{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:27:50Z","timestamp":1792787270671,"version":"4.5.0"},"reference-count":42,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T00:00:00Z","timestamp":1741564800000},"content-version":"unspecified","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"DUPR","award":["0000018830"],"award-info":[{"award-number":["0000018830"]}]},{"DOI":"10.13039\/501100001778","name":"Deakin University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001778","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,11,13]]},"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Telehealth may offer a cost-effective, accessible and convenient healthcare service model; however, the acceptability, safety and perceptions of telehealth delivered lifestyle interventions in those with non-alcoholic fatty liver disease (NAFLD) is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This was a mixed-methods evaluation of a telehealth delivered 12-week exercise, dietary support and behavioural change programme (Tele-ProEx).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting and participants<\/jats:title>\n                    <jats:p>12 adults receiving the intervention (47\u201377 years) with NAFLD living in Australia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>Participants were assessed postintervention via questionnaires to evaluate acceptability and satisfaction with the programme, usability (exercise app) and perceptions of safety. Semistructured interviews were also conducted, and qualitative thematic analysis was used to identify themes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants reported moderate to high acceptability (overall mean\u00b1SD scores out of 5: exercise programme 3.9\u00b10.5; dietary support to increase plant protein intake 4.0\u00b10.7; behavioural modification 3.6\u00b10.4). Satisfaction was high (overall mean score 3.7\u00b10.3 out of 4), the programme was perceived as safe (overall mean score, 4.4\u00b10.5 out of 5) and app usability was above average (mean score 75.6\u00b15.2 out of 100). Thematic analysis revealed participants perceived telehealth as being comparable to face-to-face interactions with health professionals. Common exercise barriers were alleviated by the personalised programme, while participants with low previous exposure to plant protein foods found the dietary recommendations challenging. Social support and engagement were deemed important for supporting motivation and adherence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In adults with NAFLD, a telehealth delivered multifaceted lifestyle programme was well accepted and perceived as safe, indicating telehealth offers a viable delivery model in this population. Key features important to participants were the personalised and flexible approach utilising engaging delivery methods that featured social support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>ACTRN12621001706864.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-086604","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T04:50:13Z","timestamp":1741755013000},"page":"e086604","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Acceptability and perceptions of a 12-week telehealth exercise programme with dietary advice to increase plant-based protein in people with non-alcoholic fatty liver disease: a programme evaluation using mixed methods"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2026-9931","authenticated-orcid":false,"given":"Christine L.","family":"Freer","sequence":"first","affiliation":[{"name":"Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1385-2371","authenticated-orcid":false,"given":"Elena S.","family":"George","sequence":"additional","affiliation":[{"name":"Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9607-202X","authenticated-orcid":false,"given":"Sze-Yen","family":"Tan","sequence":"additional","affiliation":[{"name":"Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4014-0705","authenticated-orcid":false,"given":"Gavin","family":"Abbott","sequence":"additional","affiliation":[{"name":"Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5827-1877","authenticated-orcid":false,"given":"Tonya","family":"Paris","sequence":"additional","affiliation":[{"name":"Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9897-1598","authenticated-orcid":false,"given":"Robin M.","family":"Daly","sequence":"additional","affiliation":[{"name":"Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,3,12]]},"reference":[{"key":"2025081403443444000_15.3.e086604.1","doi-asserted-by":"publisher","DOI":"10.1097\/HEP.0000000000000323"},{"key":"2025081403443444000_15.3.e086604.2","doi-asserted-by":"crossref","first-page":"1881","DOI":"10.3748\/wjg.v23.i10.1881","article-title":"Role of illness perception and self-efficacy in lifestyle modification among non-alcoholic fatty liver disease patients","volume":"23","author":"Zelber-Sagi","year":"2017","journal-title":"World J Gastroenterol"},{"key":"2025081403443444000_15.3.e086604.3","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1016\/j.jhep.2012.11.031","article-title":"Stage of change and motivation to healthier lifestyle in non-alcoholic fatty liver disease","volume":"58","author":"Centis","year":"2013","journal-title":"J Hepatol"},{"key":"2025081403443444000_15.3.e086604.4","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12038"},{"key":"2025081403443444000_15.3.e086604.5","doi-asserted-by":"crossref","unstructured":"Arredouani A . 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