Feasibility of online courses on healthy eating, food-related behaviour and sustainable living

Depression is an important risk factor for general public health and strategies to prevent the development of depression are urgently needed. Nutrition and food-related behaviour are found to be associated with mental well-being and depression and might be factors that influence public health. Online interventions focused on promoting health behaviour are increasing and found to be effective and useful to reach large populations for preventive purposes. Knowledge of experiences and preferences of participants is crucial for successful implementation of these interventions. However, this information is missing. In this study, we will explore the feasibility and perceived usefulness of behaviour change advice targeting nutrition and food-related behaviour. We will also explore if having depressive symptoms influences the feasibility of these advices. This will be done using a 8-week randomised controlled trial with 4 intervention groups consisting of online courses targeted at nutrition and food-related behaviour and one control group consisting of a online course targeting sustainability. This study is conducted in both the Netherlands and Denmark in healthy human volunteers aged 18-70 years old of which 50% has no or low depressive symptoms and 50% high depressive symptoms (but no clinical diagnosis of depression). The information of this study can be used to develop online interventions that are adopted to the level of depressive symptoms and that reach large groups of people from the general population, without leading to high numbers of drop-out and that are perceived as easy, both in content and in adopting the advices.

Rationale: Depression is an important risk factor for general public health and strategies to prevent the development of depression are urgently needed. Nutrition and food-related behaviour are found to be associated with mental well-being and depression and might be factors that influence public health. Online interventions focused on promoting health behaviour are increasing and found to be effective and useful to reach large populations for preventive purposes. Knowledge of experiences and preferences of participants is crucial for successful implementation of these interventions. However, this information is missing. In
this study, we will explore the feasibility and perceived usefulness of behaviour change advice targeting nutrition and food-related behaviour. We will also explore if having depressive symptoms influences the feasibility of these advices. The information of this study can be used to develop online interventions that are adopted to the level of depressive symptoms and that reach large groups of people from the general population, without leading to high numbers of drop-out and that are perceived as easy, both in content and in adopting the advices.

On weeks 2, 4, 6 and 8:

Closed-ended questions (Likert-scales) on:

 - Compliance

 - User experience

 - Perceived ease or difficulty to follow advice

Open-ended questions on:

 - Goal-setting and goal achievement

 - Comments on intervention

Compliance is also measured by looking at total log-ins to platform and percentage of exercises filled out (week 8).



Week 1 and 8:

Feasibility of behaviour changes:

Eating styles: Dutch Eating Behaviour

Questionnaire, van Strien 1986

Social context of eating

Depressive symptoms: Center for Epidemiological Studies Depression Scale, Radloff 1977

Change in appetite and change in sleep (atypical depressive symptoms): 2 items from BDI-II, Beck, Steer & Brown, 1996
Subjective health: single-item questionnaire as described in meta-analysis from DeSalvo, Bloser, Reynolds, He, Munther, 2006

Life satisfaction: Satisfaction with Life Scale (Diener, Emmons, Larsen, & Griffin 1985)

Body dissatisfaction: Figure Rating Scale (Stunkard, Sørensen, & Schulsinger 1983)

Food intake: based on Helius FFQ (Beukers et al. 2015)

Impulse buying: 3 items from Buying Impulsiveness Scale, Rook & Fisher, 1995

Household activities (adapted from
Brook Lyndhurst, 2007)

Cooking skills: scale from Brunner, van der
Horst, & Siegrist 2010.

General self-efficacy: General Self-Efficacy Scale, Teeuw, Schwarzer & Jerusalem, 1994

Meal pattern and meal pattern regularity; snacking behaviour

Mindful eating (self-designed; Laura Winkens)

Sustainability

Self-efficacy (difficulty in following recommendations)

Goal attainment

Interviews with subgroups of people in each group to attain experiential information.

Open ended questions on:

 Compliance

 User experience

 Difficulty of following recommendations



Questionnaire for drop-outs:

 Reason for drop-out (open-ended)

 User experience (closed-ended)

Four interventions groups:

- Mindful eating

- Healthy eating

- Food-related activities

- Meal pattern

Control intervention:

- Sustainability