Meta-Analysis: The Effectiveness of Web-Based Health Promotion Interventions on Vegetable Consumption in Children

Sinar Perdana Putra, Yulia Lanti Retno Dewi, Bhisma Murti


Background: Consuming healthy food throughout life helps prevent malnutrition in all forms of various diseases. In the first 2 years of a child's life, optimal nutrition fosters healthy growth. Vegetables and fruit are food sources that contain many nutrients that humans must consume at every meal. EHealth is playing an increasingly large role in life and the internet has great potential to be a source of low cost and effective health promotion interventions.

Subjects and Method: This study was a meta-analysis of a number of Randomized Controlled Trial study designs. The articles used in this study were obtained from several databases including PubMed, Google Scholar, and Springer Link. The articles used in this research are those published from 2010-2020. The article search was carried out by con­sidering the eligibility criteria defined using the PICO model. The population in the study was children aged 2 to 12 years old with an inter­vention in the form of web-based health promotion, comparison, which was not given a web outcome-based health promotion interven­tion in the form of vegetables consumption. The keywords for finding articles are as follows: "Intervention Health Promotion Web-Based" OR "eHealth Intervention" AND "Non-Inter­vention Health Promotion Web-Based" OR "Non eHealth Intervention" AND "Child" AND "Vegetables" AND "Randomized Controlled Trial”. The articles included in this study were full text articles with the design of a Rando­mized Controlled Trial (RCT) study. Articles were collected using PRISMA flow diagrams. Articles were analyzed using the Review Mana­ger 5.3 application.

Results: A total of 9 articles were reviewed in this study. Meta-analysis of 9 primary data shows that web-based health promotion inter­ventions can increase children's vegetable con­sumption with statistically significant results (Standarized Mean Difference= 0.82; 95% CI= 0.26 to 1.37; p= 0.004).

Conclusion: Web-based health promotion interventions can increase vegetables consump­tion in children.

Keywords: Intervention Health Promotion Web-Based, eHealth, vegetables consumption

Correspondence: Sinar Perdana Putra. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: Mobile: 085727777227.

Journal of Health Promotion and Behavior (2020), 05(03): 197-208



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Buller BD, Woodall WG, Zimmerman DE, Slater MD, Heimendinger J, Waters E, Hines JM, et al. (2014). Randomized trial on the 5 a day, the rio grande way website, a web-based program to improve fruit and vegetable consumption in rural communities. Am J Health Promot. 13(3):230-49.

Cochrane (2011). RevMan 5.3 User Guide. The Cochrane Collaboration.

Crombie IK, Davies HTO (2009). What is meta-analysis. Hayward Medical Communications, 1(1): 1-8.

Delgado-Rodriguez M (2001). Systematic review and meta-analysis. Med Intensiva, 42 (7): 444-453.

Dumas AA, Lemleux S, Lapointe A, Provencher V, Robitaille J, Desroches S (2019). Effects of an evidence informed healthy eatingblog on dietary intakes and food-related behaviors of mothers of preschool and school-aged children: A Randomized Controlled Trial. J Acad Nutr Diet. 42(7): 444-453.

Egger M, Smith GD (2001). Systematic reviews in health care: Meta-analysis in context. BMJ Publishing Group, DOI: 10.1002/9780470693926

Emma SDJ, Ekarizky FS (2019). Differences in vegetable and fruit consumption education in elementary school children using lecture methods with props and audiovisual. Journal of the Indonesian Nutrition Association, 42 (1): 53-60.

Evers KE (2006). eHealth Promotion: The Use of the Internet for Health Promotion. Am J Health Promot, 1(1): 1-9.

Fisher G, Brown AW, Brown MMB, Alcorn A, Noles C, Winwood L, et al. (2015). High intensity interval vs moderate intensity training for improving cardio metabolic health in overweight or obese males: A randomized controlled trial. PLoS One. 10(10):e0138853.

Grady A, Seward K, Finch M, Wolfenden L, Wyse R, Wiggers J, et al. (2020). A three arm randomised controlled trial of high and low intensity implementation strategies to support centre based childcare service implementation of nutrition guidelines: 12-Month follow-up. Int J Environ Res Public Health. 17 (4664): 1-21.

Grady A, Wolfenden L, Wiggers J, Rissel C, Finch M, Flood V, Salajan D, et al. (2020). Effectiveness of a web-based menu-planning intervention to improve childcare service compliance with dietary guidelines: Randomized controlled trial. J Med Internet Res, 2 (22): 1-16.

Haidich AB (2010). Meta-analysis in medical research. Hippokratia, 14 (1): 29-37.

Reid K (2006). Interpreting and under-standing meta-analysis graphs. Aust Fam Physician, 35(8): 635-638. PMID: 16894442.

Macleod MR, Tanriver-Ayder E, Hair K, Sena E (2019). Design of Meta-Analysis Studies. In J. E. Barrett (Ed.), Good Research Practice in NonClinical Pharmacology and Biomedicine (pp. 299–315). Cham, Switzerland: SpringerOpen.

Mikolajewicz N, Komarova SV (2019). Meta-analytic methodology for basic research: A practical guide. Front Physiol.

Murti B (2018). Prinsip dan Metode Riset Epidemiologi (5th ed) (Principles and Methods of Epidemiological Research (5th ed)). Surakarta: Program Studi Ilmu Kesehatan Masyarakat, Program Pascasarjana, Universitas Sebelas Maret.

Murti B (2018). Teori promosi dan perilaku kesehatan (1st ed) (Promotion Theory and Health Behavior (1st ed)). Surakarta: Program Studi Ilmu Kesehatan Masyarakat, Program Pascasarjana, Universitas Sebelas Maret.

Nikolakopoulou A, Mavridis D, Salanti G (2014). How to interpret metaanalysis models: Fixed effect and random effects meta-analyses. Evidence Based Mental Health. 17(2).

Nystrom CD, Sandin S, Henriksson P, Henriksson H, Lagerros YT, Larsson C, Maddison R, et al. (2017). Mobile-based intervention intended to stop obesity in preschool agedchildren: the MINISTOP randomized controlled trial. 105(6):1327-1335. Am J Clin Nutr.

Nystrom CD, Sandin S, Henriksson P, Henriksson H, Lagerros YT, Larsson C, Maddison R, et al. (2018). A 12-month follow-up of a mobile-based (mHealth) obesity prevention intervention in pre-school children: the MINISTOP randomized controlled trial. BMC Public Health. 18 (658): 1-7.

Overcash FM, Vickers Z, Ritter AE, Maan T, Mykerezi E, Redden J, Rendahl AK, et al. (2019). An in-home intervention of parent implemented strategies to increase child vegetable intake: results from a nonrandomized cluster allocated community trial. BMC Public Health. 19(881): 1-13.

Shahril MR, Dali WPEW, Lua PL (2013). A 10-week multimodal nutrition education intervention improves dietary intake among students: cluster randomised controlled trial. Nutr Metab. 1 (1): 1-12.

Stassen G, Grieben C, Frobose I, Schaller A (2020). Engagement with a web-based health promotion intervention among vocational school students: A secondary user and usage analysis. Int J Environ Res Public Health. 17(7): 2180.

Siddaway AP, Wood AM, Hedges LV (2019). How to do a systematic review: A best practice guide for con-ducting and reporting narrative reviews, meta-analyses, and met syntheses. Annual Review of Psychology. 70(2019): 747-770.

Thompson D, Bhatt R, Vazquez I, Cullen KW, Baranowski J, Baranowski T, Liu Y (2015). Creating action plans in a serious video gameincreases and maintains child fruit-vegetableintake: a randomized controlled trial. Int J Behav Nutr Phys Act, 12 (39): 1-11.

WHO (2019). Facts and figures on child-hood obesity. World Health Organization.

WHO (2020). Healthy Diet. World Health Organization.

Wyse R, Campbell KJ, Brennan L, Wolfen-den L (2014). A cluster randomized controlled trial of a telephone-based intervention targeting the home food environment of preschoolers (The Healthy Habits Trial): the effect on parent fruit and vegetable consumption. Int J Behav Nutr Phys Act. 11 (144): 1-10.

Yoong LS, Grady A, Seward K, Finch M, Wiggers J, Lecathelinais C, Wede-sweiler T, et al. (2019). The impact of a childcare food service intervention on child dietary intake in care: An exploratory cluster randomized controlled trial. J Health Commun, 1 (1): 1-11.


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