BackgroundInteractive multimedia is an emerging technology that is being used to facilitate interactions between patients and health professionals. The purpose of this review was to identify and evaluate the impact of multimedia interventions (MIs), delivered in the context of paediatric healthcare, in order to inform the development of a MI to promote the communication of dietetic messages with overweight preadolescent children. Of particular interest were the effects of these MIs on child engagement and participation in treatment, and the subsequent effect on health-related treatment outcomes.MethodsAn extensive search of 12 bibliographic databases was conducted in April 2012. Studies were included if: one or more child-participant was 7 to 11-years-of-age; a MI was used to improve health-related behaviour; child-participants were diagnosed with a health condition and were receiving treatment for that condition at the time of the study. Data describing study characteristics and intervention effects on communication, satisfaction, knowledge acquisition, changes in self-efficacy, healthcare utilisation, and health outcomes were extracted and summarised using qualitative and quantitative methods.ResultsA total of 14 controlled trials, published between 1997 and 2006 met the selection criteria. Several MIs had the capacity to facilitate engagement between the child and a clinician, but only one sought to utilise the MI to improve communication between the child and health professional. In spite of concerns over the quality of some studies and small study populations, MIs were found useful in educating children about their health, and they demonstrated potential to improve children’s health-related self-efficacy, which could make them more able partners in face-to-face communications with health professionals.ConclusionsThe findings of this review suggest that MIs have the capacity to support preadolescent child-clinician communication, but further research in this field is needed. Particular attention should be given to designing appropriate MIs that are clinically relevant.

BackgroundAlthough traffic light labelling (TLL) is designed to aid the selection of healthier choices, consumers often have to make trade‐offs between (un)desirable attributes. With the current emphasis of public health on sugar reduction, the present study aimed to investigate the relative influence of sugar on the perceived healthiness of products.MethodsA choice‐based conjoint analysis (CBC) survey was designed to assess the relative importance of the macronutrients commonly used in TLL, as well as the rescaled utilities of three attribute levels (red, amber and green), which involved 858 participants aged ≥18 years, who were recruited from the general population of Nottingham. An additional cross‐sectional online survey was completed by another 901 participants to assess public knowledge about the intake recommendations underpinning the TLL.ResultsUsable data for CBC analysis showed that, when deciding upon the healthiness of items, sugar was significantly the most important macronutrient (mean 0.34, 95% confidence interval = 0.32–0.35) among the 641 participants. Red labelling was significantly more influential than green across macronutrients. In the substudy, 13.3% of participants correctly identify the maximum recommended intake of free sugars. Moreover, 42.8% of the total sample could not identify whether the sugar information on TLL refers to the total or free sugar content.ConclusionsDespite a lack of knowledge about the recommendations underpinning the TLL criteria, decisions made by participants concerning the healthfulness of food products were significantly influenced by sugar content. TLL appears to guide consumer beliefs in the absence of deep knowledge. The dominance of sugar in decision making is unsurprising in the current public health climate.

Background: There are calls to enhance existing child weight management interventions and to develop new treatment approaches. The potential for interactive electronic resources (e-resources) to support child-dietitian communication has yet to be explored. Towards developing such a tool, the present study aimed to understand dietetic attitudes and approaches to communicating with preadolescent overweight children in individual consultations to support behaviour change. Methods: A purposive sample of 18 dietitians, providing weight management advice to overweight 7-11-year-old children, took part in the study. Individual semi-structured telephone interviews were conducted. Data were transcribed and then analysed using inductive thematic analysis. Content analysis was used to interpret dietetic attitude towards e-resources. Results: Six overarching themes were identified describing dietitians' views: the complexity of treating childhood obesity, the strategic balance of dietetic communication focus between child and parent, the child's capacity to communicate affecting their contribution, dietetic approaches to verbal child communication and the features of resources that can support them, as well as dietetic expectations for resources. Independent inter-rater agreement for the themes was 76.9% and 73.1%, respectively. The majority of dietitians (n = 13) supported the concept of introducing an interactive multimedia eresource into child weight management consultations. Conclusions: Most dietitians sought to engage the preadolescent child in the consultation, using dietetic visual aids to complement verbal strategies and to serve as scaffolding for the conversation. There is scope for interactive e-resources to enhance communication, provided that they are flexibly tailored to meet the needs of the dietitian and the overweight child.