P099 Collaboration Yields Evidence-Based and Stakeholder-Reviewed Online Nutrition Content for Patient Activated Learning System


      The Patient Activated Learning System (PALS) is a free web-based patient application platform designed for low literacy audiences. Evidence-based information is presented in single-objective webpages, with content ranging from pharmacological treatment to behavioral approaches to disease prevention and management. Multidisciplinary collaboration that includes nutrition education program stakeholders may benefit PALS nutrition content development.


      Pilot methods to develop and evaluate acceptability of PALS nutrition pages with a team of physicians, nutrition researchers, and Expanded Food and Nutrition Education Program (EFNEP) educators and participants.

      Study Design, Setting, Participants

      We conducted a feasibility and acceptability study with convenience samples of geographically dispersed EFNEP educators and participants in New York. We identified commonly asked cardiovascular disease (CVD) related nutrition questions using two online surveys of educators (n = 12, n = 45), then used a rapid systematic review of relevant scientific evidence and practice guidelines to generate PALS pages. We assessed page acceptability in focus groups with educators (n = 10) and interviews with participants (n = 12).

      Measurable Outcome/Analysis

      Educator-generated questions were grouped thematically, condensed, and rated based on perceived relevance. Researchers iteratively coded focus group and interview transcripts, independently summarized feedback, and met to discuss acceptability-related findings.


      Educators identified 33 common CVD-related nutrition questions; highest rated questions informed development of 4 PALS pages about coconut oil, saturated and unsaturated fat, and fiber. Educators reported the pages were clear, concise, and acceptable for educators and participants. The combination of text and figures addressed a range of learning needs, and educators appreciated the behaviorally focused content. Most EFNEP participants found the content relevant, easily digestible, and helpful. Incorporating practical information in colorful figures was particularly appealing. Participants demonstrated an understanding of the content. Most would return to PALS, citing clarity and trustworthiness of information provided.


      The multidisciplinary team successfully engaged EFNEP stakeholders in the development and review of evidence-based nutrition online information, which helped generate relevant, clear, appealing, and trustworthy content. Lessons learned can inform development of PALS content and may apply to other eHealth platforms.


      Cornell Center for Health Equity


      Supplementary data related to this article can be found at