Exploring Impacts of a Nutrition-Focused Massive Open Online Course
Abstract
:1. Introduction
2. Materials and Methods
2.1. MOOC Evaluation Protocol Applying Kirkpatrick’s Framework
2.2. Data Collection
2.3. Quantitative Data
2.3.1. Pre-Course Surveys
2.3.2. Post-Course Surveys
2.3.3. Fruit and Vegetable Survey
2.4. Qualitative Data
2.4.1. Discussion Forums
2.4.2. Interviews
2.5. Data Analysis
2.6. Reflexivity
3. Results
3.1. Participants
3.2. Mapping to NWKM
3.3. Level 1—Reaction
3.3.1. Qualitative Theme (i): MOOC Style Learning and Content Was Liked by Participants
“The most important awareness I got was about mindful eating, so that we don’t overeat things.” Interview participant 11
“This has been a very interesting, well structured and resourced course, with an impressive range of papers, guidelines and websites to support each subject covered. It’s always better when a FL course has mentor support throughout, and XXXX has been very thorough and diligent in her weekly summaries despite the current difficulties.” Discussion forum comment (Learner 0845b302)
“The best thing of all, though, has been the lively discussions, and I want to thank my fellow participants for raising excellent questions, and sharing so much.” Interview participant 11
“Before starting the course I had ideas of what you might cover during the three weeks and I was expecting information on incorporating herbs and spices into meals and their individual benefits included on the course as they have so many health giving properties.” Discussion forum comment (Learner a8960701)
3.3.2. Qualitative Theme (ii): MOOC a Trusted Source of Nutrition Information
“I can look and I can go, “Oh, that’s where they got it from. Okay, that’s fine.” And it made me feel a lot better about what I was reading so then I could continue from that point and trust what I was getting was right. I didn’t have to go over and try to figure out is it true.” Interview participant 15
3.4. Level 2—Learning
3.4.1. Qualitative Theme (iii): Learning New Information
3.4.2. Qualitative Theme (iv): Learning from Peers’ Personal Experiences and Opinions
“I liked using the comments and learning from other students, and I heard about some medicinal plant foods in Africa which was new to me.” Discussion forum comment (Learner 81337860)
3.4.3. Qualitative Theme (v): The Impact of Participant Self-Perceived Expertise
“Thank you for this course. I have to be honest and say I already knew most of the information and it hasn’t really changed the way I eat.” Discussion forum comment (Learner f0e4d141)
“I consider myself to have a healthy diet but I can now see I can make a few changes to it by incorporating more seeds and grains. I have tended to avoid these in the past as I was never too sure what to with them. I am now adding golden linseed and chia seed to my daily porridge alongside the blueberries which I always had prior to the course.” Discussion forum comment (Learner 25f4e4cc)
3.4.4. Qualitative Theme (vi): Learning Autonomously
“You have a choice whether you’re going to leave a comment. You have a choice whether going to read the comments as well. It’s up to you what level of participation you have.” Interview no.10
3.5. Level 3—Behaviour
3.5.1. Fruit and Vegetable Survey
3.5.2. Qualitative Theme (vii): Learners Changed Dietary Behaviours
“We try to have [beans and legumes] twice a week. And we mainly do, but now I’ve added more for myself personally. What else? Linseed, which was recommended in your course I’ve also added and hopefully that’s helping.” Interview participant 1
“I have changed my eating patterns since starting the course by reducing my sugar intake and drinking more water. I hope to continue this with time and become more healthy with increased exercise.” Discussion forum comment (Learner aff89aa5)
“Will try to ensure that I prepare 5 cups of veg/day for hubby and myself.” Discussion forum comment (Learner 59039e44)
3.5.3. Qualitative Theme (viii): Sharing and Influencing the Behaviours of Others
“I loved finding out why we need to eat certain foods and relaying this information to my kids in a slightly more kid friendly version! I have found they are more engaged at meal times when they understand why and what they are eating.” Discussion forum comment (Learner 5321236b)
3.6. Level 4—Results
4. Discussion
Strengths and Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
Age (Years) | Average Age of 2020 Course Participants (%) | Age of Pre-Course Survey Participants (%) |
---|---|---|
<18 | 2 | 2.0 |
18–25 | 18 | 15.7 |
26–35 | 19 | 25.1 |
36–45 | 15 | 18.0 |
46–55 | 14 | 16.7 |
56–65 | 13 | 13.1 |
65+ | 12 | 9.3 |
Unknown | 7 | 0.1 |
MOOC Run | Number of People Who Signed up to the MOOC | Number of Learners in the MOOC | Number of Countries |
---|---|---|---|
March 2020 | 17,434 | 14,207 | 173 |
June 2020 | 16,600 | 12,190 | 171 |
November 2020 | 11,472 | 6982 | 161 |
Demographics of Interview Participants | n = 12 |
---|---|
Age
| 2 3 0 4 3 0 |
Satisfaction
| 5 6 1 0 |
Participation in Discussion Forums
| 6 6 |
Gender
| 2 10 0 0 |
Appendix B
How Confident Are You in Applying What You Have Learnt | n = 1003 | Percent |
---|---|---|
Extremely confident | 497 | 49.6 |
Somewhat confident | 490 | 48.6 |
Not very confident | 16 | 1.6 |
Appendix C
Theme | Example Categories | Example Comments |
---|---|---|
Learning from peers’ personal experiences and opinions | MOOC discussion forums create community of learning Personal experiences could be the new qualifications Sharing personal experiences of symptoms after eating foods Discussion forums useful Interacting with other learners | “So, I found that quite valuable because I wouldn’t really go to support groups or anything like this because in the past that hasn’t really helped my own health. But an education setting, seeing other people’s opinions and relatable, I find that quite, um, yeah valuable.” “It is good to have other people learning along with you that you can ask questions, or that you could discuss things with. Because they might... One, they would have a different perspective that you might learn something from. And two, people have different ways of understanding things. And if you are stuck in your understanding, like them explaining it a different way might be helpful. And vice versa, it might be helpful to you to try and help somebody else or consolidate your knowledge that way.” “But other than that yeah I mean our diet it’s a large amount of vegetables and tofu, and high protein pulses, I have trouble with that is they’re not always that brilliant for IBS.” “And I thought a lot of the comments were really interesting. Yeah, I learned quite a lot from the comments as well.” “Thanks too to all the other learners because their contributions are what make the course so different with each run.” “@REDACTED Oh dear. Spirulina is potent, I hope you didn’t try it by the spoonful (yes, it’s vile, lol)—it’s best if mixed into something like a kale & spinach smoothie (minus the sugary fruits)” |
Learning autonomously | Diets can change and are influenced by information consumed and experiences Information about nutrition not enough to change dietary behaviours People are in charge of their own learning now and MOOCs help provide autonomy over learning People have own views on what is information is trustworthy and seek out difference sources People need learning resources that fit in their time pressured life to learn and make dietary changes | “So now I’ve been eating that for 10 years now. I’m going to get back again, I think. But not vegan. I’m going to be more like a vegetarian, but not vegan. But vegan is so difficult. It’s so much difficult.” Actually, when I go to office, my diet is properly. “Well, I like something that you don’t have to attend with lots of people, or that you have to attend where you’re a video camera with people or picking up all their background noises, or in and out for the pictures. So I like it that you can just access as a free agent independently and that it is free. So those things I do like.” “I think I’ll probably if something in the discussion group, I would like to if they had disagreed with something one of the lecturers or whatever had said, then I’d certainly want to be looking in to see if I could find out any more information around that.” “I’d say time was my biggest factor. I would sit down, I wanted to get the content first and then try to absorb that. So when I had to choose where to stop and draw the line, it’s at the discussion for sure.” |
Learners changed dietary behaviours | Course changed dietary habits Course a motivation to change dietary behaviours Course encouraged reflection on dietary practices Trying to implement dietary changes after course Course inspiration for new dietary behaviours Aiming to try new foods Course acting as a prompt to eat well | “Linseed, which was recommended in your course I’ve also added and hopefully that’s helping.” “Then other than that, more of green leafy vegetables. That also I have increased, after watching this MOOC.” “And then the other recommendation of the course that we eat as varied and it’s diverse as much that we diversified the food and varied as much as possible. And so I’m trying to focus on that and pick up things like mangoes is exotic here and avocados as well. So picking up items like that from the supermarket when I shop each time and getting something different in order to add variety.” “I try to eat more fresh and raw vegetables.” “The course has helped me on food choices where I’m on my way of making sure that I take daily recommended amount of fruits and vegetables.” “I will continue to eat as I do but will try and up the vegetables” “The course helped me to remember the importance of eating a varied and well balanced diet and to continue to be a wise consumer of dietary information.” |
Learning new information | Course increased awareness about nutrition and dietary patterns Course provides practical options to implement nutrition recommendations MOOC provided new learnings on nutrition and diet information MOOC provides professional and personal nutrition learning Informative course Recapping new information taken away from course Took new learning and knowledge away | “You don’t always stick by that, but it does matter, I am more aware. After the course it definitely made me more aware of what’s good and what’s not necessarily as good as you thought it was.” “So these videos gave me an idea how to apply them more practically. So practical application.” So that also I got to know, what are the vegetarian protein sources. So that also I got a good salad from this MOOC session, what all can be added with vegetables, combined with vegetables, to increase protein intake in vegetarian people, and also the use of yogurt.” “I just think I find it a very good way of learning for myself. And it keeps me up to date with different things as well, which obviously you have to do as a nurse anyway.” “There were a number of general tips like extra virgin olive oil is healthier, try to leave the skin on, nutrition is science and the way we eat is behaviour and that there are 13 vitamins and 16 minerals. There were many more, these are just a few.” “I’m leaving this course with a lot more information, awareness and better understanding of foods, nutrition and their impacts.” |
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NWKM Levels | Level Description | Questions Asked | Method of Evaluation |
---|---|---|---|
Level 1: Reaction | Satisfaction | How satisfied were you with the course? | Quantitative post course survey imbedded in final step of the MOOC |
Engagement | Did you find the discussion forums in the course useful? | ||
Relevance | How relevant was the course content for you and your goals? | ||
Satisfaction | What did you like most about the course? What did you think about the presence of discussion forums in the MOOC? | Comments in final discussion forum extracted for qualitative thematic analysis; | |
Engagement | Consider sharing with other learners some of the ways your food intake or approach to eating has changed, and how you’re now using food as medicine. You might like to take some time to read comments made by other learners, and if you find these comments interesting, respond to them. | ||
Satisfaction | What did you think of the MOOC? What did you think about the presence of discussion forums in the MOOC? | Semi-structured interviews conducted with MOOC participants, with qualitative thematic analysis conducted | |
Engagement | How active were you in the discussion forums? | ||
Relevance | Why did you/did you not use the discussion forums?How did you react when you read something that they didn’t agree with in discuss forums? How do you view the information provided by other learners in discussion forums? How likely are you follow or believe what they say? | ||
Level 2: Learning | Commitment | How likely are you to apply what you have learnt? | Quantitative post course survey imbedded in final step (on completion) of the MOOC |
Confidence | How confident are you in applying what you have learnt? | ||
Commitment | How likely are you to continue seeking further information on nutrition? | ||
What affect has the MOOC had on your beliefs/knowledge around nutrition? What new information have you learnt from the MOOC? Can you describe any changes to your views on nutrition and food topics the MOOC has had? Where the discussion forums useful for your learning? | Knowledge | Semi-structured interviews conducted with purposefully sampled participants, with qualitative thematic analysis conducted | |
Attitude | How important are credentials to you when learning information? How do you view the information provided by other learners in discussion forums? Do you believe it? Do you tend to follow what they say? | ||
Level 3:Behaviour | Behaviours: application or utilisation of what was learnt? | What has been the biggest change you have made since participating in the MOOC? Describe any impact on other members of your household taking part in the MOOC has had. How has your participation in the MOOC affected your eating habits? Describe any impacts taking part in the MOOC has had on your eating habits? | Semi-structured interviews conducted with MOOC participants, with qualitative thematic analysis |
How have your food choices changed? What are you doing to eat more healthily? How are you now using food as medicine? How has your food intake or approach to eating changed? | Comments in final discussion forum extracted for qualitative thematic analysis | ||
After completing this course, how many serves of vegetables do you now eat each day? In total, how many serves of vegetables do you usually eat each day? After completing this course, how many serves of fruit do you now eat each day? In total, how many serves of fruit do you usually eat each day? | Quantitative survey measuring self-reported fruit and vegetable intake |
Self-Perceived Level of Nutrition Knowledge | n = 4941 | Percent |
---|---|---|
I have no knowledge about nutrition | 128 | 2.6 |
I have only a little knowledge about nutrition | 1042 | 21.1 |
I know the basics of nutrition information | 1930 | 39.1 |
I have a good general knowledge of nutrition | 1617 | 32.7 |
I am very knowledgeable about nutrition | 224 | 4.5 |
Highest Level of Nutrition Study | n = 4941 | Percent |
---|---|---|
University or research institute | 514 | 10.4 |
TAFE of college | 226 | 4.6 |
High School | 341 | 6.9 |
Short course | 813 | 16.5 |
No formal nutrition study | 3047 | 61.7 |
NWKM Level | Results |
---|---|
Level 1: Reaction | 959 (95.6%) participants indicated they were extremely or somewhat satisfied975 (97.2%) participants indicated the course was very or somewhat relevant to learning goals |
Qualitative Theme (i): MOOC style learning and content was liked by participants. | |
Qualitative theme (ii): MOOC a trusted source of nutrition information. | |
Level 2: Learning | Qualitative theme (iii): Learning new information |
Qualitative theme (iv): Learning from personal experiences and opinions of peers. | |
Qualitative theme (v): The impact of participant self-perceived expertise. | |
Qualitative theme (vi): Learning autonomously. | |
Level 3: Behaviour | 96% of participants indicated they were extremely likely or somewhat likely to apply what they have learnt |
97% of participants indicated they were extremely of somewhat confident in applying learning | |
62% of participants reported having at least 1 more serve of vegetables each day | |
Qualitative theme (vii): Learners changed dietary behaviours. | |
Qualitative theme (viii): Sharing and influencing the behaviours of others. |
Very Positive | Somewhat Positive | Neither | Somewhat Negative | Extremely Negative | |
---|---|---|---|---|---|
How satisfied are you with the course? * (n = 1003) | 642 (64.0%) | 317 (31.6%) | 36 (3.6%) | 5 (0.5%) | 3 (0.3%) |
How relevant was the course for you and your goals? ** (n = 1003) | 600 (59.8%) | 375 (37.4%) | 25 (2.5%) | 3 (0.3%) | 0 (0%) |
Did you find the discussion forums in the course useful? *** (n = 1003) | 295 (29.4%) | 535 (53.3%) | 115 (11.5%) | 5 (0.5%) | 53 (5.3%) |
Serves of Vegetables and Fruit | Vegetable Intake n = 1090 | Fruit Intake n = 1088 | |
---|---|---|---|
Change of serves | Eating 1–2 serves more | 463 (42.5%) | 326 (30.0%) |
Eating 2+ serves more | 210 (19.3%) | 118 (10.8%) | |
Eating the same | 388 (35.6%) | 576 (52.9%) | |
Eating 1–2 serves less | 18 (1.7%) | 52 (4.8%) | |
Eating 2+ serves less | 11 (1.0%) | 16 (1.5%) | |
Total number of serves per day | 0–1 | 39 (3.6%) | 27 (2.5%) |
2 | 122 (11.2%) | 168 (15.4%) | |
3 | 207 (19.0%) | 715 (65.6%) | |
4 | 309 (28.3%) | 178 (16.3%) | |
5 | 243 (22.3%) | N/A | |
6 or more | 168 (15.4%) | N/A |
Vegetable Intake n = 1088 | Fruit Intake n = 1088 | |
---|---|---|
Meeting Australian Dietary Guidelines recommendation after participating in course | 37.8% | 65.7% |
Current proportion of Australian’s meeting the recommended intake [36] | <7% | 50% |
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Adamski, M.; Truby, H.; Bennett, C.; Gibson, S. Exploring Impacts of a Nutrition-Focused Massive Open Online Course. Nutrients 2022, 14, 3680. https://doi.org/10.3390/nu14183680
Adamski M, Truby H, Bennett C, Gibson S. Exploring Impacts of a Nutrition-Focused Massive Open Online Course. Nutrients. 2022; 14(18):3680. https://doi.org/10.3390/nu14183680
Chicago/Turabian StyleAdamski, Melissa, Helen Truby, Christie Bennett, and Simone Gibson. 2022. "Exploring Impacts of a Nutrition-Focused Massive Open Online Course" Nutrients 14, no. 18: 3680. https://doi.org/10.3390/nu14183680