Kidney Week

Abstract: PUB411

Patient Perspectives on Social Support-Related Facilitators and Barriers to Kidney Diet Adherence: A Photovoice Study

Session Information

• Publication Only

Category: Health Maintenance, Nutrition, and Metabolism

• 1500 Health Maintenance, Nutrition, and Metabolism

Authors

• Gunen, Bengucan, Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania, United States

Bengucan Gunen, MPH

• Stott, Dahlia, Drexel University College of Nursing and Health Professions, Philadelphia, Pennsylvania, United States

Dahlia Stott

• Milliron, Brandy-Joe, Drexel University College of Nursing and Health Professions, Philadelphia, Pennsylvania, United States

Brandy-Joe Milliron, PhD

• Butryn, Meghan, Drexel University College of Arts and Sciences, Philadelphia, Pennsylvania, United States

Meghan Butryn, PhD

• Harhay, Meera Nair, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States

Meera Nair Harhay, MD, MS, FASN

• Klassen, Ann Carroll, Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania, United States

Ann Carroll Klassen, PhD

Background

In the United States, 40% of adults with end stage kidney disease (ESKD) have obesity (body mass index, BMI, ≥30 kg/m²). Most ESKD patients with obesity report a desire to lose weight, whether to improve transplant eligibility or quality of life. Weight loss attempts may be complicated by requirements to limit intakes of fluid, sodium, potassium, and phosphorus, while ensuring adequate protein and fiber intake. Poor renal diet adherence (RDA) increases the risk of hospitalization and mortality. Understanding family and community support for weight loss strategies and RDA among ESKD patients with obesity can help healthcare providers better assist patients and empower individuals to meet health goals.

Methods

Using a participatory Photovoice activity (Figure), we will qualitatively examine the relationship between received and provided social support, and RDA within an ongoing prospective cohort of adults with ESKD and obesity. Photovoice is a unique qualitative methodology in which participants photograph their home and community environment and, in collaboration with the research team, interpret the images. In June-September 2024, Photovoice participants will capture prompt-based photos of meals, snacks, food preparation methods, and food consumption settings; then discuss images in individual and group interviews. Images and interview content will be coded and analyzed using MAXQDA software and interpreted with 12-month clinical data.

Results

The study will enroll 10 ESKD patients with obesity. Among participants in the parent study who are eligible for the Photovoice substudy, median age is 58, median BMI is 35.2 kg/m², 45% are female, 94% are Black/African American. We will describe patients’ attitudes towards renal dietary guidelines and how social support influences strategies used to maintain or improve RDA. Images will be interpreted and curated with input from the participants.

Conclusion

This study will produce participant-generated visuals and qualitative findings on diet-related sociobehavioral challenges experienced by ESKD patients with co-existing obesity in an urban setting, to inform obesity management and clinical nutrition care.

Figure. Steps for Photovoice activity

Funding

• NIDDK Support