Development and evaluation of educational booklet for Malaysian irritable bowel syndrome patients through need assessment

Abstract

The low Fermentable Oligo-, Di-, Mono-saccharides And Polyols (FODMAP) diet stands as a second-line dietary intervention for irritable bowel syndrome (IBS) patients. The low FODMAP diet consists of three phases which includes FODMAPs restriction, reintroduction and personalisation, and it needs to be delivered by dietitians. However, the application of this diet among Malaysian IBS patients remains poorly understood. This two-phase study aimed to develop and evaluate a low FODMAP educational booklet for Malaysian IBS patients based on need assessment. The first phase involved in-depth, semi-structured qualitative interviews with dietitians and IBS patients to understand their practices and barriers faced in delivering the diet by dietitians and implementing the low FODMAP diet by patients. This provided insights into the information needs and gaps in developing the educational booklet in the second phase. The interviews revealed significant challenges faced by both groups, including knowledge gaps among dietitians regarding the diet details, cultural disparities in available resources, and difficulties grasping the diet's complexity in patients. The practice among dietitians was not standardised whereby only experienced dietitians provided dietary advice based on evidence-based practice. Phase two focused on booklet development and evaluation of its understandability and actionability to ensure it provided accurate and useful information to the target audience. The resulting booklet, entitled “The Low FODMAP Diet Handbook: A Malaysian Guide” was created, and it encompasses a comprehensive food guide, with a list of low, medium, and high FODMAPs foods, simplified explanations of theory and the three phases of the diet, practical implementation tips, as well as modified low FODMAPs local recipes. Subsequent evaluation results affirmed the booklet's high understandability and actionability, suggesting its potential to overcome barriers related to health literacy and cultural relevance. By empowering Malaysian IBS patients with this culturally-adapted, user-friendly information educational booklet, it may enhance and facilitate the effective implementation of the low FODMAP diet in Malaysia