Evaluation of an Application for Mobile Telephones (e-12HR) to Increase Adherence to the Mediterranean Diet in University Students: A Controlled, Randomized and Multicentric Study

Béjar, Luís; García-Perea, María Dolores; Mesa-Rodríguez, Pedro

doi:10.3390/nu14194196

Cited by 5 publications

(24 citation statements)

References 49 publications

(85 reference statements)

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“…The present study is a continuation of previous research and follows the same study protocol, which has been described by Béjar et al [ 31 ] in detail (article free for readers published in Nutrients (an open-access journal), Volume October 2022). However, in the current study, the sample and the period for obtaining it were different.…”

Section: Methodsmentioning

confidence: 95%

“…The structure and functions of the e-12HR application (‘non-feedback’ e-12HR and ‘feedback’ e-12HR versions) have been described, in detail, by Béjar et al (in “e-12HR App” in the Section 2.4 ) [ 31 ]. No changes were made in the application compared to the original study protocol.…”

Section: Methodsmentioning

confidence: 99%

“…Previously, the research team developed and validated a mobile app for measuring AMD called e-12HR [ 21 , 30 ]. This app has been updated and improved to include an automatic feedback process in which the app not only evaluates but also generates personalized comments for the user that contribute to the improvement of AMD [ 31 ]. The results of this study conducted among university students with the e-12HR application have been promising, suggesting relative effectiveness in the short term in improving the rate of AMD, as well as satisfactory usability of the app [ 31 ].…”

Section: Introductionmentioning

confidence: 99%

“…This app has been updated and improved to include an automatic feedback process in which the app not only evaluates but also generates personalized comments for the user that contribute to the improvement of AMD [ 31 ]. The results of this study conducted among university students with the e-12HR application have been promising, suggesting relative effectiveness in the short term in improving the rate of AMD, as well as satisfactory usability of the app [ 31 ]. However, this previous study did not establish the effect of certain factors on the app’s ability to improve AMD, such as age, gender, field of study, or BMI.…”

Section: Introductionmentioning

confidence: 99%

“…As a continuation of the research team’s previous studies, the main hypothesis of this work was that the previously mentioned factors influencing AMD [ 3 , 18 , 20 , 21 , 25 , 26 , 29 ] could influence the ability of the e-12HR app to increase AMD. In the same vein, the main objective of this study was to evaluate the effectiveness of using the e-12HR app with feedback as compared to the app without feedback [ 31 ], at improving AMD in the whole sample of Spanish university students (this also included the identification of the food groups in which compliance with the MD recommendations had increased), and in different strata thereof. To the best of our knowledge, this is the first research to evaluate the influence of these factors (age, gender, field of study, and BMI) on the effectiveness of a smartphone application to improve AMD among university students.…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of a Smartphone App (e-12HR) in Improving Adherence to the Mediterranean Diet in Spanish University Students by Age, Gender, Field of Study, and Body Mass Index: A Randomized Controlled Trial

Béjar

Mesa-Rodríguez²,

Quintero‐Flórez

et al. 2023

Nutrients

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There is an urgent need to implement intervention programs to promote adherence to the Mediterranean diet (AMD) in university students to prevent non-communicable diseases. A powerful tool for this is smartphone apps. Furthermore, it is necessary to determine the subgroups that are most likely to benefit from these technologies. The objective is to evaluate the effectiveness of an app (e-12HR) at improving AMD in a sample of Spanish university students and different strata. The study method was a controlled and randomized clinical trial over a four-week follow-up period and involving 385 participants (76.9% women). The participants were in two parallel groups: the control group (CG) and the intervention group (IG), with only the IG receiving feedback to improve their AMD. There were significant statistical improvements (with higher values in the IG) at week four, after no significant statistical differences at baseline (Week One): in the whole sample: +25.7% AMD index and +74.5% percentage with moderate/high AMD index. In the subgroups, seven of eight subgroups, ranging in AMD index from +17.8% (≥20 years) to +33.0% (<20 years); and for males, in weeks two (+27.9%) and three (+23.9%), but not at week four. In conclusion, e-12HR could improve AMD among university students (in the total sample and all subgroups, except ≥25 kg/m2).

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Section: Methodsmentioning

confidence: 95%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effectiveness of a Smartphone App (e-12HR) in Improving Adherence to the Mediterranean Diet in Spanish University Students by Age, Gender, Field of Study, and Body Mass Index: A Randomized Controlled Trial

Béjar

Mesa-Rodríguez²,

Quintero‐Flórez

et al. 2023

Nutrients

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Improving student diet and food security in higher education using participatory and co-creation approaches: a systematic review

Assilian,

Dehove,

Charreire

et al. 2024

Int J Behav Nutr Phys Act

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Background Higher education students are an important target group for public health nutrition interventions. When designing tailored and contextually relevant interventions, participatory and co-creation approaches are increasingly recognized as promising but their use and effectiveness has not been assessed in this type of population. We systematically reviewed interventions aiming to improve dietary quality and/or food security in higher education settings with the aims 1) to identify and describe their participatory and co-creation approaches and 2) to compare the effectiveness of interventions using or not using participatory and co-creation approaches. Methods Our search in PubMed, Google Scholar, Web of Science, EMBASE was performed in January 2023 and yielded 3658 unique records, out of which 42 articles (66 interventions) were included. Effectiveness of interventions was assessed at the individual level (longitudinal evaluations) or at the group level (repeated cross-sectional evaluations). A five-level classification was used to describe a continuum of engagement from students and other partners in the intervention design and implementation: no participation (level one), consultation, co-production, co-design and co-creation (levels two to five). To synthetize effectiveness, comparisons were made between studies without participation (level one) or with participation (levels two-five). Results Ten (24%) out of 42 studies used a participatory and co-creation approach (levels two-five). Studies using a participatory and co-creation approach reported a positive finding on individual-level outcome (i.e. overall diet quality or food group intake or food security) in 5/13 (38%) intervention arms (vs 13/31 or 42% for those without participation). Studies using a participatory and co-creation approach reported a positive finding on group-level outcomes (i.e. food choices in campus food outlets) in 4/7 (57%) (vs 8/23 or 35% in those without participation). Conclusions Participatory and co-creation approaches may improve the effectiveness of nutrition interventions in higher education settings but the level of evidence remains very limited. More research is warranted to identify best co-creation practices when designing, implementing and evaluating nutritional interventions in the higher education setting. Trial registration PROSPERO registration number CRD42023393004.

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Short-Term Effect of a Health Promotion Intervention Based on the Electronic 12-Hour Dietary Recall (e-12HR) Smartphone App on Adherence to the Mediterranean Diet Among Spanish Primary Care Professionals: Randomized Controlled Clinical Trial

Béjar,

Mesa-Rodríguez,

García-Perea

2024

JMIR Mhealth Uhealth

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Background The World Health Organization has called for addressing the growing burden of noncommunicable diseases (NCDs) by promoting healthy lifestyles among the population. Regarding patient health, primary care professionals (PCPs) are the first line of care who can positively influence patients’ behavior and lifestyle habits. However, a significant percentage of PCPs do not lead a healthy lifestyle. Therefore, addressing their health behaviors may be the key to substantially increasing health promotion advice in general practice. The Mediterranean diet has been extensively studied, and there is strong evidence of it being a dietary pattern for the prevention of NCDs, in addition to its significant environmental, sociocultural, and local economics benefits. Objective This study focused only on the dietary aspect of the PCPs’ lifestyle. The primary objective was to evaluate the effect of using the Electronic 12-Hour Dietary Recall (e-12HR) smartphone app to improve diet, specifically to promote adherence to the Mediterranean diet (AMD), among PCPs. The secondary objectives were to establish the usability of the e-12HR app and to determine AMD among PCPs. Methods An individual-level randomized, controlled, and single-blind clinical trial was conducted with 2 parallel groups: a control group (CG), using the nonfeedback version of the e-12HR app, and an intervention group (IG), using the feedback version of the e-12HR app. The level of human involvement was fully automated through the use of the app. There was a 28-day follow-up period. Participants were PCPs (medicine or nursing) recruited offline at one of the selected primary care centers (Andalusia, Spain, Southern Europe), of both sexes, over 18 years old, possessing a smartphone, and having smartphone literacy. Results The study response rate was 73% (71 of 97 PCPs), with 27 (38%) women and 44 (62%) men: 40 (56%) PCPs in the CG and 31 (44%) in the IG. At baseline, AMD was medium (mean Mediterranean Diet Serving Score [MDSS] index 9.45, range 0-24), with 47 (66%) PCPs with a medium/high MDSS index. There were significant statistical improvements (CG vs IG, in favor of the IG) at week 4 (no significant statistical differences at baseline): +25.6% for the MDSS index (P=.002) and +213.1% for the percentage with a medium/high MDSS index (P=.001). In relation to specific food groups, there were significant statistical improvements for fruits (+33.8%, P=.02), vegetables (+352%, P=.001), nuts (+184%, P=.02), and legumes (+75.1%, P=.03). The responses to the usability rating questionnaire were satisfactory. Conclusions The results support recommending the use of the e-12HR app as a tool to contribute to improving diet and preventing NCDs among PCPs, while positively influencing patient dietary behavior and preventing diet-related NCDs among patients. Trial Registration ClinicalTrials.gov NCT05532137; https://clinicaltrials.gov/study/NCT05532137

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Evaluation of an Application for Mobile Telephones (e-12HR) to Increase Adherence to the Mediterranean Diet in University Students: A Controlled, Randomized and Multicentric Study

Cited by 5 publications

References 49 publications

Effectiveness of a Smartphone App (e-12HR) in Improving Adherence to the Mediterranean Diet in Spanish University Students by Age, Gender, Field of Study, and Body Mass Index: A Randomized Controlled Trial

Effectiveness of a Smartphone App (e-12HR) in Improving Adherence to the Mediterranean Diet in Spanish University Students by Age, Gender, Field of Study, and Body Mass Index: A Randomized Controlled Trial

Improving student diet and food security in higher education using participatory and co-creation approaches: a systematic review

Short-Term Effect of a Health Promotion Intervention Based on the Electronic 12-Hour Dietary Recall (e-12HR) Smartphone App on Adherence to the Mediterranean Diet Among Spanish Primary Care Professionals: Randomized Controlled Clinical Trial

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