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Lima SC, Melo GRDAE, Schincaglia RM, Souza Lopes AC, Toral N. Stages of change and self-efficacy are related to consumption of food markers among Brazilian adolescents and young adults. Front Public Health 2023; 10:1006898. [PMID: 36684970 PMCID: PMC9850231 DOI: 10.3389/fpubh.2022.1006898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 12/01/2022] [Indexed: 01/07/2023] Open
Abstract
Objective This study aimed at analyzing the association between stages of change, consumption of food markers, and self-efficacy in the adoption of healthy eating practices, adjusted by nutritional knowledge, among Brazilian adolescents and young adults. Methods A cross-sectional analysis was conducted with 347 individuals from schools in the Federal District, Brazil. They completed a self-administered questionnaire covering: consumption of food markers, stage of change, self-efficacy in the adoption of healthy eating practices, and nutritional knowledge. Adjusted logistic regression was conducted. Results Participants in pre-contemplation (OR = 0.22), contemplation (OR = 0.19), decision (OR = 0.13) and action (OR = 0.40) stages have less chance to have healthy eating than those in maintenance, including fruits and vegetables [pre-contemplation (OR = 0.23), contemplation (OR = 0.19), and decision (OR = 0.09)]. Adolescents and young adults in pre-contemplation (OR = 0.29) and contemplation (OR = 0.37) had lower chances of having low consumption of sugar-sweetened beverages compared to those in maintenance (p < 0.05). Adolescents and young adults in pre-contemplation (OR = 0.38) and contemplation (OR = 0.36) were less likely to have high self-efficacy scores than those in maintenance (p < 0.05). Higher score of self-efficacy was associated with a lower chance of having a high consumption of sugar-sweetened beverages (OR = 1.02; p = 0.032). Conclusion Regardless of nutritional knowledge, individuals in the earlier stages of change are less likely to have an adequate consumption of healthy foods markers, including fruits and vegetables, and low sugar-sweetened beverages consumption. They are also less likely to have high self-efficacy scores than those in maintenance. Nutritional interventions to focus on enhancing self-efficacy among adolescents and young adults in earlier stages of change to improve dietary habits.
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Affiliation(s)
- Stefany Corrêa Lima
- Center for Epidemiological Health and Nutrition Studies-NESNUT, Graduate Program in Human Nutrition, University of Brasília, Brasília, Brazil
| | - Giselle Rhaisa do Amaral e Melo
- Center for Epidemiological Health and Nutrition Studies-NESNUT, Graduate Program in Human Nutrition, University of Brasília, Brasília, Brazil
| | - Raquel Machado Schincaglia
- Center for Epidemiological Health and Nutrition Studies-NESNUT, Graduate Program in Human Nutrition, University of Brasília, Brasília, Brazil
| | - Aline Cristine Souza Lopes
- Nutrition Interventions Research Group-GIN, Graduate Program in Nutrition and Health, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Natacha Toral
- Center for Epidemiological Health and Nutrition Studies-NESNUT, Graduate Program in Human Nutrition, University of Brasília, Brasília, Brazil
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Oh C, Carducci B, Vaivada T, Bhutta ZA. Digital Interventions for Universal Health Promotion in Children and Adolescents: A Systematic Review. Pediatrics 2022; 149:186946. [PMID: 35503335 DOI: 10.1542/peds.2021-053852h] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/16/2022] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Digital media has been used mostly to deliver clinical treatments and therapies; however limited evidence evaluates digital interventions for health promotion. The objective of this review is to identify digital interventions for universal health promotion in school-aged children and adolescents globally. METHODS Eligible articles were searched in PubMed, Embase, Medline, Ovid SP, The Cochrane Library, Cochrane Central Register of Controlled Trials, WHO regional databases, Google Scholar, and reference lists from 2000 to March 2021. Randomized controlled trials and quasi-experimental studies evaluating interventions that promote health in school-aged children and adolescents (5-19.9 years) were included. Methods were conducted in duplicate. Where possible, data were pooled with a random-effects model. RESULTS Seventy-four studies were included (46 998 participants), of which 37 were meta-analyzed (19 312 participants). Interventions increased fruit and vegetable consumption (servings per day) (mean difference [MD] 0.63, 95% confidence interval [CI] 0.21 to 1.04; studies = 6; P = .003; high quality of evidence), and probably reduced sedentary behavior (MD -19.62, 95% CI -36.60 to -2.65; studies = 6; P = .02; moderate quality of evidence), and body fat percentage (MD -0.35%, 95% CI -0.63 to -0.06; studies = 5; P = .02; low quality of evidence). The majority of studies were conducted in high-income countries and significant heterogeneity in design and methodology limit generalizability of results. CONCLUSIONS There is great potential in digital platforms for universal health promotion; however, more robust methods and study designs are necessitated. Continued research should assess factors that limit research and program implementation in low- to middle-income countries.
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Affiliation(s)
- Christina Oh
- Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada
| | - Bianca Carducci
- Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada.,Department of Nutritional Sciences, University of Toronto, Toronto, Ontario,Canada
| | - Tyler Vaivada
- Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada.,Department of Nutritional Sciences, University of Toronto, Toronto, Ontario,Canada.,Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
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Rosas R, Pimenta F, Leal I, Schwarzer R. FOODLIT-Trial: Protocol of a Randomised Controlled Digital Intervention to Promote Food Literacy and Sustainability Behaviours in Adults Using the Health Action Process Approach and the Behaviour Change Techniques Taxonomy during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063529. [PMID: 35329211 PMCID: PMC8950592 DOI: 10.3390/ijerph19063529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/06/2022] [Accepted: 03/14/2022] [Indexed: 12/04/2022]
Abstract
Dietary quality and sustainability are central matters to the international community, emphasised by the burden of the COVID-19 pandemic. To promote healthier and more sustainable food-related practices, the protocol of a web-based intervention to enhance adults' food literacy is presented. The FOODLIT-Trial is a two-arm, parallel, experimental, and single-blinded randomised controlled trial delivered over 11 weeks. Based on the Food Literacy Wheel framework and supported by the Health Action Process Approach (HAPA) and the Behaviour Change Techniques Taxonomy, weekly content with customised behaviour change techniques (experimental group) is hypothesised to be more effective to promote food behaviour change when compared to a single-time and non-customised delivery of food-related international guidelines, with no theoretically informed approaches (comparison group). Primary outcome is food literacy, including food-related knowledge, skills, and behaviours, assessed with the FOODLIT-Tool; a secondary outcome includes psychological mechanisms that efficaciously predict change in participants' food literacy, measured with HAPA-driven items. Enlisted through online sources, participants will be assessed across five time points (baseline, post-intervention, and 3-, 6-, and 9-month follow-ups, i.e., T0-T4). A randomisation check will be conducted, analyses will follow an intention-to-treat approach, and linear two-level models within- (T0-T4) and between-level (nested in participants) will be computed, together with a longitudinal mediation analysis. If effective, the FOODLIT-Trial will provide for a multidimensional and cost-effective intervention to enable healthier and more sustainable food practices over the long term.
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Affiliation(s)
- Raquel Rosas
- WJCR-William James Center for Research, ISPA-Instituto Universitário, 1149-041 Lisboa, Portugal; (F.P.); (I.L.)
- Correspondence: ; Tel.: +351-918-483-078
| | - Filipa Pimenta
- WJCR-William James Center for Research, ISPA-Instituto Universitário, 1149-041 Lisboa, Portugal; (F.P.); (I.L.)
| | - Isabel Leal
- WJCR-William James Center for Research, ISPA-Instituto Universitário, 1149-041 Lisboa, Portugal; (F.P.); (I.L.)
| | - Ralf Schwarzer
- Department of Psychology, Freie Universität Berlin, 14195 Berlin, Germany;
- Department of Clinical, Health, and Rehabilitation Psychology, SWPS University of Social Sciences and Humanities, 53-238 Wroclaw, Poland
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Gamification for the Improvement of Diet, Nutritional Habits, and Body Composition in Children and Adolescents: A Systematic Review and Meta-Analysis. Nutrients 2021; 13:nu13072478. [PMID: 34371989 PMCID: PMC8308535 DOI: 10.3390/nu13072478] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 06/29/2021] [Accepted: 07/18/2021] [Indexed: 12/21/2022] Open
Abstract
Currently, one of the main public health problems among children and adolescents is poor adherence to healthy habits, leading to increasingly high rates of obesity and the comorbidities that accompany obesity. Early interventions are necessary, and among them, the use of gamification can be an effective method. The objective was to analyse the effect of game-based interventions (gamification) for improving nutritional habits, knowledge, and changes in body composition. A systematic review and meta-analysis were performed in CINAHL, EMBASE, LILACS, MEDLINE, SciELO, and Scopus databases, following the PRISMA recommendations. There was no restriction by year of publication or language. Only randomized controlled trials were included. Twenty-three articles were found. After the intervention, the consumption of fruit and vegetables increased, as well as the knowledge on healthy food groups. The means difference showed a higher nutritional knowledge score in the intervention group 95% CI 0.88 (0.05–1.75). No significant effect of gamification was found for body mass index z-score. Gamification could be an effective method to improve nutritional knowledge about healthier nutritional habits. Promoting the development of effective educational tools to support learning related to nutrition is necessary in order to avoid and prevent chronic diseases.
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Melo GR, Correa Lima S, M Dos Santos Chagas C, Nakano EY, Toral N. Tailored smartphone intervention to promote healthy eating among Brazilian adolescents: a randomised controlled trial protocol. BMJ Open 2020; 10:e038896. [PMID: 33115898 PMCID: PMC7594362 DOI: 10.1136/bmjopen-2020-038896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Adolescent eating patterns are characterised by high consumption of unhealthy foods, which has resulted in an increasing prevalence of overweight and chronic diseases. It is crucial to promote healthy eating habits, and nutritional interventions based on the transtheoretical model have been found to be especially effective. Mobile health strategies also seem promising for adolescents. This study aims to outline a smartphone intervention via WhatsApp for adolescents to promote healthy eating consumption, better nutritional knowledge, self-efficacy in the adoption of healthy practices and progress through the stages of change. METHODS AND ANALYSIS There will be three distinct groups in this randomised study: a general intervention group (GG), in which the participants will receive the same healthy eating messages, based on the Brazilian food guide; a tailored intervention group (TG), in which the participants will receive healthy eating messages based on their stage of change; and a control group (CG), in which participants will receive messages on a different theme. Possession of a smartphone, use of WhatsApp and being a senior student (16-19 years) from a public school of the Federal District of Brazil will be the study's inclusion criteria. Rural schools will be excluded. The sample size estimated is 390 individuals: 38 in the GG, 314 in the TG and 38 in the CG. The intervention will last 6 weeks, with a daily message sent to the students. We will investigate nutritional knowledge, self-efficacy in the adoption of healthy eating practices, food consumption and stages of change using preintervention and postintervention questionnaires. Memorisation of the messages will be also assessed. ETHICS AND DISSEMINATION The study was approved by the University of Brasília, School of Health Sciences and Research Ethics Committee. At the end of the study, the participating schools will receive a printed report with the main results of the intervention. TRIAL REGISTRATION NUMBER RBR-5b9jk7.
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Affiliation(s)
- Giselle Rhaisa Melo
- NESNUT- Department of Nutrition, University of Brasilia, Brasilia, Federal District, Brazil
| | - Stefany Correa Lima
- NESNUT- Department of Nutrition, University of Brasilia, Brasilia, Federal District, Brazil
| | - Carolina M Dos Santos Chagas
- NESNUT- Department of Nutrition, University of Brasilia, Brasilia, Federal District, Brazil
- Department of Nutrition, Federal University of Lavras, Lavras, Minas Gerais, Brazil
| | - Eduardo Y Nakano
- Statistics Department, University of Brasília, Brasilia, Federal District, Brazil
| | - Natacha Toral
- NESNUT- Department of Nutrition, University of Brasilia, Brasilia, Federal District, Brazil
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