School-based interventions using media technologies to promote health behavior change and active learning about nutrition: A systematic literature review and meta-analysis

The objective of this study is to analyze the structure and effectiveness of nutrition school-based interventions that use media communication technologies, designed for children aged 6 to 14. Particularly, this study aims to synthesize the best available evidence on the impacts of prevention programs on nutrition using media technologies; enumerate the main theoretical models of health behavior change applied; identify variables, moderators, and predictors to include in an intervention; and explore the main validated instruments and the most used media technologies to promote behavior change and active learning. Based on rigorous selection criteria, 16 papers were selected. Data was analyzed both qualitatively and quantitatively. A comparison table is provided, offering information on the type of intervention, participants, outcomes, ICT, theoretical models, instruments, and results. The main results indicate that most interventions focused on promoting healthy eating by promoting knowledge/learning about nutrition and by promoting the intake of healthy foods. Around one-fifth of studies were focused on other elements such as food diversity, portions, nutritional practices, or reducing the consumption of unhealthy food (sugar, sugar-sweetened beverages, snacks, fat). A meta-analysis was conducted, indicating a small to moderate significant effect of interventions. A subgroup analysis indicates that nutrition interventions applying also physical exercise are more effective, highlighting exercise as a relevant moderator variable, and that serious games (game-based learning approaches) promoted stronger results.