Background & aims: Dietetic interventions contribute to certain health objectives and other outcomes, but are mostly part of a multimodal and multidisciplinary approach what makes evaluating the actual effects of dietitians' involvement rather complex. Although monitoring and outcome evaluation (M&OE) can provide routine data to prove the effectiveness of dietetic interventions, this has not been established yet in different dietetic settings. Methods: A comprehensive framework for M&OE in dietetics was developed by dietetic experts from five European higher education institutes for dietetics in the course of the EU sponsored project "Improvement of Education and Competences in Dietetics (IMPECD)". Results: Firstly, clear definitions on M&OE are proposed to facilitate the use of consistent terminology, with a specific emphasis on the term "impact" covering macro-level outcomes such as cost-effectiveness. Secondly, the Dietetic Care Process (DCP) was merged into a logic model to demonstrate the position of M&OE in relation to intervention planning and implementation, in both group and individual settings. Thirdly, selecting the appropriate indicators is indispensable to monitor and evaluate outcomes, and requires a high level of dietitians' critical reasoning. A categorized overview of indicators is provided to support this process. Lastly, the consortium developed a checklist to give dietitians a handle on what elements could be included in their M&OE plan and trigger them to perform M&OE in practice. Conclusions: Innovative M&OE models may help dietitians to demonstrate their effectiveness in improving clinical outcomes and justify their role in health care.

No abstract

Background Diabetes mellitus is one of the four priority non-communicable diseases worldwide. It can lead to serious long-term complications and produces significant costs. Due to the chronicle character of the disease, it requires continuous medical treatment and good therapy adherence of those suffering. Therefore, diabetes self-management education (DSME) (and support DSMES) plays a significant role to increase patient’s self-management capacity and improve diabetes therapy. Research indicates that these outcomes might be difficult to maintain. Consequently, effective strategies to preserve the positive effects of DSMES are needed. Preliminary results show that peer support, which means support from a person who has experiential knowledge of a specific behavior or stressor and similar characteristics as the target population, is associated with better outcomes in terms of HbA1c, cardiovascular disease risk factors or self-efficacy at a lower cost compared to standard therapy. Peer-supported instant messaging services (IMS) approaches have significant potential for diabetes management because support can be provided easily and prompt, is inexpensive, and needs less effort to attend compared to standard therapy. The major objective of the study is to analyze the impact of a peer-supported IMS intervention in addition to a standard diabetes therapy on the glycemic control of type 2 diabetic patients. Methods A total of 205 participants with type 2 diabetes mellitus will be included and randomly assigned to an intervention or control group. Both groups will receive standard therapy, but the intervention group will participate in the peer-supported IMS intervention, additionally. The duration of the intervention will last for 7 months, followed by a follow-up of 7 months. Biochemical, behavioral, and psychosocial parameters will be measured before, in the middle, and after the intervention as well as after the follow-up. Discussion Type 2 diabetes mellitus and other non-communicable diseases put healthcare systems worldwide to the test. Peer-supported IMS interventions in addition to standard therapy might be part of new and cost-effective approaches to support patients independent from time and place. Trial registration ClinicalTrials.govNCT04797429. Registered on 15 March 2021.

Zusammenfassung Hypertonie ist der h?ufigste und wichtigste Risikofaktor f?r Schlaganf?lle, Herz-Kreislauf- und Nierenerkrankungen. Lebensstilinterventionen werden empfohlen bei hochnormalem Blutdruck und dem Vorliegen von zumindest einem Risikofaktor f?r eine koronare Herzerkrankung sowie ab einer Hypertonie Grad 1 ohne zus?tzlichem Vorhandensein von Risikofaktoren. Di?tetisch basieren die Interventionen auf den Empfehlungen der DASH-Di?t sowie der Mediterranen Di?t. Zu empfehlen ist bei Erwachsenen eine Zufuhr von 5???6?g Kochsalz pro Tag, eine Gewichtsreduktion bei ?bergewicht und Adipositas, der moderate Konsum von Alkohol, ein vermehrter Obst- und Gem?sekonsum sowie 2???3 Portionen Milchprodukte pro Tag. Weitere Lebensstilinterventionen liegen in der regelm??igen Bewegung sowie dem Verzicht auf das Rauchen. Ein besonderer Fokus sollte in der schrittweisen Reduktion von Kochsalz liegen, um die Akzeptanz der Intervention aufgrund der ver?nderten Geschmackswahrnehmung zu erh?hen. Hinsichtlich der Gewichtsreduktion ist eine starre Makron?hrstoffverteilung nicht erforderlich, was eine hohe Flexibilit?t in der Planung der Ern?hrungstherapie f?r die Betroffenen erm?glicht. Alkohol wirkt langfristig blutdruckerh?hend und sollte daher nur in geringen Mengen von t?glich maximal 1 Glas Rotwein (125?ml) f?r Frauen und 2 Gl?sern f?r M?nner konsumiert werden. Die zugef?hrte Alkoholmenge ist dabei ausschlaggebend, nicht die Art des alkoholischen Getr?nks. Die Kombination von mehreren Interventionen ist grunds?tzlich effektiver als einzelne Ma?nahmen f?r sich. Die Herausforderung in der Ern?hrungstherapie liegt darin, mit den Betroffenen umsetzbare und realistische Ziele zu setzen, um eine langfristige Lebensstil?nderung zu unterst?tzen.