Abstract
OBJECTIVES: Digital health services are used in Parkinson's disease (PD) management across many health disciplines, but not for nutrition management. The purpose of this study is to: 1) describe nutritional risk and digital competence of people with PD (PwPD) and their informal caregivers (ICG); 2) identify facilitators and barriers for using digital health to manage nutrition; 3) identify key features to include in a digital health nutrition service for PD. METHODS: We assessed 9 PwPD and their 9 ICG. Body mass index (BMI; kg/m(2)) and waist circumference were measured. Dietary Screening Tool (DST) assessed nutrition risk. Digital competence was assessed via questions adopted from the EU Wide Indicators of Digital Competence. Audio recordings from semi-structured dyadic interviews of PwPD and their ICG relating to nutrition, technology and digital health use were transcribed verbatim and coded. A > 80% agreement was achieved for each coded aim. RESULTS: 77.8% of PwPD were male, with mean age of 70.1 ± 5.1y and disease duration of 9.0 ± 5.3y. 77.8% of PwPD and 66.7% of ICG were classified overweight/obese with central obesity; there was no difference in BMI or waist circumference scores between PwPD and ICG. All participants were at possible risk or at nutrition risk (PwPD = 55.7 ± 10, ICG = 61.7 ± 6.6). 88.9% of participants owned a smartphone and 77.8% owned a tablet. All households had a computer, 4 participants had a smart watch and 2 households owned an Amazon Alexa. There was no difference in digital competence scores between PwPD (28.3 ± 11.7) and ICG (26.8 ± 14). Facilitators to using digital health nutrition services included: the convenience technology offers; knowledge acquisition; open mindedness to try new services. Barriers included: lack of access and knowledge about nutrition for PD and/or digital health products; disinterest in technology and/or nutrition; skepticism of information validity. Factors to consider when developing a digital health nutrition service include: provide specific, tailored information; delivery from a nutrition expert; involve ICG; contain a social element. CONCLUSIONS: Findings indicate PwPD and their ICG are at nutrition risk. Digital competence scores indicate comfort with some aspects of technology but PwPD and ICG will need technical support to successfully use digital health. FUNDING SOURCES: There is no external funding for this project.