A systematic evaluation of digital nutrition promotion websites and apps for supporting parents to influence children’s nutrition

Abstract

Background: Globally children's diet quality is poor. Parents are primary gatekeepers to children's food intake; however, reaching and engaging parents in nutrition promotion can be challenging. With growth in internet and smartphone use, digital platforms provide potential to disseminate information rapidly to many people. The objectives of this review were to conduct a comprehensive and systematic evaluation of nutrition promotion via websites and apps supporting parents to influence children's nutrition, from three different perspectives: 1) current evidence base, 2) end user (parent) experience and 3) current commercial offerings. Methods: Three systematic reviews were undertaken of (1) studies evaluating the effectiveness for digital platforms for improving nutrition in children and parents, (2) studies conducting user-testing of digital tools with parents, (3) websites and apps providing lunch-provision information to parents. Searches were conducted in five databases for reviews one and two, and systematic search of Google and App Store for review three. Randomised controlled trials, cohort and cross-sectional and qualitative studies (study two only) were included if published in English, from 2013, with the intervention targeted at parents and at least 50% of intervention content focused on nutrition. Search results were double screened, with data extracted into standardised spreadsheets and quality appraisal of included search results. Results: Studies evaluating digital nutrition interventions targeting parents (n = 11) demonstrated effectiveness for improving nutrition outcomes, self-efficacy and knowledge. Six of the included randomised controlled trials reported digital interventions to be equal to, or better than comparison groups. User-testing studies (n = 9) identified that digital platforms should include both informative content and interactive features. Parents wanted evidence-based information from credible sources, practical tools, engaging content and connection with other users and health professionals. Websites targeting lunch provision (n = 15) were developed primarily by credible sources and included information-based content consistent with dietary guidelines and limited interactive features. Lunchbox apps (n = 6), developed mostly by commercial organisations, were more interactive but provided less credible information.(Continued on next page)

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“…The top reasons parents gave for not attending the lessons was lack of transportation and not having enough time. Other school-based interventions have shown success with delivering parental nutrition education through telephone counseling [ 66 ], text messaging [ 67 ], websites [ 68 ], family-fun nights [ 69 ], or newsletters/home assignments [ 43 ]. However, parental reach in these types of studies is unclear.…”

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“…Further, it will encourage the use of the intervention home-use materials and facilitate interaction among participants. According to a recent review by Zarnowiecki et al [ 37 ], content should be specific and relevant, such as serving sizes for different ages, and relevant for all family members, especially the child (e.g., appropriate recipes). Moreover, affirming content will be given, rather than negative content (e.g., avoiding a weight management focus or shaming).…”

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“…Awareness is difficult to quantify especially on social media, however the growth in reach and engagement across platforms (web and social media) indicated a likely growing consciousness. Zarnowiecki et al (2020) found a positive effect of the digital intervention on child nutrition across a range of dietary outcomes. Additionally, having reviewed and analyzed the data obtained from both web pages and their interactions on Instagram, we consider these data to be of great use for future research related to the implementation of MD, as well as to promote nutritional health through social media, applications, blogs, etc.…”

“…Digital nutrition promotion interventions provide an opportunity to address the public health issue of improving people's nutrition (Zarnowiecki et al, 2020). There are inherent elements of subjectivity in the interpretation of this case study (Nieubuurt, 2020), however it presents insight into how our subjects (audience) engaged with one science communication endeavor using digital platforms as webs or social media.…”

“…Digital health provides the opportunity to enhance the reach, engagement and intensity of supporting specialists to improve the MD quality in the population (Zarnowiecki et al, 2020). Social media has an increasingly important influence on science and environmental communication, particularly amongst young people, but research on such sources, and the potential of their role, is also still emerging (Allgaier, 2019;León and Bourk, 2020;Pavelle and Wilkinson, 2020).…”