  Background Multiple sclerosis (MS) is a complex immune-mediated disease with
no currently known cure. There is growing evidence to support the role of diet
in reducing some of the symptoms and disease progression in MS, and we
previously developed and tested the feasibility of a digital nutrition
education program for people with MS. Objective The aim of this study was to
explore factors that influenced engagement in the digital nutrition education
program, including features influencing capability, opportunity, and motivation
to change their dietary behaviours. Methods Semi-structured interviews were
conducted with people who MS who completed some or all of the program, until
data saturation was reached. Interviews were analysed inductively using
thematic analysis. Themes were deductively mapped against the COM-B behaviour
change model. Results 16 interviews were conducted with participants who
completed all (n=10) or some of the program (n=6). Four themes emerged: 1)
Acquiring and validating nutrition knowledge; 2) Influence of time and social
support; 3) Getting in early to improve health; and 4) Accounting for food
literacy experiences. Discussion This is the first online nutrition program
with suitable behavioural supports for people with MS. It highlights the
importance of disease-specific and evidence-based nutrition education to
support people with MS to make dietary changes. Acquiring nutrition knowledge,
coupled with practical support mechanisms such as recipe booklets and
goal-setting, emerged as crucial for facilitating engagement with the program.
Conclusions When designing education programs for people with MS and other
neurological conditions, healthcare professionals and program designers should
consider flexible delivery and building peer support to address the needs and
challenges faced by participants.
