Clinical Decision Support for Collaborative Diet Goal Setting in Primary Care

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In this project we will optimize and pilot test a novel clinical decision support for collaborative diet goal setting in primary care encounters at clinics serving un- and under-insured patients. Because of the strong link between diet, obesity, and chronic disease, dietary behavior change interventions are a vital component of chronic disease prevention and management. Although patients whose providers talk with them about diet and weight have more success reaching diet and weight goals, these conversations are rare. This missed opportunity is attributed to PCPs’ lack of training and time, as well as mixed attitudes, competence, and confidence about diet counseling. At the same time, even as dietary approaches for chronic disease increasingly leverage mobile applications and patient-generated data for sophisticated personalization, these interventions rely heavily on patients to collect and interpret personal data and solely address self- management for implementation of dietary behavior change goals. This makes these interventions less accessible and user-friendly for the populations who are most affected by chronic disease. In the proposed research we will refine Diet Goal Clinical Decision Support a health information technology (HIT) tool that provides PCPs with data-driven guidance for personalized, evidence-based, collaborative diet goal setting so that patients can leave their primary care encounter with the behavioral intention and goal self-efficacy necessary to initiate dietary self-management. We aim to make this collaborative goal setting feasible in primary care encounters through user-centered design to optimize both the technology and its insertion into the clinical workflow. We will also pilot test Diet Goal CDS with 20 primary care providers in federally qualified health center (FQHC) clinics to plan for a large-scale confirmatory trial. Our long-term goal is to embed Diet Goal CDS into the clinical workflow at FQHCs that serve patients from communities experiencing health disparities and simplify the collection, synthesis, and interpretation of patient-reported dietary data as easy-to- communicate diet goal options to support collaborative goal setting in primary care encounters.