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The objective of this study was to understand community-dwelling older people’s readiness for receiving telehealth by studying their intention to use videoconferencing and capacities for using digital technology in daily life as indicators. A mixed-method triangulation design was used. First, a cross-sectional survey study was performed to investigate older people’s intention to use videoconferencing, by testing our theoretical framework with a multilevel path analysis (phase 1). Second, for deeper understanding of older people’s actual use of digital technology, qualitative observations of older people executing technological tasks (eg, on a computer, cell phone) were conducted at their homes (phase 2).
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Digitally supported dietary counselling may be helpful in increasing the protein intake in combined exercise and nutritional interventions in community-dwelling older adults. To study the effect of this approach, 212 older adults (72.2 ± 6.3 years) were randomised in three groups: control, exercise, or exercise plus dietary counselling. The dietary counselling during the 6-month intervention was a blended approach of face-to-face contacts and videoconferencing, and it was discontinued for a 6-month follow-up. Dietary protein intake, sources, product groups, resulting amino acid intake, and intake per eating occasion were assessed by a 3-day dietary record. The dietary counselling group was able to increase the protein intake by 32% at 6 months, and the intake remained 16% increased at 12 months. Protein intake mainly consisted of animal protein sources: dairy products, followed by fish and meat. This resulted in significantly more intake of essential amino acids, including leucine. The protein intake was distributed evenly over the day, resulting in more meals that reached the protein and leucine targets. Digitally supported dietary counselling was effective in increasing protein intake both per meal and per day in a lifestyle intervention in community-dwelling older adults. This was predominantly achieved by consuming more animal protein sources, particularly dairy products, and especially during breakfast and lunch.
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Rationale: The dietary protein counselling of the VITAMIN trial showed to be effective in increasing the protein intake in community-dwelling older adults up to 1.41 g/kg/day after 6-months intervention and sustaining this intake up to 1.24 g/kg/day at 12-months. In this sub-analysis we determine how the increased protein intake was established. Methods: The VITAMIN (VITal AMsterdam older adults IN the city) RCT randomised older adults into: control, exercise, or exercise plus dietary counselling (protein) group. The dietary counselling intervention was blended, by use of face-to-face contacts and videoconferencing during a 6-month intervention, followed by a 6-month follow-up. Dietary intake was measured by a 3d dietary record at 0, 6 and 12 months (m). Sub-group analysis included characterisation of protein sources, product groups, resulting amino acid intake, and intake per meal moment. Linear Mixed Models were performed with SPSSv25; whereas time and time*group interaction were defined as fixed factors, and the protein group as reference.Results: In total 212 subjects were eligible for analysis (72.2 ± 6.3y), with an average protein intake at baseline of 77.8 (20) g/day and 1.08 (0.3) g/kg/day. Animal protein (g) accounted as major source (6m +25.6 (2.7) p<0.001 | 12m +15.6 (2.8) p<0.001), with the main increase in dairy products (g) (6m +14.2 (1.5) p<0.001 | 12m +10.0 (1.5) p<0.001), followed by fish and meat. This resulted in significant changes in amino acid intake: e.g. leucine (g) 6m +2.3 (0.3) p<0.001 | 12m +1.1 (0.3) p<0.001. Significant increased intake for the protein group was seen at all 6 meal moments, and particularly at breakfast (g) 6m +6.2 (1.0) p<0.001 | 12m +6.5 (1.1) p<0.001) and lunch (g) 6m +7.2 (1.3) p<0.001 | 12m +4.0 (1.3) p=0.003.Conclusions: Blended dietary counselling was effective in increasing protein intake in a lifestyle intervention in community-dwelling older adults. This was predominantly achieved by consuming more animal protein sources, particularly dairy products, and especially during breakfast and lunch. Keywords: Ageing, Behaviour change, E-health, Nutrition, Protein
De fysiotherapie staat onder toenemende druk, daarom is er een noodzaak om de zorg effectiever en efficienter in te richten. Dit project onderzoekt of de toepassing van technologieën als augmented videoconferencing (integratie van sensoren in videoconsulten) de fysiotherapiebehandeling effectiever en efficiënter kan maken.