Discussion
fifty-four
RECRUITMENT
Intention-to-treat analyses found no significant group-by-time interaction for diet quality outcomes in this RCT of three levels of personalised dietary feedback for young adults. Recruiting and retaining young adults over the 12-month intervention was a challenge. Web-based interventions tailored to young adults require further investigation as a strategy to engage them in improving dietary patterns.While our study attracted over 4000 and recruited over 1000 young adults, we did not reach the sample size required. Reporting of recruitment and retention in young adult nutrition and physical activity interventions is generally poor, with less than half of 107 RCT adequately reporting recruitmentThe characteristics of the young adults enrolled in the In this study, only 3 %, 9 % and 14 % of participants were retained at 3, 6 and 12 months, respectively. Additionally, less than one-third of participants in Groups 2 and 3 accessed the personalised dietary feedback from the AES. In a systematic review of fifty-four RCT investigating behaviour change techniques for improving dietary intake of young adults, the mean retention rate was 78 % (range 22–98 %)Technology-based interventions have rapidly entered the health research setting but few studies report the unintended consequences of study implementation. In our study, many participants did not engage with the website, complete surveys or attend dietitian consultations. While we are unable to ascertain whether these problems were user-related (e.g. participants lacked motivation) or a design issue (e.g. the website was difficult to navigate), they were exacerbated by technical issues. The Another unexpected finding was the low uptake of dietitian consultations (15 % of Group 3 participants). Young adults more frequently source their nutrition information from online resources (93 %) compared to healthcare professionals (5 %)Participants who did use the dietitian consultation generally provided positive feedback. Due to the conflicting nutrition information found online and considering dietitians’ skills in facilitating dietary behaviour change, it is important for nutrition professionals to bridge this gap with young adults and assist them in accessing professional advice. A systematic review has found that counselling by Accredited Practising Dietitians confers annual savings of $830 to $1893 per person, with fewer medications and hospital admissions related to chronic diet-related conditionsAdding tailored feedback and counselling to digital interventions can increase their effectiveness in improving eating behaviours, although further support is likely required to assist young adults to achieve long-term dietary improvements