HEALTH TECHNOLOGIES AND INCLUSIVE NUTRITIONAL CARE: DEVELOPMENT AND APPLICATIONS OF STRATEGIES FOR VULNERABLE POPULATIONS
Digital Health; Deglutition Disorders; Nutrition Therapy; Health Literacy;
Nutritional care for populations experiencing clinical and functional vulnerability poses challenges that extend beyond the scope of conventional care approaches. In the context of oropharyngeal dysphagia, rare neuromuscular diseases, and disability, there is a clear insufficiency in both the availability of assessment instruments and validated intervention strategies, compromising the quality and equity of care delivery. The overall objective of this thesis was to develop and evaluate health technologies and inclusive nutritional care strategies aimed at promoting accessibility, autonomy, and food safety among vulnerable populations. Seven scientific products were developed: (1) the development and content validation of web stories and evaluative questionnaires for identifying food consistency levels according to the International Dysphagia Diet Standardisation Initiative framework; (2) a photographic e-book on food consistencies based on the same framework; (3) a pragmatic randomized clinical trial protocol registered in the Brazilian Registry of Clinical Trials; (4) a pragmatic randomized clinical trial evaluating the effectiveness of quick response (QR) codes with audio narration and web stories in improving knowledge of food consistency levels among individuals with dysphagia; (5) a scoping review protocol on the use of digital technologies in the nutritional management of dysphagia, developed in accordance with the Joanna Briggs Institute methodology; (6) a study evaluating the accuracy of photographic food records among individuals with visual impairment; and (7) a quasi-experimental study investigating the effects of oral zinc supplementation on bone and serum parameters in patients with Duchenne Muscular Dystrophy. The findings demonstrated that web stories with audio narration were superior to conventional printed materials in dysphagia management, that photographic food records constituted a feasible method for dietary intake assessment among individuals with visual impairment, and that zinc supplementation influenced bone and biochemical parameters in Duchenne Muscular Dystrophy. Collectively, the products developed contribute to the advancement of more inclusive, accessible, and person-centered models of nutritional care for vulnerable populations.