eHealth

A recent study published in Nutrition Journal examined the effects of eHealth interventions on the eating habits of children in Switzerland.

Adults and children in Switzerland consume an excess of meat and an insufficient amount of fruits and vegetables. The country also has high incidences of obesity, with the highest rates in the state of Canton Ticino. There are many potential intervention options to improve healthy living, but one recommended by the World Health Organization (WHO) is social marketing. This tool uses marketing to induce beneficial changes in society, which in this case would be better health through avenues such as the internet.

What is eHealth?

When information and communication technology are used for health, these technologies are termed eHealth. Some examples of eHealth are websites, short messaging service (SMS), and emails which provide healthy living information directly to consumers, and these have all been shown to have an impact on health behaviours. In the current study published in Nutrition Journal, researchers investigated the efficacy of various eHealth interventions in improving food consumption in children.

An online social marketing program, called Famiglia, Attività fiscia, Nutrizone (FAN), was developed specifically for Ticino residents to improve their dietary habits. Eligibility criteria for this study included residency in Ticino, being proficient in Italian, having internet, a cell phone, and an email address, and finally, having school-going children in the first two years of high school or younger.

For the study, the researchers gave information packages to children at school to invite parents to use FAN. Following registration, parents completed an initial survey that asked questions about their children’s eating habits and anthropometric measures. Upon completion of the survey the parents were assigned at random to one of three groups:

  1. Receiving information by web only
  2. Receiving information by web and email
  3. Receiving information by web and SMS

Based on previous research demonstrating the ability of a Web intervention to improve health habits, the web-only group served as the control group.

As part of the intervention, individualized nutrition and exercise information was made available to parents on a website and children received mailed letters. The website showed recipes and tips on how to incorporate healthy alternatives into their lives but also had a theme each week. For the eight weeks of the study, themes with titles including “You are off to a good start and that is half the battle!” and “Lunch and snacks with imagination” were presented online. An online forum was also available for those involved to engage in discourse with each other as well as with a dietician. Additionally, participants in the Web and email or Web and SMS groups received messages summarizing the week’s nutrition theme with a link to the website to remind families to go to the website.

Fruit and Water Consumption Increased

Fruit and water consumption increased across all groups similarly and soft drinks and sweets consumption decreased across all groups similarly. At the completion of the study, vegetable consumption was similar to baseline levels, with a significant increase in consumption only among those who received Web and SMS.

This study provided insight into the dietary habits of children in Ticino, where no data was previously available. However, a larger sample size is needed to truly apply the results to the whole population. The study had a high proportion of six-year-olds, but Ticino has a fairly even distribution of age groups, thus the study population was not representative of the population of children in Ticino. As the eHealth information was directed to the parents, future studies can investigate the effects on food consumption when children are directly given this intervention.

Written by Monica Naatey-Ahumah, BSc

Reference: Rangelov, N., Bella, S.D., Marques-Vidal, P., and S, L.S. (2018). Does additional support provided through e-mail or SMS in a Web-based Social Marketing program improve children’s food consumption? A Randomized Controlled Trial. Nutrition Journal 17(24). https://doi.org/10.1186/s12937-018-0334-1

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