Eat Out With KP: A Pilot to Improve the Impact of Dietary Advice for Families
Condition: Obesity
Study type: Interventional

Summary: 
      Dietary counseling at the point of purchase could improve patient adherence to dietary advice
      and downstream health outcomes. The aim of our pilot is to test the efficacy of a novel
      delivery system for dietary advice. We will study the effect of relocating family weight
      management counseling sessions into restaurants, where registered dieticians and patients
      will conduct scheduled group visits while enjoying a meal together. As with office-based
      visits, our goal is for members and their families to learn how to select food options based
      on their unique health needs, budgetary concerns, and time constraints. In contrast to a
      traditional counseling visit, however, co-dining with a dietitian will give members a
      hands-on experience designed to enhance their learning and improve adherence. The proposed
      study would build on an existing pilot of a similar program, the "KP Personal Shopper", where
      dietitian visits were conducted with individuals either in the clinic setting or while
      shopping in a grocery store.

      We will compare the new "Eat Out with Kaiser" approach to the current standard of
      clinic-based dietary and lifestyle counseling for weight management among 40 families
      affected by obesity, with the following outcomes in mind:

        1. Change in dietary measures

        2. Nutritional knowledge of families

        3. Participant self-efficacy and confidence in food purchasing decisions

        4. Participant and dietician perception of visit

      We hypothesize that, compared to clinic-based visits, our "Eat Out with Kaiser" visits will
      result in more favorable perception of the visit by both dietitian and participant, higher
      nutritional knowledge scores, higher self-efficacy and confidence of patients around food
      decisions, and larger improvements in diet components.
    

Detailed description: 
      Dietary counseling at the point of purchase could improve patient adherence to dietary advice
      and downstream health outcomes. The aim of our pilot is to test the efficacy of a novel
      delivery system for dietary advice. We will study the effect of relocating family weight
      management counseling sessions into restaurants, where registered dieticians and patients
      will conduct scheduled group visits while enjoying a meal together. As with office-based
      visits, our goal is for members and their families to learn how to select food options based
      on their unique health needs, budgetary concerns, and time constraints. In contrast to a
      traditional counseling visit, however, co-dining with a dietitian will give members a
      hands-on experience designed to enhance their learning and improve adherence. The proposed
      study would build on an existing pilot of a similar program, the "KP Personal Shopper", where
      dietitian visits were conducted with individuals either in the clinic setting or while
      shopping in a grocery store.

      Our study population will come from a local employer group, and we will use the electronic
      medical record to identify families where at least one child and one parent are affected by
      obesity. Assuming families are interested and meet eligibility criteria, they will be
      enrolled in the study.

      Our study design is a randomized trial, where randomization occurs at the unit of the family.
      45 families will be randomized into one of two arms. All families will receive a baseline 30
      minute phone call with the dietitian, followed by three in-person group visits. Those in the
      intervention (Eat Out) arm will have their in-person visits conducted during mealtimes at a
      restaurant. Those in the control (clinic) arm will have their in-person visits conducted in a
      classroom at a Kaiser medical office building.

      We will compare the new "Eat Out with Kaiser" approach to the current standard of
      clinic-based dietary and lifestyle counseling for weight management among 40 families
      affected by obesity, with the following outcomes in mind:

        1. Change in dietary measures including - Fruit and Vegetable Intake, Whole Grain Intake,
           Saturated Fat Intake and Added Sugars.

        2. Nutritional knowledge of families

        3. Participant self-efficacy and confidence in food purchasing decisions - all family
           members

        4. Participant and dietician perception of visit type (attendance, feasibility,
           effectiveness, e.g.)

      We hypothesize that, compared to clinic-based visits, our "Eat Out with Kaiser" visits will
      result in more favorable perception of the visit by both dietitian and participant, higher
      nutritional knowledge scores, higher self-efficacy and confidence of patients around food
      decisions, and larger improvements in diet components.
    

Intervention name(s): Diet/Nutrition Education
Intervention type(s): Behavioral
Intervention description(s): As described elsewhere, all participants will receive 1 phone call and 3 in person sessions with the registered dietitian.
Participants in the "clinic" arm will receive the education intervention in the clinic.
Participants in the "restaurant" arm will receive the education intervention while dining in a restaurant.
Allocation: Randomized
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Other
Keywords: Nutrition