Nutrition and Physical Activity: Digital Health and Telephone Interventions to Increase Healthy Eating and Physical Activity among Students at Institutions of Higher Education

Community Preventive Services Task Force (CPSTF) (2021)

CPSTF - doi.org/10.15620/cdc/164246

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Evidence Categories

• Care setting: College/University Setting
• Population group: Students
• Intervention: Intra-/Inter-personal: Multicomponent programme remote
• Outcome: Healthy Eating: Energy intake
• Outcome: Healthy eating: Sugar-added food intake
• Outcome: Healthy Eating: Fruit and veg intake
• Outcome: Healthy Eating: Wholegrain intake
• Outcome: Healthy Eating: Fibre intake
• Outcome: Healthy Eating: Fat intake
• Outcome: Healthy Eating: Whole diet quality

Type of Evidence

Guidance

Overview

The systematic review, which underpins this CPSTF recommendation, provides evidence on the following topic:

• "Digital health and telephone interventions to increase healthy eating and physical activity aim to support students at institutions of higher education who are interested in improving these behaviors. Interventions are delivered through websites, mobile apps, text messages, or email, or by one-on-one telephone calls. Interventions include educational information, plus one or more of the following:
  • Coaching or counseling from a professional or trained peer who provides personalized assistance related to eating or physical activity behaviors, or weight
  • Self-monitoring to record eating or physical activity behaviors, or weight
  • Goal setting related to eating or physical activity behaviors, or weight
  • Computer-generated feedback that provides tailored information based on performance (i.e., prompts, meeting goals, and adherence)
  • Social support from peers through social media, internet forums, or discussion groups
  • Motivational strategies that include incentives, rewards, and gaming techniques"

The authors state:

• "The CPSTF recommendation is based on evidence from a systematic review of 17 studies with 18 arms"

• "Study designs included randomized controlled trials (16 studies, 17 arms) and other controlled trials (1 study)."

• "Included studies were conducted in the United States (14 studies), Australia (1 study), and the United Kingdom (2 studies)."

• "Evidence from the seventeen included studies showed interventions increased fruit and vegetable intake, decreased fat intake, and improved or maintained weight."

• "Fruit and Vegetable Intake, 12 studies (13 arms), Median: 0.40 servings/day,
  (Range: 0.18 to 0.74 servings/day;9 studies, 10 arms), 3 studies could not be calculated in median: 2 of 3 studies were favorable; Favors the intervention"

• "Fat Intake, 5 studies (6 arms), All studies were favorable, Favors the intervention"

• "Five studies reported on sugar intake; two were favorable; two showed no change: and one was unfavorable. Four studies (5 arms) reported on whole grain or fiber intake; three arms were favorable: one arm showed no change: and one arm was unfavorable. Three studies reported energy intake; two were favorable, and one was unfavorable. One study reported overall diet quality and was favorable."

Recommendations

Taking into consideration evidence and stakeholder input, the CPSTF recommends:

"The Community Preventive Services Task Force (CPSTF) recommends digital health and telephone interventions that are implemented at institutions of higher education and focus on improving healthy eating and physical activity among students who are interested in improving these behaviors. Sufficient evidence of effectiveness shows these interventions lead to meaningful increases in fruit and vegetable intake, decreases in fat intake, and improvements or maintenance of weight status."