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

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.