Abstract: PUB273
Picture This Plate: Photovoice Study of Renal Dietary Adherence Among Patients on Hemodialysis with Obesity and Varying Social Support
Session Information
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
- Harhay, Meera Nair, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States
- Butryn, Meghan, Drexel University College of Arts and Sciences, Philadelphia, Pennsylvania, United States
- Milliron, Brandy-Joe, Drexel University College of Nursing and Health Professions, Philadelphia, Pennsylvania, United States
- Ghotane, Mridula C, Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania, United States
- Moore, Renee' H, Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania, United States
- Klassen, Ann Carroll, Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania, United States
Background
40% of US adults with end-stage renal disease (ESRD) have obesity (BMI ≥30 kg/m2), impacting transplant eligibility and long-term health. Renal dietary guidelines (RDG) advise patients to limit fluid, sodium, potassium, phosphorus intake while consuming adequate protein and fiber. Poor adherence to RDG may lead to hospitalization and mortality. Diet is shaped by sociobehavioral factors, yet the link between RDG adherence and social support is unclear.
Methods
In July-Nov. 2024, we recruited 10 prior participants in our completed cohort study of ESRD patients with obesity (R01DK124388) to a participatory Photovoice project in Philadelphia. Patients took guided photos of meals, food preparation methods, consumption settings. Images were interpreted with input from patients, first in individual interviews, then in focus group discussions with patients of similar age (30-39, 40-59, and 65+). Thematic analysis of images and transcripts was conducted with NVivo; findings were integrated with dietary intake, social support, 1-yr clinical data.
Results
Participants varied in age (32-72 yrs), BMI at baseline (30-42 kg/m2), Medical Outcomes Study Social Support Survey scores (17-86/100). Younger patients had an inner circle (household members, immediate relatives) aware of their dietary needs, and an outer circle (colleagues, distant relatives) that provided an escape from their ESRD patient persona. Portion-controlled packaged foods facilitated following RDG during social events (Figure). Moving near family, preparing meals in advance helped patients access instrumental support. Older patients had less social support due to retirement, death of peers, reduced mobility, health issues. Home health aides filled this gap by grocery shopping and cooking.
Conclusion
Long-term planning and instrumental social support help younger patients integrate dietary needs into social settings. Social support may influence dietary behaviors among ESRD patients.
Figure: Male patient in his 30s brings portion-packaged frozen foods to social event
Funding
- NIDDK Support