Evaluating the Impact of a Health Literacy Intervention on the Quality of Dietetic Communication in Outpatient Kidney Care.

INTRODUCTION

Effective communication between patients and health professionals is essential in chronic disease management. In the context of conditions like chronic kidney disease this is especially critical given the complexity of dietary advice that may be required. The technical quality of dietetic communication in nephrology settings remains underexplored. This study evaluated the technical quality of dietetic communication in renal outpatient clinics and assessed changes in communication following implementation of a health literacy intervention.

METHODS

This secondary analysis utilised audio recordings from a quasi-experimental pre-post study conducted in three outpatient kidney clinics. The health literacy sensitive intervention included teachback, use of a renal diet-specific question prompt sheet (QPS), and plain English dietary education resources. Paired consultations (initial and review) were assessed using the validated DIET-COMMS tool with scores converted to percentages and classified as poor (< 40%), average (41%-75%), or good (> 75%).

RESULTS

Fifty-four appointments from 27 participants were analysed. The mean DIET-COMMS score was 80.9% (SD 10.2), with 81.5% of consultations demonstrating high-quality communication. No significant changes in DIET-COMMS scores were observed between pre- and post-intervention groups, appointment types, or dietitian experience levels. However, appointments using both teachback and QPS achieved the highest mean scores (86.0%). Notably, active listening and interview structure scores declined post-intervention, while provision of condition-specific dietary information improved.

DISCUSSION: The intervention did not result in further increases in overall communication scores from baseline but influenced specific communication behaviours. The decline in active listening may reflect increased cognitive load or altered consultation flow due to prompt sheet use. Combined use of teachback and the QPS shows promise for enhancing communication quality.

CONCLUSION

Dietitians in nephrology outpatient settings generally demonstrate high-quality communication. Targeted interventions can influence specific communication behaviours, highlighting the need for ongoing training and structured tools to support effective, patient-centred care.