JMIR Publications

ABSTRACT

Background:

eHealth and virtual service delivery became increasingly commonplace during the COVID-19 pandemic. Digital interventions may be highly appealing to youth, yet their effectiveness, compared to usual face-to-face interventions is unknown. As nutrition interventions merge into the digital world, there is a need to determine best practices for digital interventions for children.

Objective:

Examine the effectiveness of digital nutrition interventions for children on dietary outcomes compared to status-quo interventions (e.g., conventional face-to-face programming or non-digital supports)

Methods:

Umbrella review – systematic reviews of studies of digital interventions aimed at improving food and nutrition outcomes for children under 18 years of age compared to conventional nutrition education were eligible for inclusion.

Results:

Eleven systematic reviews were included (7 of moderate quality), published since 2015. Digital interventions ranged from internet, computer, or mobile interventions, and included websites, programs, applications, email, videos, CD-ROMs, games, telehealth, short message service, and social media, or a combination thereof. The dose and duration of interventions varied widely (single to multiple exposures; 1 minute to 1 hour). Many studies were informed by theory or used behavior change techniques (e.g., feedback, goal setting, tailoring). The effect of digital nutrition interventions for children on dietary outcomes is small and inconsistent. Digital intervention seemed to be most promising for improving fruit and vegetable intake, however many reviews found mixed results.

Conclusions:

Due to heterogeneity of digital interventions, duration of interventions, follow-up evaluations, comparison groups, and outcomes measured, the effectiveness of these interventions remains unclear. High quality evidence with common definitions for digital intervention types evaluated with validated measures is needed to improve the state of evidence to inform policy and program decision for health promotion in children. Now is the time for critical robust evaluation of adopted digital interventions during and after the COVID-19 pandemic to establish best practices for health eating interventions for children.