Application of Just-in-Time Adaptive Interventions in Dietary Health Management: Systematic Review

Area of Science:

• Digital Health
• Behavioral Science
• Nutrition Science

Background:

• Just-in-time adaptive interventions (JITAIs) leverage real-time data to provide personalized support during critical moments, potentially enhancing dietary behaviors in real-world settings.
• JITAIs deliver tailored interventions based on individual needs and context, offering a promising approach for managing dietary health.

Purpose of the Study:

• To systematically review the application, characteristics, and effectiveness of JITAIs specifically within the domain of dietary health management.
• To synthesize evidence on JITAIs for dietary interventions, addressing gaps in broader reviews of digital behavior change and weight management.

Main Methods:

• Systematic review of human studies on JITAIs for dietary management delivered via digital platforms, utilizing real-time data for personalization.
• Searched multiple databases (PubMed, Embase, etc.) and clinical trial registries; included studies reporting behavioral, engagement, physiological, or clinical outcomes.
• Assessed methodological and reporting quality; synthesized findings narratively due to heterogeneity; registered in PROSPERO (CRD420261285292).

Main Results:

• Twenty studies (2948 participants) evaluated JITAIs for diverse populations (overweight/obesity, chronic conditions, general public).
• Interventions primarily used smartphone apps, SMS, wearables, and notifications, showing consistent benefits for proximal behavioral outcomes (e.g., fruit/vegetable intake, self-monitoring).
• Inconsistent improvements in distal clinical outcomes (e.g., weight, BMI, blood pressure); common barriers included device issues, digital literacy, and signal limitations.

Conclusions:

• JITAIs show potential for timely, individualized dietary behavior change, particularly for proximal behavioral outcomes, but clinical effect consistency is limited.
• This review clarifies JITAIs' role in dietary health, highlighting intervention characteristics, delivery methods, and effects across populations.
• Findings support developing scalable, context-sensitive digital dietary interventions for clinical care, self-management, and public health nutrition.