Impacts of consumption tracking and tailored feedback on meeting nutritional recommendations: a longitudinal regression discontinuity study

Abstract Background Malnutrition continues to have large and negative impacts on millions of people. Lack of nutrition education and access to accurate information can be large barriers to healthy eating. Methods In this paper, we causally tested if providing participants with consumption tracking information accompanied by tailored messaging that referenced internationally recognized dietary guidelines improved their consumption patterns. To do so, we developed a smartphone application that participants used to record their consumption and that of their children. Those self-recorded data were then used to provide the participants with tailored feedback by comparing their recorded consumption against recommended consumption patterns. The causal impacts of the tailored feedback were estimated using a regression discontinuity estimation strategy and validated using alternative empirical strategies and a parallel dataset collected from the same participants by Community Health Volunteers. Results We found that the informational and feedback treatments improved consumption patterns of the caregivers and their children. Specifically, once caregivers began receiving tracking information and tailored feedback on their children’s diet, their children’s likelihood of meeting the minimum dietary threshold increased by at least 23 percentage points. An analogous, although smaller and less precisely estimated, effect on the caregivers’ consumption was caused by providing them with tracking and feedback information on their own consumption. To verify these findings, we tested for the same effects using a parallel dataset collected by Community Health Volunteers from the same participants at the same period. The results of these analysis remained consistent with those estimated from self-recorded data but showed smaller effect sizes. Tests for persistence of the effects found no loss in impacts over the remaining months of the project. Conclusions These findings show that improving access to information on recommended consumption and providing easy methods for tracking own performance against those recommendations can improve consumption patterns while also demonstrating that low-cost, light-touch approaches can be effective for collecting related data and delivering such services. Trial registration Pan African Clinical Trial Registry ACTR202407500217236. Retrospectively registered on July 15 2024.