A Randomized Controlled Trial Evaluating Online to In‐Person Education to Improve Breakfast Behaviors, Beliefs and Knowledge in WIC Participants

Abstract

The purpose of this randomized‐controlled trial was to compare the impact of online to in‐person group nutrition education on changes in knowledge, beliefs, and behaviors related to breakfast eating. The content of the lesson focused on ways to reduce breakfast skipping and promoted healthy options at breakfast for parents and their 1‐5 year‐old children on WIC. Questionnaires were administered before and after‐education, and at a 2‐4‐month follow‐up to 604 California WIC participants. T‐tests and x2 tests were used to compare changes within and between in‐person versus online groups. ANOVA and GEE analysis were used to assess differences in change between groups over time. Increases in the frequency of eating breakfast were greater for both parents (P=0.001) and children (P=0.003) in the online group compared to the in‐person group. Both groups reported reductions in barriers to eating breakfast due to time constraints, not having enough foods, and hunger. Positive changes in knowledge were similar, but decreasing 100% fruit juice consumption was only seen in the in‐person compared to the online group for both parents (P=0.005) and children (P=0.01). Satisfaction with the class was high in both groups, but significantly higher in the online group (P=0.0001). Overall, this study supports online nutrition education as a viable supplement to traditional education to promote healthy breakfast behaviors; however in‐person education may be better for sustained behavior change in WIC participants.