Researchers in Australia talked to 9 nutrition experts who work in rural areas to understand how they help patients prevent heart disease. They discovered that the most important things for successful online nutrition visits are building trust with patients, training doctors to use video calls well, and making sure all the healthcare team members communicate with each other. These findings will help create better online nutrition services for people living far from cities who need help managing their heart health.

The Quick Take

  • What they studied: How nutrition experts in rural Australia deliver nutrition counseling both in-person and through video calls, and what makes these services work well for preventing heart disease
  • Who participated: 9 qualified nutrition experts (called Accredited Practising Dietitians) who work in rural areas of New South Wales, Australia
  • Key finding: The most successful nutrition visits happen when doctors build strong trust with patients, get trained in video call skills, and work closely with other healthcare team members like family doctors
  • What it means for you: If you live in a rural area and need nutrition help for heart health, online visits with trained nutrition experts who understand rural healthcare may work just as well as in-person visits, especially if they’re trained in building relationships through video calls

The Research Details

Researchers conducted one-on-one interviews with 9 nutrition experts in rural New South Wales between March and April 2021. They asked detailed questions about the experts’ experiences working in rural areas, delivering nutrition advice through video calls, what makes nutrition visits successful, and how they work with other doctors. The researchers then looked for common themes and patterns in what the nutrition experts said, and used these patterns to create practical recommendations for designing better online nutrition services.

This type of research is called qualitative research, which means the researchers focused on understanding people’s experiences and opinions rather than collecting numbers or statistics. The researchers carefully analyzed the interviews to find the most important ideas and turned those ideas into actionable steps that could improve rural telehealth nutrition services.

This research approach is important because it asks the actual experts—the nutrition doctors working in rural areas—what they think works best. Rather than guessing what rural patients need, the researchers asked the professionals who see these patients every day. This makes the recommendations more practical and realistic for real-world use.

This study has some important strengths: it directly consulted with qualified nutrition experts, all 9 invited experts participated (100% participation rate), and the researchers used a systematic approach to find common themes. However, the study is small (only 9 people) and only included experts from one region of Australia, so the findings may not apply everywhere. The study was conducted in 2021, so some details about telehealth technology may have changed.

What the Results Show

The nutrition experts identified three main themes that make rural nutrition services successful. First, building trusting relationships with patients is crucial—patients need to feel comfortable and understood by their nutrition expert. Second, telehealth (video call visits) is a useful tool but requires special training; doctors need to learn how to build relationships and show they care through a screen, which is different from in-person visits. Third, teamwork matters—the nutrition expert needs to communicate well with the patient’s family doctor and other healthcare providers to provide the best care.

Based on these findings, the researchers created specific recommendations for improving rural telehealth nutrition services. These include hiring nutrition experts who actually live and work in rural areas (rather than having them travel from cities), providing training in online communication skills and video call software, offering flexible scheduling for online visits, and making sure the system helps nutrition experts and family doctors share information easily.

The experts emphasized that rural patients often have unique challenges—they may live far from specialists, have limited transportation, and have strong community connections. A successful rural nutrition service needs to understand and respect these differences.

The nutrition experts also discussed how their work helps prevent heart disease in rural communities. They noted that consistent follow-up care is important—patients benefit from regular check-ins rather than one-time visits. Additionally, the experts highlighted that rural healthcare teams are often smaller and more connected, which can be an advantage if communication systems are set up well.

This research builds on earlier studies showing that telehealth can work well for nutrition counseling. However, most previous research focused on urban areas or didn’t specifically ask rural healthcare workers what they thought. This study fills that gap by directly asking rural nutrition experts about their experiences. The findings support the idea that telehealth is effective but also show that success depends heavily on proper training and good communication systems—not just having the technology available.

This study is small with only 9 participants, all from one region of Australia, so the findings may not apply to rural areas in other countries or even other parts of Australia. The interviews were conducted in 2021, and telehealth technology has improved since then. The study only asked nutrition experts’ opinions and didn’t follow actual patients to see if the recommended changes actually improved health outcomes. Additionally, the study didn’t include perspectives from rural patients themselves or family doctors, which could provide additional important insights.

The Bottom Line

Based on this research, rural telehealth nutrition services should: (1) hire nutrition experts from rural areas when possible, (2) provide training in video call communication skills, (3) offer flexible scheduling, and (4) create systems for nutrition experts and family doctors to communicate easily. These recommendations have moderate confidence because they come directly from expert practitioners but haven’t yet been tested in actual practice.

This research is most relevant for: people living in rural areas who need nutrition help for heart disease prevention, healthcare administrators designing rural nutrition services, nutrition experts working in rural areas, and family doctors in rural communities. It’s less relevant for people living in cities with easy access to in-person nutrition services, though some recommendations (like telehealth training) could apply anywhere.

If rural telehealth nutrition services are improved based on these recommendations, patients might notice benefits within a few weeks as they become comfortable with their nutrition expert and the video call system. However, meaningful improvements in heart health typically take 3-6 months of consistent nutrition changes to become noticeable.

Want to Apply This Research?

  • Track weekly video call visits with your nutrition expert and daily adherence to nutrition recommendations (such as servings of vegetables, sodium intake, or specific heart-healthy foods). Use the app to set reminders for scheduled telehealth appointments and to log nutrition changes discussed during visits.
  • Use the app to schedule regular telehealth nutrition visits with a rural-based nutrition expert, set up automatic reminders for appointments, and create a shared nutrition plan that your family doctor can also see. This helps ensure continuity of care and keeps all your healthcare providers informed.
  • Track your comfort level with telehealth visits over time (rating from 1-10), monitor attendance at scheduled nutrition appointments, and measure progress on specific nutrition goals set with your nutrition expert. Share this data with both your nutrition expert and family doctor to ensure coordinated care.

This research describes expert opinions about designing rural telehealth nutrition services and has not yet been tested in actual practice. The findings are based on interviews with 9 nutrition experts in one region of Australia and may not apply to all rural areas or countries. This information is intended to inform healthcare service design and should not replace personalized medical advice from your doctor or nutrition expert. If you need nutrition help for heart disease prevention, consult with a qualified nutrition expert or your family doctor who can assess your individual health needs. Always discuss any major changes to your diet or health routine with your healthcare provider.