Eat Out With KP: A Pilot to Improve the Impact of Dietary Advice for Families

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.

Study Overview

• Status: Completed
• Conditions: Obesity
• Intervention / Treatment: Behavioral: Diet/Nutrition Education

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.

• Study Type: Interventional
• Enrollment (Actual): 94
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Georgia
    • Atlanta, Georgia, United States, 30305
      • Kaiser Permanente Center for Health Research, Southeast

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 8 years to 64 years (Child, Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• adult member of Kaiser Georgia, in a specific employer group
• families in which at least one parent and one child are obese
• family with 2 or fewer children all between 8-13 years of age
• no-show rate for clinic visits <10%
• adult is 18-64 years of age

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Clinic-based counseling; Participants in this arm will receive 1 baseline phone call with the registered dietitian to get preliminary dietary counseling tailored to their family's needs. They will then have 3 sessions in-person in a group setting with another family and the registered dietitian where a set dietary curriculum geared at promoting weight loss and/or maintenance of a healthy weight will be emphasized. All in-person visits will take place in the clinic setting.	Behavioral: Diet/Nutrition Education; 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.
Experimental: Restaurant-based counseling; Participants in this arm will receive 1 baseline phone call with the registered dietitian to get preliminary dietary counseling tailored to their family's needs. They will then have 3 sessions in-person in a group setting with another family and the registered dietitian where a set dietary curriculum geared at promoting weight loss and/or maintenance of a healthy weight will be emphasized. All in-person visits will take place in a restaurant, while dining.	Behavioral: Diet/Nutrition Education; 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.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Fruit and Vegetable Intake	Will be measured in one parent and one child per enrolled family using the Block food screeners for adults and children.	3 months
Change in Whole Grain Intake	Will be measured in one parent and one child per enrolled family using the Block food screeners for adults and children.	3 months
Change in Saturated Fat Intake	Will be measured in one parent and one child per enrolled family using the Block food screeners for adults and children.	3 months
Change in Added Sugars Intake	Will be measured in one parent and one child per enrolled family using the Block food screeners for adults and children.	3 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Nutritional Knowledge of Families	Will be assessed using a modified version of previously validated nutritional knowledge from the UK. Total possible score of 65 points. Covers topics such as recommendations from experts, types of fat, foods high in sodium, added sugar, fiber and fat.	3 months
Self-efficacy around food purchasing and dietary decisions	Will be assessed using a series of questions about how confident a participant feels about his / her ability to change food and dietary behaviors in the near future. Paper survey to be administered to one adult per participating family.	3 months

Collaborators and Investigators

• Sponsor: Kaiser Permanente
• Investigators: Principal Investigator: Kristina H Lewis, MD MPH SM, Kaiser Permanente

Study record dates

Study Major Dates

• Study Start: May 1, 2014
• Primary Completion (Actual): October 1, 2014
• Study Completion (Actual): December 1, 2014

Study Registration Dates

• First Submitted: April 24, 2014
• First Submitted That Met QC Criteria: April 24, 2014
• First Posted (Estimate): April 28, 2014

Study Record Updates

• Last Update Posted (Actual): August 18, 2017
• Last Update Submitted That Met QC Criteria: August 15, 2017
• Last Verified: August 1, 2017

More Information

Terms related to this study

• Keywords: Nutrition
• Other Study ID Numbers: Pro00004774