Effects of an Individualized Dietary Counseling Program on Health Literacy, Dietary Self-efficacy, and Dietary Adherence in Patients with Chronic Kidney Disease.

OBJECTIVE

To examine the effects of an individualized dietary counseling program informed by health literacy theory in a pilot study of Chinese patients with chronic kidney disease (CKD).

METHODS

Randomized controlled trial. Sixty adult hospitalized patients with stage 1-4 nondialysis-dependent CKD, mean age 36.6±12.3 years, were randomly assigned to the intervention group that received a 3-month individualized dietary counseling or the control group receiving enhanced usual care, with outcomes assessed at baseline (T0), discharge (T1), 1 month (T2), and 3 months (T3).

MAIN OUTCOME MEASURES: Health literacy (assessed at T0, T2, T3), dietary self-efficacy (assessed at T0, T1, T2, T3), and dietary adherence (assessed at T0, T2, T3).

ANALYSIS: Intervention effects on outcomes over time were evaluated using generalized estimating equations.

RESULTS

Compared with enhanced usual care, patients receiving the intervention program had a significantly greater increase in health literacy at T2 and T3; dietary self-efficacy at T1, T2, and T3; and better self-reported dietary behaviors at T2 and T3 from baseline. However, there was no significant difference in adherence to recommended nutrients intake, as assessed by 24-hour dietary recall, between the 2 groups at T2 and T3.

CONCLUSIONS AND IMPLICATIONS: This health literacy-informed program offers promise for promoting the well-being of Chinese patients with CKD, although confirmation in fully powered trials is recommended before widespread adoption.