The effectiveness of nutrition education and implications for nutrition education policy, programs and research; A review of research: Special issue

Authors' objectives: To evaluate the effectiveness of nutrition education for the public. More specifically, to address two key questions:

1. Does nutrition education work? If so, what are the successful elements across interventions?
2. What are the implications of the findings for nutrition education program implementation, research, and policy?

Results of the review: This review included 217 nutrition education intervention studies. Nutrition education generally works, but intervention effects may be different depending on outcome measures and gender. Positive results were often only achieved in some components in large, multicomponent interventions. In general, interventions using educational methods directed at behavioural change were more effective than those focusing on the dissemination of information, which assumed attitude and behavioural changes would ensue. Behaviourally-focused nutrition education uses a set of learning experiences to facilitate the voluntary adoption of food- and nutrition-related behaviours that are conducive to health and well-being. The behaviours addressed are identified from the needs, perceptions, motivations and desires of the target audience, as well as from national nutrition and health goals, and science-based research findings. More effective educational strategies have the following characteristics: they take into account the motivations of particular population groups; they involve self-assessment and feedback; and they require active participation. Mass media campaigns can improve knowledge and may change behaviour if the behaviour is highly targeted and messages are carefully focused. Systematic behavioural change strategies should be tailored to the needs of target groups or individuals. Availability of healthy food in restaurants and the community supports the maintenance of change. Active participation by community leaders is likely to improve long-term effectiveness.

Authors' conclusions: Nutrition education programmes should be ongoing and multifaceted. The more effective programmes are those that are behaviourally-focused and based on appropriate theory and prior research. This review has also found that effective programmes use a combination of contemporary models of individual, social and environmental change. Studies based on a 'dissemination of information and teaching of skills' model were not very effective in bringing about behavioural change.