The effects of delivering nutrition education using the computer or Internet on what children eat 

The use of digital media and/or technology, such as computers or Internet, as an educational tool is growing. This summary of a NEL review presents what we know from research about the effects of using the computer or Internet to teach nutrition education on what children eat.

Conclusion

Moderate evidence shows that nutrition education delivered via digital media/technology may be effective for improving dietary intake-related behaviors among children and adolescents.

What the Research Says

• Twenty-one of twenty-four studies in this review found that using computer or Internet for nutrition education improved what children ate.
• Three studies did not find big differences in what children ate after using the computer or Internet to get nutrition education compared to other types of education.
• Using the computer or Internet for nutrition education has a number of benefits, especially when the education is based on theory and is given more often over longer periods of time:     
  • A wide range of children can be reached by using the computer or Internet.
  • The education provided using the computer or Internet is high quality and consistent.
• This review raised some key issues that make it harder to make stronger recommendations:     
  • There were many differences in how the studies were done.
  • Technology is rapidly changing.  
  • Using technology for nutrition education is a new concept, so more research is needed to look at long-term impacts.     
  • Keeping students interested can be hard.

Background

The use of digital media and/or technology, such as computers or Internet, for delivering education is increasing. The objective of this systematic review was to determine the effect of nutrition education delivered via digital media and/or technology on children’s and adolescents’ dietary intake-related behavior.

Conclusion Statement

Moderate evidence shows that nutrition education delivered via digital media/technology (computer- and Internet-based programs) may be effective for improving dietary intake-related behaviors among children and adolescents. 

Grade: Moderate

Methods

Literature searches were conducted using PubMed, EBSCOhost, Education Fulltext, and Global Health to identify studies that tested the effects of nutrition education delivered using some type of digital media/technology (e.g., computer, internet) on dietary-intake related outcomes.

• Inclusion criteria: published between January 1995 and December 2010; conducted in subjects aged 0–18 years; randomized controlled trials, non-randomized controlled trials, or quasi-experimental studies; subjects from countries with high or very high human development (based on the Human Development Index); subjects who were healthy or at elevated chronic disease risk; published in English in a peer-reviewed journal.
• Exclusion criteria: systematic reviews, meta-analyses, narrative reviews, or prospective cohort, cross-sectional, or case-control designs; studies with no control group; subjects hospitalized, diagnosed with disease, and/or receiving medical treatment

The results of each included study were summarized in evidence worksheets (including a study quality rating), an evidence paragraph, and evidence table. A group of subject matter experts were involved in a qualitative synthesis of the body of evidence, development of a conclusion statement, and assessment of the strength of the evidence (grade) using pre-established criteria including evaluation

Findings

• Twenty-four articles were included in this systematic review. Nineteen studies were randomized controlled trials and five were non-randomized controlled trials. Twelve studies received a positive quality rating (12 RCTs), and 12 studies received a neutral quality rating (7 RCTs, 5 non-RCTs).
• Twenty-one studies found that nutrition education delivered via digital media/technology significantly improved dietary intake-related behaviors.
  • Fifteen studies found that nutrition education delivered via digital media/technology was more effective than the no-intervention control or a comparison intervention with another type of nutrition education method.
  • Two studies found delivering nutrition education using digital media/technology or traditional methods were equally effective
  • One study found that nutrition education delivered via digital media/technology improved dietary intake, but not more than the control/comparison.
  • Two studies found that nutrition education delivered via digital media/technology improved dietary intake in girls, but not in boys.
  • One study found that nutrition education delivered via digital media/technology was effective immediately following the intervention, but not six months post-intervention.
• Three studies found no significant differences in dietary intake following nutrition education delivered via digital media/technology compared to a control or comparison intervention.

Discussion

The ability to draw strong conclusions was limited due to the following issues:

• The large degree of variation in intervention design and study characteristics
• The field of digital media/technology is rapidly evolving
• The use of digital media/technology in the field of nutrition is novel

In general, use of digital media/technology can ensure that interventions are delivered to a wide range of children in a variety of settings with high fidelity. In addition, using a theoretical framework that targets specific behaviors, and providing frequent doses of education over longer periods of time can help ensure that the intervention is successful. However, keeping students engaged is a challenge, and more research is needed to better understand the utility and effectiveness of using digital media/technology to deliver nutrition education.