Abstract P087: Effectiveness of Mass Media Campaigns for Improving Dietary Behaviors: A Systematic Review and Meta-analysis
BACKGROUND Although mass media campaigns (MMC) are often used in attempts to influence diet, their effectiveness has not been systematically quantified.
OBJECTIVE To conduct a systematic review and meta-analysis of the impact of MMC on dietary change.
Methods Using PRISMA and MOOSE guidelines, we systematically searched PUBMED, manuscript citations, and related articles for original studies assessing the influence of MMC, in isolation or as part of multi-component strategies, on dietary habits. We included any interventional (randomized, quasi-experimental) or prospective cohort study. Studies were excluded if cross-sectional; only reporting on attitudes or knowledge; or limited to one specific organization (e.g., workplace, school). Data were extracted independently and in duplicate. Outcomes included change in diet (servings/d), % of population meeting specific diet target, and CVD risk factors including adiposity, BP, and blood lipids. Pooled estimates were calculated using inverse variance-weighted meta-analysis. Prespecified sources of heterogeneity were analyzed using meta-regression; and publication bias by funnel plots and Begg’s test.
Results From 855 identified studies, 14 interventional studies met inclusion criteria. These included 8 studies of MMC in isolation, and 4 studies of MMC as part of a multicomponent strategy. Campaigns were performed at local (n=8), regional (n=2), and national (n=4) levels, with durations from 1 month to 30 years. In adults, pooled estimates demonstrated that MMC, in isolation, increased fruit and vegetable intake by 0.25 servings/d (95% CI 0.15 - 0.35; n=5 studies), but did not significantly alter % meeting specific diet targets (n=4; prevalence ratio=1.20; 95% CI 0.93 - 1.55; n=4). Sustained national multicomponent strategies that included prominent MMC (n=3) were associated with reduced prevalence of hypertension (15% less, 95% CI 10, 21%) and hypercholesterolemia (61% less, 95% CI 40, 75%). In children, MMC as part of multicomponent community programs led to a nonsignificant trend toward reduced BMI z-score (-0.073, 95%CI: -0.149, 0.003; n=3). Too few studies reported on effectiveness of MMC on diet habits in children or other diet factors in adults. Heterogeneity was evident in these estimates, but meta-regression did not identify significant sources, including campaign level or duration. Evidence for publication bias was not seen.
CONCLUSIONS Based on the available data, isolated MMC can effectively increase fruit and vegetable intake in adults, and when deployed in multicomponent strategies, can reduce CVD risk factors in adults and may reduce BMI in children. Effects appear modest, but would be important at the population level. Our findings also demonstrate certain gaps in the evidence and a need for further quasi-experimental studies of MMC.
- © 2013 by American Heart Association, Inc.