Moderators of nutrition education programs

When developing nutrition education programs, it may be important to think about factors that act as mediators. Mediators are factors that explain the effects of the program on what children eat. In nutrition education examples of mediators include: nutrition knowledge, self-efficacy, and attitude. This summary of a NEL evidence scan presents what we know from research about mediators of nutrition education programs.

What the Research Says

• Eight studies were included in this scan.
• We are unable to compare the results across studies because few studies analyzed these factors and the studies tested different factors and measured different outcomes.
• More research is needed to understand what factors mediate the effects of nutrition education programs.

Background

In designing nutrition education programs, it may be important to consider whether there are certain variables that could act as mediators, explaining the effects of a nutrition education intervention on children’s dietary intake. The objective of this systematic evidence scan was to examine factors that mediate the effects of nutrition education interventions on children’s and adolescents’ dietary-intake related behavior.
 

Methods

Literature searches were conducted using PubMed, EBSCOhost, Education Fulltext, and Global Health to identify studies that conducted mediator analyses related to nutrition education interventions.

• 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 review of the body of evidence and development of research recommendations. Due to the limited and disparate nature of the literature identified, conclusions were not drawn.

Findings

Eight studies were included in this systematic evidence scan; four randomized controlled trials and four non-randomized controlled trials. Five studies received a neutral quality rating (1 RCT, 4 non-RCTs), and three studies received a positive quality rating (3 RCTs)

The studies included in this systematic evidence scan examined a wide range of variables as potential mediators. Because few studies were identified that conducted mediator analyses, and each study differed in terms of the variables tested, it is difficult to compare results across studies.

Discussion

This systematic evidence scan was conducted to examine factors that mediate the effects of nutrition education interventions on children’s and adolescents’ dietary-intake related behavior. The studies identified and reviewed examined a wide range of variables as potential mediators. However, because few studies were identified that conducted mediator analyses, and each study differed in terms of the variables tested, it is difficult to compare results across studies. Therefore, a full systematic review was not conducted, and instead, a systematic evidence scan was completed. This systematic evidence scan provides an overview of existing research that addresses this topic area, and offers a series of research and systematic review recommendations for the future.