Table 5

Acceptability and feasibility of ENTICE-CKD programme at completion of phase 1 (intervention group): qualitative content analysis of semistructured interviews (n=21)

CategoryAttributesQuote
Acceptability
 Acceptable alternative to clinic
  • Overcomes clinic wait times, transport logistics.

  • Flexibility of phone call appointment times.

  • Preferred talking from a familiar environment and not feeling rushed.

  • No identified disadvantages of telehealth communication vs face-to-face.

  • Building rapport with coach.

‘At home I’m more relaxed and I have the book in front of me and I was able to jot down anything that was important, if I was at the hospital there’s so many people around and you don’t feel very relaxed, you feel like everyone is listening to your conversation, so you don’t say personal information’ Female, 69
 Preference for voice communication
  • More benefit from voice calls.

  • Frequency of fortnightly phone calls.

‘I found the calls better than the texts…they were more personable and kept me on track’ Female, 68
 Regular contact via text message
  • Text messages were an acceptable mode of communicating information.

  • Preference for receiving text messages with personal encouragement and general tips.

  • All text messages were acceptable.

We solved a lot of my little issues, and it’s given me a lot better understanding, and you know the more you think about it and communicate about it, ah the better it is’ Male, 71
 Personalised messages valued
  • Health professional expertise.

  • Usefulness of coordinated nutrition advice.

  • Removal of multiple conflicting nutrition recommendations.

It’s given me simple tasks, simple methods, or methodologies, to improve the situation, and they’re not a whole lot of gobbledygook, just basic stuff that we can understand.’ Male, 65
Feasibility
 Programme integrated into lifestyle
  • Length of phone calls easily accommodated.

  • Twelve-week telephone intervention enough time for change.

  • Self-monitoring the behaviour of choice.

As long as you’re getting information backwards and forwards, that’s the more important thing than the length of the call, it’s what you’re getting out of it’ Male, 78
 Diverse delivery modes
  • Active learning from a range of understandable delivery modes.

  • Hard copy workbook as reference tool.

  • Receiving explanations develops understanding and awareness of reasons for dietary change.

  • Quantifiable dietary recommendations (food groups, ‘good vs bad’ foods, portion sizes, sodium levels).

You’ve got to eat these foods, food groups and that, but you don’t actually know the right quantities…this program shows it to you and it’s like, it’s teaching someone how to walk again’ Male, 46
The book I think was brilliant, because you’ve got that to go back through all the time, well any time you’re doubtful you’ve got thoughts, you just look at the book, I did, I still do it’ Male, 64
 Social accountability
  • Supportive relationship with one coach allows progressive dietary change.

  • Frequent reminders and reinforcing goals.

  • Interaction with coach via text messages.

If I didn’t have the phone calls from [my coach] once a fortnight I probably wouldn’t have taken it as serious as I have’ Male, 65
‘The support, even just texting and that, it’s still, you know someone’s doing it. It’s, it just makes you feel better as a person, to know someone cares’ Male, 64
 Responding to dietary advice
  • Small changes at a time.

  • Practical strategies, manipulating environment to support behaviours, skill development (label reading).

  • Setting goals and finding satisfaction in quantifiable outcomes (eg, portion sizes, food group servings).

‘The program is delivered in segments, you’re just having a bit of information at a time, so it’s not overwhelming’ Female, 68
I was astounded at the salt content of it all, so when I read that I immediately stopped all salt that I put on my plate…I’ve not had salt since, so that was 3 months ago’ Male, 65
 Infeasible elements beyond intervention
  • Physical comorbidities a barrier for lifestyle component of programme.

  • Lack of support from others with poor understanding or low interest.

  • Unstable or unsupportive environment for creating healthy habits.

I have just been moving around a lot more and not in a stable environment of being in familiar surroundings, being unable to replicate…the menus…due to my transient nature of where I am presently’ Male, 46
  • ENTICE-CKD, Evaluation of iNdividualized Telehealth Intensive Coaching to promote healthy Eating and lifestyle in Chronic Kidney Disease.