Successful treatment of hemodialysis patients depends upon their ability to self-monitor complex and restrictive dietary and fluid regimens. Patients, however, are given few tools to help them track or record their dietary and fluid intake and often are nonadherent. Only a few studies have been conducted to promote adherence to dietary and fluid restrictions in this population and often this research was not theory-based or easily applied to practice. The central aims of the proposed study, based on Bandura's social-cognitive theory, are to develop and pilot test an electronic self-monitoring intervention designed to promote adherence to dietary and fluid restrictions in hemodialysis patients. Once developed, the intervention will be pilot tested for effectiveness and usability by hemodialysis patients in the practice setting. The duration of the proposed study is 2 years. During year 1, we will iteratively develop the computer program and graphical interface using the participatory design approach. During year 2 we will pilot test the effectiveness and assess the usability of the electronic system. During the pilot study, a sample of 20 individuals will electronically self-monitor diet and fluid intake for 6 weeks using a PDA and an incorporated Universal-Product-Code scanner; an additional 20 attention control participants will receive usual care. We will collect dietary and fluid intake data throughout the self-monitoring period. We will collect interdialytic weight gain data 2 weeks before baseline data collection and continue throughout the study to determine overall effectiveness. Data related to the mediating variables will be collected at baseline, at the end of selfmonitoring, and 8 weeks after self-monitoring to determine the influence of self-monitoring on these variables. Parametric statistical methods will be used to analyze data. This study is the first step in the development of an electronic self-monitoring system that has the potential for improving quality of life in these patients and decreasing costs associated with costly emergency room visits or extra dialysis sessions resulting from dietary or fluid nonadherence. Data from this study will be used in developing a large randomized controlled trial to evaluate the intervention's effectiveness. ? ?

National Institute of Health (NIH)
National Institute of Biomedical Imaging and Bioengineering (NIBIB)
Exploratory/Developmental Grants (R21)
Project #
Application #
Study Section
Special Emphasis Panel (ZLM1-HS-R (O1))
Program Officer
Peng, Grace
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Indiana University-Purdue University at Indianapolis
Schools of Nursing
United States
Zip Code
Welch, Janet L; Astroth, Kim Schafer; Perkins, Susan M et al. (2013) Using a mobile application to self-monitor diet and fluid intake among adults receiving hemodialysis. Res Nurs Health 36:284-98
Chaudry, Beenish Moalla; Connelly, Kay; Siek, Katie A et al. (2013) Formative evaluation of a mobile liquid portion size estimation interface for people with varying literacy skills. J Ambient Intell Humaniz Comput 4:779-789
Connelly, Kay; Siek, Katie A; Chaudry, Beenish et al. (2012) An offline mobile nutrition monitoring intervention for varying-literacy patients receiving hemodialysis: a pilot study examining usage and usability. J Am Med Inform Assoc 19:705-12
Chaudry, Beenish; Connelly, Kay; Siek, Katie A et al. (2011) The Design of a Mobile Portion Size Estimation Interface for a Low Literacy Population. Int Conf Pervasive Comput Technol Healthc :160-167
Welch, Janet L; Siek, Katie A; Connelly, Kay H et al. (2010) Merging health literacy with computer technology: self-managing diet and fluid intake among adult hemodialysis patients. Patient Educ Couns 79:192-8