Abstract
There has been a proliferation of digital health interventions (DHIs) targeting dietary intake. Despite their potential, the effectiveness of DHIs are thought to be dependent, in part, on user engagement. However, the relationship between engagement and the effectiveness of dietary DHIs is not well understood. The aim of this review is to describe the association between DHI engagement and dietary intake. A systematic search of four electronic databases and grey literature for records published before December 2019 was conducted. Studies were eligible if they examined a quantitative association between objective measures of engagement with a DHI (subjective experience or usage) and measures of dietary intake in adults (aged ≥18 years). From 10,653 citations, seven studies were included. Five studies included usage measures of engagement and two examined subjective experiences. Narrative synthesis, using vote counting, found mixed evidence of an association with usage measures (5 of 12 associations indicated a positive relationship, 7 were inconclusive) and no evidence regarding an association with subjective experience (both studies were inconclusive). The findings provide early evidence supporting an association between measures of usage and dietary intake; however, this was inconsistent. Further research examining the association between DHI engagement and dietary intake is warranted.
Highlights
Poor diet is a leading preventable risk factor for non-communicable disease, accounting for 11 million deaths and 255 million disability-adjusted life years per annum [1]
The current review addresses an important knowledge gap in the engagement literature and is the first to synthesize the association between digital health interventions (DHIs) engagement and dietary intake
The findings suggest there is some evidence supporting an association with usage, this was inconsistent
Summary
Poor diet is a leading preventable risk factor for non-communicable disease, accounting for 11 million deaths and 255 million disability-adjusted life years per annum [1]. The use of digital health interventions (DHI) has been recommended as a strategy to improve population dietary intake [6]. The World Health Organization refers to ‘digital health’ as the use of digital, mobile, and wireless technologies to support the achievement of health objectives and is both inclusive of m-health and e-health [7]. Digital health technologies may include mobile phones, portable computer tablets (e.g., iPads), webbased interventions, smartphone applications (apps) and wearable devices [8]. With 3.9 billion internet users and the potential to reach over 90% of the global population [9], DHIs, once developed, can be a cost-effective way of delivering interventions to large numbers of individuals and organizations in the population, and can be delivered with high fidelity and at low cost to a wide variety of populations, including disadvantaged groups [10]
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