Assessing the effectiveness of a 4-week online intervention on food literacy and fruit and vegetable consumption in Australian adults: The online MedDiet challenge

Evaluating the effectiveness of a food literacy pilot program for university students: using a mixed-methods research approach

BACKGROUND/OBJECTIVES

As awareness of climate change increases, the relevance of environmental education in dietary choices gains prominence. Although diversely defined, food literacy (FL) is increasingly recognized as the ability to make food choices with an awareness of environmental sustainability. This study aims to conduct a pilot implementation and assess the effectiveness of a program developed to improve FL among university students.

SUBJECTS/METHODS

The study spanned from August 2022 to February 2023, involving 92 participants (42 in the intervention group and 50 in the control group). Over 11 weeks, the program included cooking classes, local farm visits, and environmental impact lectures developed through extensive literature reviews and interviews with students and experts. FL was measured using a 33-item survey along with basic sociodemographic factors. After the intervention, both groups participated in qualitative interviews. All statistical analyses were carried out in Stata/SE version 17.0, and interview data were analyzed in Microsoft Excel using the framework analysis method.

RESULTS

The FL scores of the intervention group improved significantly from an average of 65.8 to 69.6 points (P = 0.015), with notable gains in the socio-ecological domain in FL from 65.3 to 71.5 points (P < 0.001). A linear regression analysis comparing FL between the intervention and control groups found that only the knowledge items were marginally significant (P = 0.054), with no statistically significant difference in the practice aspect before and after the intervention (P = 0.657). The interviews revealed that the intervention group experienced broadened perspectives and heightened environmental consciousness, although translating these into practice was challenged by unchanged daily routines.

CONCLUSION

This pilot program effectively enhanced some aspects of FL-related knowledge of participants. High satisfaction among participants and no dropouts indicated its potential for scaling. Future programs will benefit from strategies that facilitate the transition from educational improvement to practical application.

A Scoping Review of Food Literacy Interventions

INTRODUCTION

Food literacy (FL) is a rapidly emerging area of research that provides a framework to explain the interplay of food-related skills, beliefs, knowledge and practises that contribute to nutritional health and wellbeing. This review is the first to scope the current literature for FL interventions, assess their characteristics against the components provided in the most widely cited definition of FL. and describe their characteristics to identify gaps in the literature.

METHODS

This review scopes original articles describing FL interventions in the Medline, CINAHL, ProQuest Education, Web of Science and AMED databases up to August 2023.

RESULTS

Despite the heterogeneity between all seven included studies, they all demonstrated some improvements in their FL outcome measures alongside dietary intake (DI), with the greatest improvements seen in studies that employed a FL theoretical framework in intervention design. Populations at high risk of food insecurity, such as university students and people living in disadvantaged areas, were the main targets of FL interventions.

CONCLUSION

The minimal inclusion of FL theory amongst interventions led to an overall poor coverage of essential FL components, indicating researchers should aim to design future FL interventions with a FL theoretical framework.

Self-perceived food literacy in relation to the quality of overall diet and main meals: A cross-sectional study in Japanese adults

This cross-sectional study aimed to assess the relationship between self-perceived food literacy (SPFL) and quality of overall diet and main meals in Japanese adults. In total, 5998 adults aged 20-79 years were included in this analysis. The SPFL was assessed using the Japanese version of the 29-item Dutch SPFL scale (score range 1-5). Using validated dietary information, the Healthy Eating Index-2015 (HEI-2015) was calculated (score range 0-100). The mean SPFL was 3.18; the internal consistency of the overall scale was considered good (Cronbach's alpha: 0.80). The mean HEI-2015 for overall diet was 50.4. The SPFL was significantly and positively associated with the HEI-2015. Using multiple linear regression, one point increase of SPFL corresponded to an increase in HEI-2015 by a point of 4.8 for overall diet, 6.2 for breakfast, 4.6 for lunch, and 3.6 for dinner (all P < 0.0001). Six of the eight domains of SPFL (i.e., food preparation skills, resilience and resistance, healthy snack styles, examining food labels, healthy budgeting, and healthy food stockpiling) were significantly associated with the HEI-2015 for overall diet. When the HEI-2015 for each meal was examined, the domains showing significant associations with all three meals included food preparation skills, healthy snack styles, and healthy budgeting. The healthy food stockpiling was associated with the HEI-2015 for breakfast and lunch, but not dinner. The social and conscious eating and daily food planning were associated with the breakfast HEI-2015 only, with the resilience and resistance associated with the dinner HEI-2015 only. In conclusion, the SPFL was cross-sectionally associated with the quality of overall diet and main meals in Japanese adults. Further observation and intervention studies are needed to confirm the associations observed here.

A scoping review of food and nutrition literacy programs

The impact of food literacy (FL) and nutrition literacy (NL) programs on lifestyles and health is recognized in the literature, yet few studies systematize it. This study aims to deepen the understanding of FL/NL from the characterization of programs in terms of (i) theoretical foundations, conceptualization and measuring instruments; (ii) characterization of the FL/NL programs and results and (iii) limitations and future directions declared. A scoping review of original articles addressing FL/NL programs from the Web of Science, Scopus and PubMed databases published between 2015 and 2023. There was a somewhat restricted view of the construct and the absence of a clear boundary between FL and NL. Half of the studies reported theoretical foundations. The most used model was Social Cognitive Learning Theory. More significant development of programs was observed in Australia, using quasi-experimental designs. Most of the studies informed positive results. Limitations of the studies related to the sampling process, absence of a control group and lack of follow-up. It is suggested that long-term interventions consider economic, social and cultural factors. Despite that theoretical and empirical aspects should be revised, FL/NL programs are a suitable strategy to mitigate the social and health effects of inadequate nutrition.

Food and Nutrition Literacy: Exploring the Divide between Research and Practice

This study addresses the growing recognition of the importance of food and nutrition literacy, while highlighting the limited research in this field, particularly the gap between research and practice. A bibliometric analysis of publications on food and nutrition literacy research from the Scopus database was carried out. Endnote 20, VOSviewer, and Harzing's Publish or Perish were used to analyze the results. The growth of publications, authorship patterns, collaboration, prolific authors, country contributions, preferred journals, and top-cited articles were the bibliometric indicators used. Subsequently, articles aimed at measuring food or nutrition literacy-implemented programs were analyzed. Existing studies have primarily concentrated on defining and measuring food or nutrition literacy. Although interventions targeting food and nutritional literacy have shown promise in promoting healthy eating, further research is required to identify effective approaches in diverse populations and settings. This study emphasizes the need for additional research to measure intervention program efficacy to enhance the policies and practices in this critical area of public health. These findings underscore the importance of understanding food/nutrition literacy and developing effective interventions to promote healthy eating habits. By bridging the research-practice divide, this study provides valuable insights for policymakers, practitioners, and researchers to address the gaps and improve food/nutrition literacy in various contexts.

The Effect of an eHealth Coaching Program (Smarter Pregnancy) on Attitudes and Practices Toward Periconception Lifestyle Behaviors in Women Attempting Pregnancy: Prospective Study

BACKGROUND

Lifestyle behaviors during the periconception period contribute to achievement of a successful pregnancy. Assessment of attitudes and practices toward these modifiable behaviors can aid in identifying gaps in unhealthy lifestyle behaviors with impact on intervention effectiveness.

OBJECTIVE

This study investigates the effectiveness of coaching by the eHealth program Smarter Pregnancy during the periconception period on improvement of attitudes and practices toward fruit and vegetable intake and smoking in women attempting pregnancy through assisted reproductive technology (ART) or natural conception.

METHODS

Women attempting pregnancy through ART (n=1060) or natural conception (n=631) were selected during the periconception period. The intervention groups, conceived through ART or naturally, received Smarter Pregnancy coaching for 24 weeks, whereas the control group conceived through ART and did not receive coaching. Attitudes and practices at baseline and follow-up periods were obtained from self-administered online questionnaire provided by the program. Attitudes were assessed in women with unhealthy behaviors as their intention to increase their fruit and vegetable intake and to quit smoking using a yes/no question. Outcomes on practices, suggesting effectiveness, included daily fruit (pieces) and vegetable (grams) intake, and if women smoked (yes/no). Changes in attitudes and practices were compared at 12 and 24 weeks with baseline between the ART intervention and ART control groups, and within the intervention groups between ART and natural conception. Changes in practices at 12 and 24 weeks were also compared with baseline between women with negative attitude and positive attitude within the intervention groups: ART and natural conception. Analysis was performed using linear and logistic regression models adjusted for maternal confounders and baseline attitudes and practices.

RESULTS

The ART intervention group showed higher vegetable intake and lower odds for negative attitudes toward vegetable intake after 12 weeks (β_adj=25.72 g, P<.001; adjusted odds ratio [OR_adj] 0.24, P<.001) and 24 weeks of coaching (β_adj=23.84 g, P<.001; OR_adj 0.28, P<.001) compared with ART controls. No statistically significant effect was observed on attitudes and practices toward fruit intake (12 weeks: P=.16 and .08, respectively; 24 weeks: P=.16 and .08, respectively) and smoking behavior (12 weeks: P=.87; 24 weeks: P=.92). No difference was observed for the studied attitudes and practices between the ART intervention and natural conception intervention groups. Women with persistent negative attitude toward fruit and vegetable intake at week 12 showed lower fruit and vegetable intake at week 24 compared with women with positive attitude (β_adj=-.49, P<.001; β_adj=-30.07, P<.001, respectively).

CONCLUSIONS

The eHealth Smarter Pregnancy program may improve vegetable intake-related attitudes and practices in women undergoing ART treatment. Women with no intention to increase fruit and vegetable intake had less improvement in their intakes. Despite small changes, this study demonstrates again that Smarter Pregnancy can be used to improve vegetable intake, which can complemented by blended care that combines face-to-face and online care to also improve fruit intake and smoking behavior.

Food Literacy and Dietary Intake in German Office Workers: A Longitudinal Intervention Study

Widespread patterns of poor dietary behavior are a key factor causing the increasing prevalence of chronic diseases around the world. Research has provided initial insights into the potential of food literacy (FL) to empower individuals to improve their dietary behavior. However, studies on FL interventions in working adults are scarce. The intervention delivered in this study was a comprehensive 3-week full time education-based workplace health promotion program (WHPP) that provided the participants with in-depth knowledge and skills regarding nutrition and health. We aimed to investigate the short- and long-term effects of the WHPP on FL and dietary intake (DI) and to examine the association between FL and DI in a sample of 144 German office workers (30.0% female). Using two random intercept mixed linear regression models, we found significant strong improvements for both FL (β = 0.52, p < 0.0001) and DI (β = 0.63, p < 0.0001) after the WHPP when compared to baseline. Significant long-term improvements at 18 months were strong for FL (β = 0.55, p < 0.0001) and weak for DI (β = 0.10, p < 0.0001). FL showed a significant moderate effect on DI across all measurement time points (β = 0.24, p < 0.0001). We conclude that well-designed WHPPs can induce long-term improvements in FL and DI, and that FL can be viewed as an asset to further expand food-related knowledge and skills and to enhance dietary behavior. Our study fills a gap of long-term findings regarding the role of FL in WHPPs and supports the idea of implementing FL in the development of comprehensive WHPPs to improve DI.