Findings from an exploration of a social network intervention to promote diet quality and health behaviours in older adults with COPD: a feasibility study

Abstract

Background: Diet quality in older people with chronic obstructive pulmonary disease (COPD) is associated with better health and lung function. Social factors, such as social support, social networks and participation in activities, have been linked with diet quality in older age. A social network tool-GENIE (Generating Engagement in Network Involvement)-was implemented in a COPD community care context. The study aimed to assess the feasibility of the GENIE intervention to promote diet quality and other health behaviours in COPD. Methods: Twenty-two community-dwelling older adults with COPD were recruited from a local COPD service. Participants were offered usual care or the GENIE intervention. Process evaluation methods were used to assess intervention implementation, context and mechanisms of impact; these included observations of patient interactions with the intervention, documented in observational field notes and in films of a patient group discussion. Diet quality was assessed by food frequency questionnaire; 'prudent' diet scores were used to describe diet quality at baseline and at 3-month follow-up. Change in diet quality was expressed per month, from baseline to follow-up. Results: Feasibility data showed that the GENIE intervention could be implemented in this sample of community-living older people. The intervention was acceptable to clinicians and older people with COPD, especially for those with less severe disease, when facilitated appropriately and considering the levels of literacy of participants. There was no significant change in diet quality in the intervention group over the follow-up period (median change in prudent diet score per month (interquartile range (IQR), 0.03 (− 0.24-0.07)), whereas an overall fall in diet quality was observed in the control group (− 0.15 (− 0.24-0.03)). Conclusion: The process evaluation findings suggest that this intervention is feasible and acceptable to both patients and clinicians. Although the sample size achieved in this study was small, findings suggest that the intervention may have a protective effect against declines in diet quality, and other health behaviours, in an older COPD population. Findings from this feasibility study indicate that further evaluation of the GENIE intervention is warranted in a larger study, with a longer follow-up.

Social network participation towards enactment of self‐care in people with chronic obstructive pulmonary disease: A qualitative meta‐ethnography

“…The continuum can be influenced positively through peer support structures and positive social networks, but can be influenced negatively when isolated and a novice in COPD. 48 , 49 Furthermore, poor experiences and/or repetitive failures in self‐care or disease complexity can lead to dependency and fear of engagement and enactment in self‐care practices. 33 , 34 , 36 , 40 …”

“…This knowing developed from experiential constructs can, however, both positively and negatively influence participation in SSMS and relies on peer information and a wish on the part of the individual living with COPD to reduce a perceived sense of dependence 36,37,40 . Prompting the broadening of social networks, as in lay coaching, to support interpretation of symptoms and shared decision making, 40 can promote independence in people with COPD, enabled through feeling informed to make decisions about their own care, through peer discussion or valued relationships with healthcare professionals 48,49 …”

“… 36 , 37 , 40 Prompting the broadening of social networks, as in lay coaching, to support interpretation of symptoms and shared decision making, 40 can promote independence in people with COPD, enabled through feeling informed to make decisions about their own care, through peer discussion or valued relationships with healthcare professionals. 48 , 49 …”

Informing future nursing: An exploration of respiratory teaching in the pre-registration nurse curriculum

“…Similarly, there was no mention of symptom burden or management. Patients with respiratory presentations commonly present with cough, dyspnoea and fatigue, all significant manifestations that can have an impact on quality of life and daily activities (Bloom et al, 2020;Donaldson & Wedzicha, 2013). Overall, curricula appeared to lack a 'patient centred' approach to teaching and learning, more commonly focussing on pharmacology and medical management.…”

Implementing a digital tool to support meaningful engagement with socially isolated or lonely older adults

“…As GENIE has been successfully applied in Canada and the United Kingdom, it merits research to assess its feasibility in an Australian setting. GENIE has been primarily implemented as a self‐management support tool to empower individuals with long‐term conditions (Bloom et al, 2020 ; Kennedy et al, 2016 ; Valaitis et al, 2021 ; Welch et al, 2020 ). However, further research is needed to understand GENIE's potential in supporting the social engagement and well‐being of older adults.…”