Food-Focused Media Literacy for Remotely Acculturating Adolescents and Mothers: A Randomized Controlled Trial of the "JUS Media? Programme"

Gail M Ferguson; Julie M Meeks Gardner; Michelle R Nelson; Cagla Giray; Hari Sundaram; Barbara H Fiese; Brenda Koester; Steve P Tran; Rachel Powell

doi:10.1016/j.jadohealth.2021.06.006

Food-Focused Media Literacy for Remotely Acculturating Adolescents and Mothers: A Randomized Controlled Trial of the "JUS Media? Programme"

J Adolesc Health. 2021 Dec;69(6):1013-1023. doi: 10.1016/j.jadohealth.2021.06.006. Epub 2021 Jul 17.

Authors

Gail M Ferguson¹, Julie M Meeks Gardner², Michelle R Nelson³, Cagla Giray⁴, Hari Sundaram⁵, Barbara H Fiese⁶, Brenda Koester⁶, Steve P Tran⁷, Rachel Powell⁸

Affiliations

¹ Institute of Child Development, University of Minnesota, Minneapolis, Minnesota. Electronic address: [email protected].
² Carribbean Child Development Centerm, The University of the West Indies Open Campus, Kingston, Jamaica.
³ Department of Advertising, University of Illinois at Urbana-Champaign, Champaign, Illinois.
⁴ Research-to-Policy Collaboration, Pennsylvania State University, State College, Pennsylvania.
⁵ Department of Advertising, University of Illinois at Urbana-Champaign, Champaign, Illinois; Department of Computer Science, University of Illinois at Urbana-Champaign, Champaign, Illinois.
⁶ Department of Human Development and Family Studies, University of Illinois at Urbana-Champaign, Champaign, Illinois.
⁷ School of Social Work, University of Illinois at Urbana-Champaign, Champaign, Illinois.
⁸ CDC Foundation, Atlanta, Georgia.

Abstract

Purpose: Unhealthy eating is a major modifiable risk factor for noncommunicable diseases and obesity, and remote acculturation to U.S. culture is a recently identified cultural determinant of unhealthy eating among adolescents and families in low/middle-income countries. This small-scale randomized controlled trial evaluated the efficacy of the "JUS Media? Programme," a food-focused media literacy intervention promoting healthier eating among remotely acculturating adolescents and mothers in Jamaica.

Methods: Gender-stratified randomization of 184 eligible early adolescents and mothers in Kingston, Jamaica (i.e., 92 dyads: M_{adolescent.age} = 12.79 years, 51% girls) determined 31 "Workshops-Only" dyads, 30 "Workshops + SMS/texting" dyads, and 31 "No-Intervention-Control" dyads. Nutrition knowledge (food group knowledge), nutrition attitudes (stage of nutritional change), and nutrition behavior (24-hour recall) were primary outcomes assessed at four time points (T1/baseline, T2, T3, T4) across 5 months using repeated measures analysis of covariances.

Results: Compared to control, families in one or both intervention groups demonstrated significantly higher nutrition knowledge (T3 adolescents, T4 mothers: mean differences .79-1.08 on a 0-6 scale, 95% confidence interval [CI] .12-1.95, Cohen's ds = .438-.630); were more prepared to eat fruit daily (T3 adolescents and mothers: .36-.41 on a 1-5 scale, 95% CI .02-.77, ds = .431-.493); and were eating more cooked vegetables (T4 adolescents and T2 and T4 mothers: .20-.26 on a 0-1 scale, 95% CI -.03-.50, ds = .406-.607). Postintervention focus groups (6-month-delay) revealed major positive impacts on participants' health and lives more broadly.

Conclusions: A food-focused media literacy intervention for remotely acculturating adolescents and mothers can improve nutrition. Replication in Jamaica and extension to the Jamaican diaspora would be useful.

Trial registration: ClinicalTrials.gov NCT04492592.

Keywords: Adolescent health; Advertising; Family intervention; Globalization; Jamaica; Media literacy; Nutrition; Obesity; Remote acculturation; Transdisciplinary.

Publication types

Randomized Controlled Trial
Research Support, N.I.H., Extramural

MeSH terms

Acculturation
Adolescent
Child
Diet, Healthy
Humans
Literacy*
Mothers*
Vegetables

Associated data

ClinicalTrials.gov/NCT04492592

Grants and funding

R21 TW010440/TW/FIC NIH HHS/United States