A Review of Factors Contributing to Adults' Adherence to Dysphagia Dietary Recommendations Through an Ecological Lens

Purpose: The purpose of this review was to identify the factors affecting adher-ence to dysphagia dietary recommendations, a necessary contributor to the effectiveness of this compensatory strategy. Method: A rapid review of two electronic databases was conducted in April 2021. Studies were included based on the following criteria: (a) were empirical studies published in English, (b) included data from the adult population, and (c) measured adherence to dietary recommendations. The ecological model and the health belief model were used as frameworks during the analysis process. Results: The literature search resulted in 930 unique abstracts, of which 14 articles were included based on the final criteria. Across the literature, multi-ple factors were identified as having an influence on adherence, classified according to three unique levels: the individual (e.g., dissatisfaction), the care-giver (e.g., knowledge), and the environment (e.g., institutional policies and values). Conclusions: Improving adherence to dysphagia dietary recommendations is crucial for the effectiveness of those recommendations. As suggested by the current review, increased adherence will require careful attention to the multiple levels of factors that likely play a role, acknowledging the multifaceted nature of this complex behavior. Furthermore, characterizing the multilevel factors that influence adherence can contribute to future theoretical models, which could help guide speech-language pathologists in their clinical practices.