participants based on descriptions and images included in the clinical frailty scale. Scores range from 1 (very fit) to 9 (terminally ill) and a score 5 or more indicates frailty.

Adverse eventsFrom recruitment until study end (approximately 14 weeks)

Number of adverse events that occurred as a result of participation in the study

Risk of malnutritionBaseline, 12 weeks

The Global Leadership Initiative on Malnutrition (GLIM) diagnostic criteria will also be used to assess risk of malnutrition. Participants are assessed on 3 phenotypic criteria (non-volitional weight loss, low body mass index, and reduced muscle mass) and 2 etiologic criteria (reduced food intake or assimilation, and inflammation of disease burden). To diagnose malnutrition at least 1 phenotypic criterion and 1 etiologic criterion should be present.

Participants socio-demographic characteristicsBaseline

Age, gender, marital status, occupation, education, income, ethnicity, smoking status, use of digital technology, shopping and cooking habits.

Change in health related quality of lifeBaseline, 12 weeks

The participants perceived state of health and quality of life will be assessed using the validated EuroQol- 5 Dimension (EQ-5D-5L). The EQ-5D-5Lcomprises five questions assessing mobility, self-care, usual activities, pain or discomfort and anxiety or depression to produce an overall score representing the participant's health profile. The score ranges from one (full health) to zero (state of health equitable to death) with the option to have negative values that indicates a state of health considered to be worse than death

Change in BMIBaseline, 12 weeks

Body weight \[kg\] and height \[m\] to calculate body mass index (BMI)

Change in moodBaseline, 12 weeks

Participants will complete the 4-item Geriatric depression scale as part of the baseline and follow-up questionnaire. A cumulative scores of 0 indicates participant is not depressed, a score of 1 shows uncertainty and a score between 2 and 4 (inclusive) indicates the participant is depressed.

Trial Locations

Locations (1)

Manchester

🇬🇧

Manchester, United Kingdom

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