Associations between Digital Health Intervention Engagement and Dietary Intake: A Systematic Review.

Tessa Delaney, Matthew Mclaughlin, Alix Hall, Sze Lin Yoong, Alison Brown, Kate O'Brien, Julia Dray, Courtney Barnes, Jenna Hollis, Rebecca Wyse, John Wiggers, Rachel Sutherland, Luke Wolfenden

Journal: Nutrients 2021;13(9):3281

PMID: 34579158

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Plain Language Summary

Digital health interventions (DHIs) are a cost-effective way of delivering public health programs. Current evidence on the effectiveness of DHIs on behaviour change is inconclusive, yet many public health nutrition strategies rely on this modality. The aim of this review is to assess the literature on the efficacy on user engagement and improvements in dietary intake. This review included seven studies and showed supportive yet inconsistent results. The lack of user engagement was shown to be the primary limiting factor. Based on these results, the authors conclude DHIs can be an effective tool when used in conjunction with mixed-method approaches as health behaviour change is nuanced and non-linear. They acknowledge further qualitative research is required to better understand the relationship between DHIs, engagement, and improvements in dietary intake.

Abstract

There has been a proliferation of digital health interventions (DHIs) targeting dietary intake. Despite their potential, the effectiveness of DHIs are thought to be dependent, in part, on user engagement. However, the relationship between engagement and the effectiveness of dietary DHIs is not well understood. The aim of this review is to describe the association between DHI engagement and dietary intake. A systematic search of four electronic databases and grey literature for records published before December 2019 was conducted. Studies were eligible if they examined a quantitative association between objective measures of engagement with a DHI (subjective experience or usage) and measures of dietary intake in adults (aged ≥18 years). From 10,653 citations, seven studies were included. Five studies included usage measures of engagement and two examined subjective experiences. Narrative synthesis, using vote counting, found mixed evidence of an association with usage measures (5 of 12 associations indicated a positive relationship, 7 were inconclusive) and no evidence regarding an association with subjective experience (both studies were inconclusive). The findings provide early evidence supporting an association between measures of usage and dietary intake; however, this was inconsistent. Further research examining the association between DHI engagement and dietary intake is warranted.

Address: School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia.; Hunter New England Population Health, Wallsend, NSW 2287, Australia.; Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia.; Priority Research Centre for Heath Behavior, University of Newcastle, Callaghan, NSW 2308, Australia.; Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, VIC 3122, Australia.; School of Psychology, University of Newcastle, Callaghan, NSW 2308, Australia.

DOI: 10.3390/nu13093281

Patient Centred Factor

Mediators: User engagement

Clinical Imbalances

Neurological

Modifiable Lifestyle Factors

Diet Psychological

Nutrition Evidence Keywords

Behaviour change Dietary Intake

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MeSH Terms: Adolescent, Adult, Diet, Digital Technology, Eating, Female, Health Promotion, Humans, Internet-Based Intervention, Male, Middle Aged, Nutritional Sciences, Public Health, Telemedicine, Young Adult