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Table 1 Characteristics and outcomes of studies evaluating efficacy of children’s nutrition digital health interventions (Objective 1)

From: A systematic evaluation of digital nutrition promotion websites and apps for supporting parents to influence children’s nutrition

  Digital intervention, duration Study design, participants, timepoints Outcomes Quality rating Dietary intake BMI/weight Knowledge Self-efficacy / SCT Attitudes/ beliefs
Delisle Nystrom 2018 1 [37]; Sweden I: MINISTOP app (HE/PA); 6-months; content delivered bi-weekly; contact time not reported
C: HE/PA pamphlet
RCT; Parents 4yo children; BL (n = 315), 6-month (n = 315), 12-month (n = 263) • Fat mass (FM) [measured]
• FV, lollies, SSB intake [Food photos on smartphone]
• Composite score - FM, PA, sedentary time, FV, lollies, SSB
Strong 0 B (SSB, FV, lolly, score) 0 B (FM)
+ I (FFM)
   
Delisle Nystrom 2017 1 [38]; Sweden Strong + I (SSB)
0 (FV, lolly)
+ I (Score)
0 B (FM)    
Grimes 2018 [31]; Australia I: DELISH Website (Salt Ed); 5-weeks; content delivered weekly; contact time ~ 23 mins per session
C: Nil
Pre/post; Child (mean 9.2y) & parent;
BL (n = 83), 5-weeks (n = 83)
• Salt knowledge, attitudes, self-efficacy [Online Qus]
• Salt intake [24 h urine], behaviours [Online Qus]
Moderate 0 (Salt intake)
+ (Salt behav)
  + + 0
Knowlden 2018 2 [33]; USA I: EMPOWER website (SCT-based Obes prev program); 4 weeks; content delivered weekly; contact time ~ 30 mins per session
C: Online healthy lifestyle info
RCT; Mothers 4–6 yo child;
BL (n = 57); 4-weeks (n = 51); 8-weeks (n = 50); 1 year (n = 44); 2 years (n = 37)
• Mother’s self-efficacy [Online Qus]
• Child intake: FV; sugar-free beverages [Online Qus]
Moderate + I (FV)
+ B (SFB)
   +/− I (FV env only)  
Knowlden 2016 2 [32]; USA Moderate + I (FV)
+ B (SFB)
   +/− I (FV env only)  
Knowlden 2015 2 [34]; USA Moderate + I (FV)
+ B (SFB)
   +/− I  
Rangelov 2018 [35]; Switzerland C: Website only (HE/PA)
I1: Website + SMS
I2: Website + email
8-weeks; content delivered weekly; contact time not reported
RCT; Children grades 1–2 & parents; BL: (n = 774); 8 weeks (n = 608) • Child intake [7-day food diary] Weak + C (F)
+ C (Sweets)
+ I1 (V)
0 (all other)
    
De Lepeleere 2017 [29]; Belgium I: Website (Health promoting videos); 4-weeks; content delivered weekly; contact time ~ 2 mins per video (22 videos)
C: Waitlist control
Quasi-experimental CT; Parents primary school age child; BL (n = 207); 1-month (n = 135); 3-month (n = 128) • Parent self-efficacy; Parenting practices [Qus]
• Child intake: FV, water, SSB, snacks [FFQ]
Weak 0 (FV, water, SSB, snacks)    +/− I +/− I (parent practices high SES only)
Au 2016 [28]; USA I: Website (BF Ed); 1 online lesson; contact time ~ 15–20 min
C: 1 x in-person group ed. session
RCT; Mothers 1-5yo child
BL, 2-month, 4-month (n = 590)
• BF knowledge, attitudes, self-efficacy [Qus]
• Child, parent BF intake [Qus]
Moderate + I (BF)   + B + B + I
Wilson 2014 [36]; USA I: Website (FV); once-off module; contact time predicted ~ 45–60 min
C: Nil
Pre/post; Parents & adolescents(mean 13.3y);
BL (n = 47); 1-week (n = 41)
• Parent & adolescent FV intake [Screening Qus] Weak + (FV parent, adolescent)     
Delamater 2013 [30]; USA I: FIT-4-Health Website as information source; contact time not reported
C: Nil
Pre/post; Families with overweight children 8-12y; BL & 4 weeks (n = 24) • Self-efficacy
• BMI z-score [measured]
• Food intake [Qus]
• Healthy lifestyle score (Food intake, PA, sedentary)
Weak +/0 (HE, high vs low users)
+ (Score)
+/0 (high vs low users)   + (high users)  
TOTAL 11 3 2 7 3
  1. 1,2Studies reporting follow-up findings from the same intervention
  2. Abbreviations: A app; Behav behaviours; BF breakfast; BL baseline; BMI body mass index; CT controlled trial; Ed education; Env environment; F fruit; FFM fat free mass; FFQ food frequency questionnaire; FM fat mass; FV fruit and vegetables; HE Healthy eating; Info information; Mins minutes; Nil not present; Obes prev obesity prevention; PA Physical activity; QE quasi-experimental; Qus questionnaire; RCT Randomised controlled trial; Pre/Post pre-test post-test; SCT social cognitive theory; SES socioeconomic status; SFB sugar free beverage; SSB sugar sweetened beverages; USA United States of America; yo years old
  3. Abbreviations to denote results: B=Significant change in both groups, no difference between groups; I=Significant effect in intervention group; C=Significant effect in control group; + = positive intervention effect/improvement (hypothesised intervention effect); − = negative intervention effect / worsening, 0 = no effect; +/0 or +/− = mixed results