Adherence to the hemodialysis (HD) diet is difficult for patients with renal failure due to their anorexia and the complicated nature of the dietary regimen. Few studies have been done in this area. No studies were found in the literature in which a PDA was used with patients for self-monitored dietary management. The purpose of this study was to develop and pilot test a 4-month adherence enhancement program (BalanceWise) based on Social Cognitive Theory (SCT) to enhance adherence to the dietary regimen. Verbal persuasion, mastery, stepped goals, self-monitoring, and problem solving were major focal points of BalanceWise. The intervention also included computer-based instruction regarding the HD diet and dietary self-monitoring using a personal digital assistant (PDA) containing the BalanceLog„µ Program. A small cohort of individuals (n=7) on maintenance hemodialysis, from one dialysis clinic in Southwestern Pennsylvania was recruited to the study. Participants were included if they: were > 18 years of age, had been receiving dialysis for > 3 months, planned on remaining at the clinic for an 8 month period and were not scheduled to receive a living related donor transplant. Exclusionary criteria included: diagnosis with terminal illness, and significant cognitive impairment as determined by staff RN or dietician. Outcome measures included: nutritional adherence as measured by the Nutrition Data System, a variety of serum laboratory measures of nutritional status, % of body fat measured by bioelectrical impedance analysis, and an investigator-developed self-efficacy scale. Covariates, including cognitive function, locus of control, comorbidity, knowledge of the HD diet, and social support were also measured. This presentation will describe the development and implementation of the intervention, and present baseline descriptive statistics.
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