Lambert, Kelly Dr

Coeliac disease is a gastrointestinal condition managed solely through a lifelong gluten-free diet, and affects one in 70 Australians. Carefully following a gluten-free diet is crucial in preventing complications such as bowel cancer, osteoporosis and infertility. However for Australian families with a member affected by coeliac disease, the expense of a gluten-free diet is an unavoidable reality. <br /><br />In the first research of its kind in Australia, we published a study that demonstrated that families could be paying up to 17 per cent more for a gluten–free diet and for some single gluten-free items as much as 500 per cent more. The study we published compared the cost of a basket of gluten-free healthy foods, with a traditional healthy food basket, among four different family types. We found that following a healthy gluten free diet was most expensive for nuclear families, single parent families and single young males – and was even more difficult for these family types receiving welfare payments.  <br /><br />This research demonstrated that following a gluten-free diet was unaffordable for the majority of family types, and for most families receiving welfare payments in Australia. The research also documented a hefty mark-up for gluten-free staples, like bread and flour, compared with ‘regular’ foods. For example, gluten free items were between 316% (for wraps) and 574% (for flour) more expensive per 100g. <br /><br />The publicity generated by this research was extensive and generated significant discussion both online, on radio and on TV. This included discussions about the need for the federal government to consider a national subsidised medical foods program in Australia, similar to a model being used in England, so that people with coeliac disease can have better access to affordable gluten-free staple foods via prescription.

Patient education materials are widely used by health professionals to increase knowledge, facilitate behaviour change and reinforce key concepts. Unfortunately patients frequently find the patient educational materials used by dietitians to be <a href="https://www.ncbi.nlm.nih.gov/pubmed/30259677" target="_blank" rel="noopener">confusing and contradictory.</a> This has been demonstrated to be related to<a href="https://www.ncbi.nlm.nih.gov/pubmed/29061163" target="_blank" rel="noopener"> treatment adherence</a>. This is especially important given the high rates of <a href="https://www.ncbi.nlm.nih.gov/pubmed/27505310" target="_blank" rel="noopener">cognitive impairment</a> and <a href="https://www.ncbi.nlm.nih.gov/pubmed/26513027" target="_blank" rel="noopener">low health literacy </a>amongst patients seen by dietitians. <br /><br />One consequence of poorly designed patient education materials is that patients turn online to find diet information. This is problematic because the patient education materials found online are often <a href="https://www.ncbi.nlm.nih.gov/pubmed/28211108" target="_blank" rel="noopener">inaccurate </a>and not evidence based but are <a href="https://www.ncbi.nlm.nih.gov/pubmed/29056159" target="_blank" rel="noopener">highly understandable and actionable.</a><br /><br />Guidance for dietitians about how to design effective printed educational materials is<a href="https://www.ncbi.nlm.nih.gov/pubmed/29968271" target="_blank" rel="noopener"> scarce</a>. To counter this, Kelly has embarked on a program of workshops to facilitate health professionals in this area. The first presentation at the Australasian Enteral and Parenteral Annual Scientific Meeting in November 2018, was considered highly valuable and feedback from more than 240 participants was that the guidance was immediately applicable. For example: <br /><br /><em>" 3 steps to making patient education truly patient centred by Dr Kelly Lambert... was most transferable into day to day practice"</em><br /><em><br />"Kelly Lambert's talk on patient education was practical and relevant to the here and now"<br /><br />"Kelly Lambert's session on patient education and information. Absolutely brilliant re readability, actionability and understandability"<br /><br /></em>Following this, an additional workshop was held with the Nutrition Education Materials Online group in Queensland. This website is widely used by QLD health professionals and is the central portal for health professional to access consensus based accurate printed dietary education materials for use in education with patients. The event was webcast to more than 30 sites. Feedback again was highly positive. <br /><br />Another event was held in Auckland New Zealand and webcast across the country. The workshop feedback from dietitians in New Zealand was also highly positive and has led to important practice change: "<em>Our clinical lead has told the team that anyone who is working on updating or making new diet sheets for our health board needs to view this presentation as a requirement.  This was minuted in our meeting". </em>Similarly:<em> "The presentation was clear and easy to follow.  It provided great insight as to what patients may take away from the information we provide.  It also provided clear guidelines with additional resources to help improve.  This is very useful information".<br /><br /><br /> </em>The research work has contributed to the scholarly literature and provided health professionals with practical advice for developing resources and education sessions targeted at patients<em><br /></em>

<p>Using seed funding provided by the UOW Pitch competition, Kelly has developed a mobile application for people with kidney disease. The free app uses Australian food composition data and allows users to record their food intake as well as determine the energy, protein, fat, sodium, potassium, calcium and phosphate intake. The app also includes bar code scanning capabilities to enable users to analyse new foods in renal time. The app is the only one of its type available in the Australasian & Singapore app markets. It is ranked #33 in the Apple App store in the Medical app category (of which there are an estimated 47 526 apps as at January 2019). Feedback from users is overwhelmingly positive with an average rating 4.7 out of 5 stars. The app has been downloaded thousands of times.  Feasibility testing has also confirmed that use of the app enhances motivation and patient adherence to the renal diet. </p>

Coeliac disease is a gastrointestinal condition managed solely through a lifelong gluten-free diet, and affects one in 70 Australians. Carefully following a gluten-free diet is crucial in preventing complications such as bowel cancer, osteoporosis and infertility. However for Australian families with a member affected by coeliac disease, the expense of a gluten-free diet is an unavoidable reality. <br /><br />In the first research of its kind in Australia, we published a study that demonstrated that families could be paying up to 17 per cent more for a gluten–free diet and for some single gluten-free items as much as 500 per cent more. The study we published compared the cost of a basket of gluten-free healthy foods, with a traditional healthy food basket, among four different family types. We found that following a healthy gluten free diet was most expensive for nuclear families, single parent families and single young males – and was even more difficult for these family types receiving welfare payments.  <br /><br />This research demonstrated that following a gluten-free diet was unaffordable for the majority of family types, and for most families receiving welfare payments in Australia. The research also documented a hefty mark-up for gluten-free staples, like bread and flour, compared with ‘regular’ foods. For example, gluten free items were between 316% (for wraps) and 574% (for flour) more expensive per 100g. <br /><br />The publicity generated by this research was extensive and generated significant discussion both online, on radio and on TV. This included discussions about the need for the federal government to consider a national subsidised medical foods program in Australia, similar to a model being used in England, so that people with coeliac disease can have better access to affordable gluten-free staple foods via prescription.

Patient education materials are widely used by health professionals to increase knowledge, facilitate behaviour change and reinforce key concepts. Unfortunately patients frequently find the patient educational materials used by dietitians to be <a href="https://www.ncbi.nlm.nih.gov/pubmed/30259677" target="_blank" rel="noopener">confusing and contradictory.</a> This has been demonstrated to be related to<a href="https://www.ncbi.nlm.nih.gov/pubmed/29061163" target="_blank" rel="noopener"> treatment adherence</a>. This is especially important given the high rates of <a href="https://www.ncbi.nlm.nih.gov/pubmed/27505310" target="_blank" rel="noopener">cognitive impairment</a> and <a href="https://www.ncbi.nlm.nih.gov/pubmed/26513027" target="_blank" rel="noopener">low health literacy </a>amongst patients seen by dietitians. <br /><br />One consequence of poorly designed patient education materials is that patients turn online to find diet information. This is problematic because the patient education materials found online are often <a href="https://www.ncbi.nlm.nih.gov/pubmed/28211108" target="_blank" rel="noopener">inaccurate </a>and not evidence based but are <a href="https://www.ncbi.nlm.nih.gov/pubmed/29056159" target="_blank" rel="noopener">highly understandable and actionable.</a><br /><br />Guidance for dietitians about how to design effective printed educational materials is<a href="https://www.ncbi.nlm.nih.gov/pubmed/29968271" target="_blank" rel="noopener"> scarce</a>. To counter this, Kelly has embarked on a program of workshops to facilitate health professionals in this area. The first presentation at the Australasian Enteral and Parenteral Annual Scientific Meeting in November 2018, was considered highly valuable and feedback from more than 240 participants was that the guidance was immediately applicable. For example: <br /><br /><em>" 3 steps to making patient education truly patient centred by Dr Kelly Lambert... was most transferable into day to day practice"</em><br /><em><br />"Kelly Lambert's talk on patient education was practical and relevant to the here and now"<br /><br />"Kelly Lambert's session on patient education and information. Absolutely brilliant re readability, actionability and understandability"<br /><br /></em>Following this, an additional workshop was held with the Nutrition Education Materials Online group in Queensland. This website is widely used by QLD health professionals and is the central portal for health professional to access consensus based accurate printed dietary education materials for use in education with patients. The event was webcast to more than 30 sites. Feedback again was highly positive. <br /><br />Another event was held in Auckland New Zealand and webcast across the country. The workshop feedback from dietitians in New Zealand was also highly positive and has led to important practice change: "<em>Our clinical lead has told the team that anyone who is working on updating or making new diet sheets for our health board needs to view this presentation as a requirement.  This was minuted in our meeting". </em>Similarly:<em> "The presentation was clear and easy to follow.  It provided great insight as to what patients may take away from the information we provide.  It also provided clear guidelines with additional resources to help improve.  This is very useful information".<br /><br /><br /> </em>The research work has contributed to the scholarly literature and provided health professionals with practical advice for developing resources and education sessions targeted at patients<em><br /></em>

<p>Using seed funding provided by the UOW Pitch competition, Kelly has developed a mobile application for people with kidney disease. The free app uses Australian food composition data and allows users to record their food intake as well as determine the energy, protein, fat, sodium, potassium, calcium and phosphate intake. The app also includes bar code scanning capabilities to enable users to analyse new foods in renal time. The app is the only one of its type available in the Australasian & Singapore app markets. It is ranked #33 in the Apple App store in the Medical app category (of which there are an estimated 47 526 apps as at January 2019). Feedback from users is overwhelmingly positive with an average rating 4.7 out of 5 stars. The app has been downloaded thousands of times.  Feasibility testing has also confirmed that use of the app enhances motivation and patient adherence to the renal diet. </p>