Welch 2013.

Methods	Study design: parallel RCT; 89 assessed for eligibility, 44 randomised Study duration: 6‐week intervention Study follow‐up: 8 week follow‐up
Participants	Country: USA Setting: community, dialysis unit Patients receiving maintenance HD Number (randomised/analysed): intervention group (24/16); control group (20/17) Mean age ± SD (years): intervention group (53 ± 15.1); control group (47.1 ± 11.5) Sex (M/F): intervention group (12/12); control group (13/7) Exclusion criteria: living in an assisted or extended care facility, receiving outpatient HD on a temporary basis following a PD complication or an episode of transplant rejection, reported having no intent to comply with dietary or fluid restrictions and were receiving home HD.
Interventions	Intervention type classification: self‐monitoring eHealth intervention used: PDA application Intervention group Dietary Intake Monitoring Application (DIMA) Electronic dietary self‐monitoring app Participants trained for 2‐3 hours; used for 1 week to familiarise Participants can scan food labels, feedback screen in relation to dietary prescriptions to facilitate awareness of performance attainment, totals automatically computed Dietary and usage data downloaded at each dialysis session 24‐hour telephone number provided Control group Daily Activity Monitoring Application (DAMA) DAMA to ensure these participants got equal time as to DIMA Participants used DAMA for 1 week to familiarise; trained for 30 min Instructed to self‐monitor activity in 8 categories (walking, biking, weight lifting, shopping, yard work, childcare, housework, cooking) Selected icons representing activities and amount of time. Could view total daily activity time. Usage data downloaded every dialysis session 24 hour telephone number provided
Outcomes	Average IDWG (baseline and 6 weeks) Cardiac Diet Self‐Efficacy Instrument and Fluid Self‐Efficacy Scale (baseline, 6 weeks, 14 weeks) ‐ RAs read out questionnaires to patients Benefits of Sodium Adherence and Fluid Adherence Scale (baseline, 6 weeks, 14 weeks) ‐ RAs read out questionnaires to patients 7‐item mastery scale (baseline, 6 weeks, 14 weeks) ‐ RAs read out questionnaires to patients Dietary intake in intervention only (Week 1, week 6) ‐ Automatically computed dietary intake data based on patient recorded food items from DIMA. Summed weekly intake and then divided by number of days for which entries made Acceptability (end of study)
Notes	Dietary intake data was only recorded and reported for the intervention group Funding source: supported by grants from NIH/National Institute of Biomedical Imaging and Bioengineering (R21EB007083), a T32 Postdoctoral Training Grant (NIH T32 NR007066), and Indiana University School of Nursing Research Investment Funds
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Randomisation was blocked and stratified by dialysis unit
Allocation concealment (selection bias)	Unclear risk	Insufficient information to permit judgement
Blinding of participants and personnel (performance bias) Blinding of participants	High risk	Blinding not possible
Blinding of participants and personnel (performance bias) Blinding of personnel	High risk	No mention of blinding but likely would be broken
Blinding of outcome assessment (detection bias) Objective outcome	Low risk	Objective measures (IDWG) used
Blinding of outcome assessment (detection bias) Subjective outcomes	High risk	Participant data were collected by RAs during HD treatment. The RAs read questionnaire items for baseline and follow‐up data collections to each participant, who responded verbally to each item
Incomplete outcome data (attrition bias) All outcomes	High risk	overall attrition rate of 25% by the end of the 8‐week follow‐up. There were no statistically significant differences in age, gender, race, dialysis unit, or group between those who continued in the study and those who did not
Selective reporting (reporting bias)	Unclear risk	Insufficient information to permit judgement
Other bias	High risk	Under powered, small sample size only 2 dialysis units involved and not generalisable