MEDIA PENELITIAN DAN
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Vol 35 No 4.
Desember 2025
e-ISSN: 2338-3445
p-ISSN: 0853-9987
MODELS OF NUTRITION EDUCATION INTERVENTIONS FOR
ADOLESCENT LIFESTYLE CHANGES: A SCOPING REVIEW
Model Intervensi Pendidikan Gizi untuk Perubahan Gaya Hidup Remaja:
Scoping Review Alda Adzika1*.
Martha Irene Kartasurya2.
Zahroh Shaluhiyah1 Departement of Health Promotion.
Universitas Diponegoro.
Semarang.
Indonesia Departement of Public Health Nutrition.
Universitas Diponegoro.
Semarang.
Indonesia *Email: aldaadzikaal@gmail.
ABSTRAK
Masa remaja merupakan masa transisi yang menentukan pola makan sehat dan perilaku gaya hidup sepanjang hidup.
Intervensi edukasi gizi memiliki peran strategis dalam mencegah pola makan tidak sehat pada remaja.
Penelitian ini bertujuan menggambarkan dan mengevaluasi berbagai model intervensi pendidikan gizi yang efektif bagi remaja melalui identifikasi pola, hasil, hambatan, dan faktor pendukung yang Metode pada kajian ini menggunakan scoping review yang mengikuti panduan PRISM-Scr dan kerangka Arksey dan OAoMalley.
Pencarian literatur dilakukan pada database PubMed.
Science Direct, dan Scopus menggunakan kata kunci:
"remaja," "gizi," "intervensi," dan "hambatan" pada bulan Maret 2025.
Studi dipilih berdasarkan kriteria inklusi dan eksklusi yang telah ditentukan sebelumnya.
Hasil menunjukan bahwa dari 1.
936 artikel, sebanyak 10 artikel terpilih untuk dianalisis.
Artikel yang dipilih berasal dari negara berkembang dan dikategorikan ke dalam tiga pendekatan utama: intervensi berbasis digital, intervensi berbasis tradisional, dan intervensi berbasis sekolah.
Masing-masing menunjukkan efektivitas yang bervariasi dalam meningkatkan pengetahuan, sikap, dan perilaku gizi remaja.
Faktor keberhasilan meliputi integrasi dalam sistem pendidikan, relevansi budaya, serta kolaborasi Beberapa hambatan meliputi keterbatasan durasi, pendekatan pasif, dan akses makanan sehat.
Temuan ini menekankan pentingnya strategi yang multikomponen dan adaptif terhadap konteks lokal.
Keywords: negara berpenghasilan menengah ke bawah, pendidikan gizi, perubahan gaya hidup, remaja, tinjauan cakupan ABSTRACT Adolescence is a transition period that determines healthy eating patterns and lifestyle behaviors throughout life.
Nutrition education interventions play a strategic role in preventing unhealthy dietary habits among adolescents.
This study aims to describe and evaluate various effective models of nutrition education interventions for adolescents by identifying patterns, outcomes, barriers, and supporting factors comprehensively.
The method applied in this review is a scoping review guided by the PRISMA-Scr framework and Arksey and OAoMalleyAos methodological framework.
Literature was retrieved from PubMed.
ScienceDirect, and Scopus databases using the keywords: "adolescents," "nutrition," "intervention," and "barriersAy in March 2025.
Studies were selected based on pre determined inclusion and exclusion criteria.
The results show that out of 1,936 articles identified, 10 studies were selected for further analysis.
The selected articles originated from developing countries and were categorized into three main intervention approaches: digital-based, traditional-based, and school based interventions.
Each model demonstrated varying levels of effectiveness in improving adolescentsAo nutritional knowledge, attitudes, and behaviors.
Key success factors included integration into the educational system, cultural relevance, and multisectoral collaboration.
Several barriers were also identified, such as limited duration, passive delivery approaches, and limited https://doi.
org/10.
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MEDIA PENELITIAN DAN
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Vol 35 No 4.
Desember 2025 e-ISSN: 2338-3445 p-ISSN: 0853-9987 access to healthy foods.
These findings underscore the importance of multicomponent strategies that are contextually adaptable to local settings.
Keywords: adolescents, lifestyle change, low and middle income, nutrition education, scoping review
INTRODUCTION
In 2024, the global prevalence of obesity reached 3 billion individuals .
, while hypertension affected 19% of the population .
, and diabetes impacted 10.
5% of the global population.
These health conditions are closely associated with poor dietary habits, physical inactivity, and the excessive consumption of fast food and sugar sweetened beverages, which are high in calories but low in nutritional value.
The global rise in obesity and diet related non communicable diseases (NCD.
underscores the urgency of effective, targeted interventions.
Adolescence is a critical phase for establishing long term dietary and lifestyle habits, as nutritional needs increase significantly to support rapid physical and cognitive development .
, .
However, this period also presents heightened vulnerability to nutritional problems due to poor eating habits, sedentary behavior, and the easy access to processed, energy dense foods .
, .
, .
The behaviors formed at this stage such as food choices and meal patterns tend to persist into adulthood and significantly influence future health outcomes .
, .
Promoting healthy eating through education in adolescence therefore holds strategic value in the prevention of chronic diseases later in life.
To address adolescent nutrition issues, education is a key public health strategy.
However, the methods, models, and contexts of nutrition education interventions vary widely due to differences in delivery mechanisms, socioeconomic conditions, and cultural factors.
This scoping review aimed to map and evaluate types of Nutrition Education Intervention (NEI) models promoting healthy lifestyle changes among adolescents, assess their effectiveness in influencing behavior, and identify barriers and facilitators to implementation.
The synthesis of existing evidence is expected to guide the development of more effective, sustainable, and context-appropriate strategies for improving adolescent nutrition and health outcomes.
METHODS
This study followed the scoping review guidelines provided by Arksey and O'Malley and suggestions from Levac et al and adhered to the PRISMA-Scr Reporting Checklis .
The checklist was employed to improve the transparency and thoroughness of the review, adhering to established best practices in systematic review methodologies .
The initial step in this scoping review involved conducting a comprehensive literature search across three major scientific databases: PubMed.
ScienceDirect, and Scopus.
The review followed the methodological framework proposed by Arksey and O'Malley, which includes the following stages: identifying relevant sources, selecting studies, charting the data, and finally compiling, summarizing, and reporting the results.
The search strategy employed Boolean operators such as AND and OR to combine key concepts related to Auadolescents,Ay Aunutrition,Ay Auinterventions,Ay and Aulifestyle related Ay The search was conducted in March 2025, and articles were limited to those published between January 1, 2019, and March 15, 2025.
Only articles written in English were considered for inclusion in this review.
Eligible studies included original peer-reviewed research on nutrition education interventions targeting adolescents, conducted in Low and Middle Income Countries (LMIC.
Studies were excluded if they were literature reviews, qualitative studies without experimental components, focused on non adolescent populations, adolescents with specific medical conditions, or were protocols or unpublished works still under review.
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MEDIA PENELITIAN DAN
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Vol 35 No 4.
Desember 2025 Identification The initial database search identified 1,936 articles .
from PubMed, 527 from Scopus, and 416 from Science Direc.
After removing three duplicates, 1933 articles were screened through a two-stage process consisting of title and abstract screening followed by full text review.
Screening was conducted collaboratively by the research team to ensure consistent application of the eligibility criteria.
From the 21 articles that underwent full-text review, 10 met all inclusion criteria and were retained for analysis.
The selection process is illustrated in the PRISMA Flowchart (Figure .
, which, while primarily used for randomized trial reviews, also serves as a useful framework for documenting the screening and selection process in systematic and scoping reviews of intervention studies.
Search results of the articles :
PubMed = 993
Scopus
= 527
Science Direct
= 416
= 1.
3 duplicates removed Included Eligibility Screening Articles screened .
=1.
Irrelevant articles .
=1,.
Inclusion Criteria:
- Original research on nutritional education intervention for adolescent - Conducted in LMICs - Published between Januari 1, 2019 and March 16, 2025 - Articles in English Full text articles assessed for eligibility .
Full text articles excluded, with reasons .
- 4 Specific populations - 4 Irrelevant outcomes - 3 study protocol/pilot study Studies included in the scoping review .
Figure 1.
PRISMA Flowchart.
Article Selection Process A standardized charting form was used to extract key data, including authorship, year, location, objectives, design, sample size, intervention type and duration, outcomes, and barriers or facilitators.
Two reviewers conducted independent extraction and crosschecking to ensure consistency.
Studies were then categorized into three intervention models: digital-based, traditional-based, and school-based.
Given the methodological diversity, a narrative synthesis was applied to map intervention characteristics, evaluate outcomes, analyze implementation contexts, and identify evidence gaps.
RESULT
Data from ten selected studies were organized in a standardized charting table detailing study location, objectives, design, intervention type, sample size, duration, and Article quality was evaluated through critical appraisal, and thematic analysis was used to identify patterns and research gaps.
The findings were classified into three main intervention modelsAidigital-based, traditional-based, and school-basedAieach summarized in a separate table for clarity and comparison.
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Desember 2025 Digital-based Intervention Based on the analysis of the selected studies, two articles were identified that applied digital-based intervention models.
These interventions utilized technological platforms such as mobile applications and digital games to improve nutritional knowledge, attitudes, and behaviors among adolescents.
Differences were observed in the types of platforms, duration, and outcome effectiveness (Table .
Author.
Year.
Study Location Chagas et .
Brazil Table 1.
Data Charting Digital-based Intervention Intervention Objective.
Study Design Type al Assessing the impact of a game-based nutrition intervention on food consumption, nutrition knowledge, and selfefficacy implementing healthy eating practices.
Mahmudiono et Indonesia Designing effectiveness of an application based on the Traffic Light Diet System and attitudes regarding sugar, salt, and fat.
Outcomes This randomized controlled trial involved 319 schools, with 117 in the intervention group and 202 in the control The Rango Cards digital played over a period of 7 to 17 days.
There significant increase in plans for healthy Quasi-experimental with 55 people to the intervention group and 55 people to the control group, without any intervention The system was through an over an 8 week period.
Increased knowledge and attitudes in both control group were Both studies had the same objective, which was to improve adolescent nutrition knowledge and behavior using digital-based approaches.
However, different platforms and study designs were used.
Mahmudiono et al.
developed an Androidbased application utilizing a food scanning feature called the Traffic Light Diet System .
, while Chagas et al.
developed the Rango Cards Game, an interactive digital game application .
Chagas et al.
applied a cluster randomized controlled trial design, where the control group did not receive any intervention.
Meanwhile.
Mahmudiono et al.
used a quasi-experimental study design, in which the control group was only given a PPT presentation.
In the study using the Rango Cards Game, no significant improvement was found in nutrition knowledge, and only a slight but not significant increase was observed in self-efficacy scores .
However, there was a significant improvement in the perception of the benefits of fruits and vegetables, the intention to reduce salt consumption, and the intention to prepare healthy meals.
In Mahmudiono et al.
Aos study, both groups showed significant improvements in knowledge.
however, the control group showed a greater increase.
Regarding attitudes, the intervention group showed a modest but significant improvement, while the control group demonstrated a greater change .
Both studies had advantages in utilizing digital technology to support nutrition education interventions.
However, there were several limitations that could serve as input for future studies to achieve better outcomes in nutrition interventions.
The Traffic Light Diet System study had limitations in terms of the control group having a higher number of respondents due to the specific use of Android devices, which led to selection bias and limited sample representation.
Furthermore, participants with https://doi.
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Desember 2025 diverse educational backgrounds might interpret nutrition education differently .
Additionally, there were facilitators such as the integration of a food database customized with local food in online ordering applications, making it closely related to daily life and easier to implement .
The Rango Cards Game study had limitations in terms of the short intervention duration, a limited number of game phases, and the lack of incorporation of local food culture preferences or local health priorities, relying only on national guidelines.
Nevertheless, it had the advantage of being playercentered in its game design, resulting in a stronger relationship between the player and the technology .
Traditional-based Interventions Based on the analysis of the selected articles, three studies were identified that evaluated traditional-based interventions.
However, five different intervention models were found within these three studies.
This was due to the studies in India .
and Indonesia .
, which each evaluated two different intervention approaches within a single study, namely the comparison between a complete intervention package and a pamphlet in India, and the comparison between individual and group approaches in Indonesia.
Meanwhile, the study in Mexico .
, compared two intervention groups, but only the group that received lecture-based food education was categorized as a traditional intervention.
In terms of study design, one study used a Cluster Randomized Controlled Trial (RCT) design .
while the other two studies used a quasi-experimental design .
, .
(Table .
Table 2.
Data Charting Traditional-based Interventions Author.
Year.
Study Location Objective.
Study Design Intervention Type Outcomes Figueroa Piya Improving .
Mexico nutritional literacy and food education that disciplines such as health, food science, agriculture, and the This quasiexperimental study selected through sampling, with 34 assigned to the intervention and 30 assigned to the Food education implemented over a 12-week period.
Increase frequency of eating fruit and vegetables.
Mallick et al.
India To assess and compare the effectiveness of interventions, practices, and physical activity levels in group 1 which received the complete (Health education with flip chart and pamphle.
students from four schools selected random sampling Health education using a flip chart over 4 weeks.
Significant decrease in screen time for There was nutritional knowledge and sleep duration.
Mallick et al.
India To assess and compare the effectiveness of Cluster Pamphlet distributed over a 4 week period.
There significant increase in nutritional knowledge and physical activity.
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Desember 2025 Author.
Year.
Study Location Objective.
Study Design Intervention Type Outcomes nutritional knowledge, practices and physical activity levels in group 2 students from four schools selected random sampling Kamsiah et al.
Indonesia Evaluating the impact of nutrition education on patterns in preventing KEK in adolescent girls through an individual Quasiexperimental study students, selected random sampling.
Individual based education using discussions,and booklets over a 3 week period.
There significant increase in knowledge, attitudes, protein intake.
Kamsiah et al.
Indonesia Evaluating the impact of nutrition education on patterns in preventing KEK in adolescent girls Quasiexperimental study students, selected random sampling.
Group education using discussions,and booklets over a 3 week period.
There significant increase in knowledge, attitudes, protein intake.
However, it showed positive behavioral changes in the form increase in healthy All traditional-based interventions demonstrated positive effects on improving knowledge, attitudes, and behaviors, though results varied across studies.
In India, pamphlet-only interventions had a greater impact on promoting healthy eating practices compared to those combining flip charts and pamphlets.
Conversely, the combined flip chart and pamphlet intervention significantly reduced screen time for studying but did not produce significant improvements in nutrition knowledge or sleep Both intervention and control groups showed inconsistent changes in physical activity.
The study in Mexico reported that lecture based food education was able to significantly increase the frequency of fruit and vegetable consumption and improve nutrition attitudes and awareness.
However, its impact was still lower compared to interventions that combined it with direct practice .
In contrast, the study in Indonesia found significant improvements in knowledge, attitudes, as well as energy and protein intake using the booklet and group discussion approach compared to individual mentoring .
Several barriers were identified in studies using traditional-based interventions.
India and Indonesia, limitations included short intervention durations, socioeconomic complexities, and the delivery of education models that were passive, leading to a lack of practical integration in learning, which became obstacles in sustainable behavior change .
, .
The study in Mexico found that the group receiving only food education showed cognitive improvements but lacked practical engagement .
However, some factors facilitated success, such as access to and support from the home environment for behavior change.
, various and easily accessible visual and printed information sources.
, and social interaction support in group approaches.
School Based Intervention Five studies were identified in the category of school based interventions.
One study used a qualitative exploratory approach through in depth interviews and focus group discussions .
, while the other four studies applied a cluster randomized https://doi.
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, .
, .
, .
In these five analyzed studies, seven intervention models were identified, showing a diversity of approaches.
Some studies implemented nutrition education and multi component healthy lifestyle programs .
, .
, as well as interventions integrating the school curriculum .
Other studies developed interventions based on school integration with meal programs and gardening or using only school gardens combined with nutrition education and community workshops .
In addition, there were interventions in the form of training school canteen and shop operators .
, as well as culinary nutrition education based on direct practice .
The target groups of interventions in these five studies also varied, including students, parents, and the school community who were actively involved in the implementation of the programs.
Table 3.
Data Charting School Based Intervention Author.
Year.
Study Location Objective.
Study Design Intervention Type Outcomes Azizan et Malaysia Evaluating implementation of a school based intervention that promotes healthier eating habits in the Quasiexperimental study involved 76 selected through sampling, with 38 assigned to the intervention group and 38 to the control group.
Training canteen and shop operators to sell subsidization of healthy food over a 3 month period.
Changes consumption of fruits and vegetables, acceptance of healthy foods and the availability of a healthy canteen environment.
Kim Ethiopia Evaluating effectiveness of a nutrition education through 4 school Cluster students selected Routine activities .
lag ceremony, peer mentoring.
BMI measurement and counseling, teacher meetings over a 12 month Significant decrease in increase in food diversity and meal frequency of knowledge of students and However, significant change in junk food consumption was Kim Ethiopia Assessing included in the Cluster students selected The nutrition is similar to that already Ethiopian public schools over a 12 month period Consumption of sweet foods such as candy was found to be still high.
Getting significantly lower scores in food diversity, compared to the group given additional nutritional education intervention.
Wang et Tanzania Implementing and evaluating a full package through four components of nutritional intake.
Cluster students, selected School Meals.
School Gardens.
Nutrition Education.
Community Workshops over a 12 month period There was an increase in students' self-efficacy and There total energy, protein and https://doi.
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Study Location Wang et Tanzania Objective.
eating behavior of elementary school Implementing and evaluating a partial package through three components of school based nutritional intake, eating behavior of elementary school Study Design e-ISSN: 2338-3445 p-ISSN: 0853-9987 Intervention Type Outcomes significant differences were found in anthropometric indicators (BMI).
Cluster students, selected School Gardens.
Nutrition Education.
Community Workshops over a 12 month period There were no significant increases in energy or However, increases in vegetable consumption, self-efficacy and preference for healthy foods, although the results were not as strong as in the group receiving the full Barbosa Filho .
Brazil Assessing effectiveness of the Fortaleya Sayde program in promoting healthy lifestyle behaviors among adolescents with low Human Development Index.
Cluster
1,256
students selected Fortaleya Sayde Program (Training subject teachers Changes in the School Environment.
Education parent.
, over a 7 month period.
There was a significant increase in physical activity.
Increased healthy behavior related to reduced screen Computer/games.
And a significant decrease in the behavior of consuming sweet foods was found.
Malaysia Evaluating effectiveness of a education program at a 3 month follow up, in terms of children's dietary Quasiexperimental study involved 21 parent child dyads, cluster sampling, without a control Culinary nutrition education based on direct practice session about the environment 5 hands on healthy meal preparation session.
, over 6 The intervention had a vegetables, and decreasing Helped improve the variety of foods at dinner.
In general, school based interventions had a positive impact on adolescent lifestyle This was reflected in changes in eating behaviors such as increased consumption of fruits, vegetables, and other healthy foods.
Several interventions reported changes in vegetable consumption .
, .
, .
Some studies also reported a significant reduction in the consumption of sugary foods or beverages .
, .
, .
However, in the intervention model reported by Kim, one model that only provided nutrition education through the school curriculum still reported high consumption of sugary foods and beverages .
Multi component interventions involving students, teachers, parents, and communities .
, .
, .
showed improvements in physical activity, meal frequency, reduction in consumption of sweets and ultra processed foods, https://doi.
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However, reductions in junk food consumption and anthropometric indicators were not significant .
, .
, .
The limitations identified in several studies included the use of self reported measurement methods and relatively short intervention durations .
, .
In addition, the lack of components for changing the school food environment was a consistently reported barrier in several studies .
, .
, .
Specifically, in the study by .
the absence of school meal support was a significant differentiator between the partial and full intervention groups.
Other barriers included established preferences and habits .
, .
, resistance to change from the school environment .
, .
, and challenges in accessing healthy food at home and in the community .
, .
On the other hand, several facilitating factors found in the intervention models were stakeholder, teacher, family, and community support, which served as driving factors in the effectiveness of the interventions .
, .
, .
, .
Support from trained facilitators, peer monitoring involvement, and logistical support also contributed positively to program implementation .
, .
, .
, .
All studies emphasized the importance of program sustainability, cross sectoral integration, and local context adaptation.
DISCUSSION