Assessing the effectiveness and cost effectiveness of adaptive e-Learning to improve dietary behaviour: protocol for a systematic review

Abstract

BackgroundThe composition of habitual diets is associated with adverse or protective effects on aspects of health. Consequently, UK public health policy strongly advocates dietary change for the improvement of population health and emphasises the importance of individual empowerment to improve health. A new and evolving area in the promotion of dietary behavioural change is e-Learning, the use of interactive electronic media to facilitate teaching and learning on a range of issues, including diet and health. The aims of this systematic review are to determine the effectiveness and cost-effectiveness of adaptive e-Learning for improving dietary behaviours.Methods/DesignThe research will consist of a systematic review and a cost-effectiveness analysis. Studies will be considered for the review if they are randomised controlled trials, involving participants aged 13 or over, which evaluate the effectiveness or efficacy of interactive software programmes for improving dietary behaviour. Primary outcome measures will be those related to dietary behaviours, including estimated intakes of energy, nutrients and dietary fibre, or the estimated number of servings per day of foods or food groups. Secondary outcome measures will be objective clinical measures that are likely to respond to changes in dietary behaviours, such as anthropometry or blood biochemistry. Knowledge, self-efficacy, intention and emotion will be examined as mediators of dietary behaviour change in order to explore potential mechanisms of action. Databases will be searched using a comprehensive four-part search strategy, and the results exported to a bibliographic database. Two review authors will independently screen results to identify potentially eligible studies, and will independently extract data from included studies, with any discrepancies at each stage settled by a third author. Standardised forms and criteria will be used.A descriptive analysis of included studies will describe study design, participants, the intervention, and outcomes. Statistical analyses appropriate to the data extracted, and an economic evaluation using a cost-utility analysis, will be undertaken if sufficient data exist, and effective components of successful interventions will be investigated.DiscussionThis review aims to provide comprehensive evidence of the effectiveness and cost-effectiveness of adaptive e-Learning interventions for dietary behaviour change, and explore potential psychological mechanisms of action and the effective components of effective interventions. This can inform policy makers and healthcare commissioners in deciding whether e-Learning should be part of a comprehensive response to the improvement of dietary behaviour for health, and if so which components should be present for interventions to be effective.

E‐&mHealth interventions targeting nutrition, physical activity, sedentary behavior, and/or obesity among children: A scoping review of systematic reviews and meta‐analyses

“…During full‐text review of articles that included child and adolescent interventions (57 articles), 10 articles were excluded for the following reasons: Only one child study included in the article ( n = 5) 41,43–46 and did not present outcomes separately for children ( n = 5) 47–51 . Two protocols of retrieved studies ( n = 2) were identified 52,53 ; thus, this scoping review includes 47 papers of 45 reviews for the scoping analysis.…”

“…It is possible reviews were conducted to the AMSTAR 2 standard but did not report these components within their manuscript. For example, two articles reported using an adequate risk of bias tool in their published protocols for the review 52,53 but did not report this information within the actual systematic review or supplementary files 80,82 . In addition, it is likely that systematic reviews will have recorded excluded studies and reasons for exclusion during the conduct of their review but may not have reported these details in the publication.…”

Influences on individuals’ decisions to take up the offer of a health check: a qualitative study

“…The TDF is a theoretical framework for implementation research drawn from models to explain behaviour change. It was originally developed to identify psychological and organizational theory relevant to health practitioner behaviour change but has also been used to explain health‐related behaviour change among non‐health‐care professionals, including general population samples . At the time this study was designed, the framework covered a set of twelve domains comprising the main evidence‐based factors influencing behaviour change, such as beliefs about capabilities, social influences, knowledge and beliefs about consequences.…”

Theories of behaviour change synthesised into a set of theoretical groupings: introducing a thematic series on the theoretical domains framework

“…Two reports described questionnaire studies [ 13 , 14 ], and two reported both interviews and questionnaires [ 15 , 16 ]. There were four systematic reviews in which the theoretical domains were investigated as mediators of behaviour change [ 17 - 20 ], two randomised studies [ 21 , 22 ], and one protocol for a process evaluation study to explain trial effects in the context of a randomised trial [ 23 ]. The included studies provide evidence that the TDF has considerable breadth and cross-disciplinary impact in research about health-related behaviour (studies were published in 13 journals) and geographical reach (six countries from four continents were represented).…”