title: Using a verbal prompt to increase protein consumption in a hospital setting: a field study.
abstract: BACKGROUND
  Sufficient protein intake among hospitalized patients may contribute to faster recovery and a decrease in healthcare costs. Nevertheless, hospitalized patients are often found to consume too little protein. This field study explored the success of a small, inexpensive intervention adapted from the marketing literature, to encourage protein consumption among hospitalized patients.
  
  
  METHODS
  The study was performed at a hospital where patients order food by calling to the meal service. The intervention consisted of a verbal prompt: "Would you like some [target product] with that?", which was presented to patients by trained telephone operators, after patients finished ordering their lunch. Target products were two foods rich in protein; fruit quark and yoghurt drink. For half of the patients, the verbal prompt was preceded by verbal praise on their lunch order, which was aimed to increase compliance with the verbal prompt.
  
  
  RESULTS
  Three hundred and fifteen hospitalized patients, aged 18-87 years took part in the study. Verbal prompts significantly increased ordering of the target products nearly sevenfold (from ordering by 6.5% of patients to 45.2% of patients). Protein content of ordered lunch and all food orders of the day combined showed a trend, with orders of patients receiving only a verbal prompt or a verbal prompt and verbal praise containing a larger amount of protein than lunch orders of patients in the control condition. At an individual level, protein content of ordered food increased significantly, reaching the 25-30 g of protein per main meal recommended by dieticians of the hospital. Verbal praise did not increase compliance with the verbal prompt. Patients consumed most or all of the target product and verbal prompts were not perceived to be obtrusive.
  
  
  CONCLUSIONS
  Although changing eating patterns is challenging, this study shows that simple interventions such as verbal prompts may be useful tools for health professionals to stimulate healthy food consumption among patients during hospitalization.
authors.affiliation: Marketing and Consumer Behaviour Group, Department of Social Sciences, Wageningen University, Wageningen, The Netherlands. lotte.vanderzanden@wur.nl.
authors.forename: Lotte D T
authors.initials: LD
authors.lastname: van der Zanden
authors.affiliation: Marketing and Consumer Behaviour Group, Department of Social Sciences, Wageningen University, Wageningen, The Netherlands. harmenvanessen@gmail.com.
authors.forename: Harmen
authors.initials: H
authors.lastname: van Essen
authors.affiliation: Marketing and Consumer Behaviour Group, Department of Social Sciences, Wageningen University, Wageningen, The Netherlands. ellen.vankleef@wur.nl.
authors.forename: Ellen
authors.initials: E
authors.lastname: van Kleef
authors.affiliation: Food and Biobased Research, Consumer Science & Intelligent Systems, Wageningen University, Wageningen, The Netherlands. rene.dewijk@wur.nl.
authors.forename: René A
authors.initials: RA
authors.lastname: de Wijk
authors.affiliation: Marketing and Consumer Behaviour Group, Department of Social Sciences, Wageningen University, Wageningen, The Netherlands. hans.vantrijp@wur.nl.
authors.forename: Hans C M
authors.initials: HC
authors.lastname: van Trijp
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003463:Cues; D004044:Dietary Proteins / Q000008:administration & dosage*; D005260:Female; D005521:Food Service, Hospital; D006801:Humans; D062409:Lunch; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009426:Netherlands; D010349:Patient Compliance / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D004044:Dietary Proteins