Table 2.

Summary and key characteristics of each included study.

Lead Author and Year Title Country	Study Design Aim	Participants Sample Size Setting	Theoretical Basis	Structure Duration	Food Literacy Outcome Measure	Secondary Outcome Measures	Results: Primary Outcome	Results: Secondary Outcome	Study Limitations
Begley 2019 Effectiveness of an Adult Food Literacy Program [15] Australia	Pre-post study Assess how effective the Food Sensation for Adults programme is in changing FL and selected dietary behaviours.	Adults from low–middle-income households who would like to increase their FL skills n = 1092 Community-based groups and virtual sessions for regional areas	Vidgen and Gallegos FL model (Vidgen and Gallegos, 2014), Best Practice Criteria for Food Literacy Programs (WA Department of Health), Health Belief Model, Social Learning Theory	I = 2.5 hr sessions. Four core modules (healthy eating, food safety, cooking, label reading, food selection, budgeting, and meal planning) taught over 3 sessions. Recipe book provided to all participants. Four sessions	Validated pre/post-programme questionnaires: 14-item FL behaviour checklist.	Four close-ended questions on dietary behaviours: average consumption of fruit and vegetable servings, frequency of fast food meals and sugar-sweetened drink consumption (self-reported)	Significant ↑ in all three assessed FL behaviour factors (all p ≤ 0.0001) from pre- to post-programme.	Significant ↑ in servings of fruits (p ≤ 0.0001) and vegetables (p ≤ 0.0001), comparing pre- to post-programme. Significant decreases in fast food meal consumption pre- to post-programme.	Self-selection bias, number of questions assessing domains of FL were limited, potential that culturally and linguistically diverse populations not represented in evaluations, self-reported data, no control
Begley 2020 Identifying who improves or maintains their food literacy behaviours after completing an adult program [26]	Cross-sectional Compare demographic characteristics of participants who completed the programme’s follow-up questionnaire three months after programme completion and assess whether FL and dietary behaviour changes were improved or maintained	n = 621					Mean scores for 2 of the 3 domains significantly ↑ (Plan and Manage, p < 0.0001. Selection, <0.0001) from end-of-programme to follow-up. Preparation scores decreased but remained significantly ↑ from baseline.	Servings of fruit and veg decreased but remained significantly ↑ from baseline. Intake of fast food meals significantly ↑ between end-of-programme and follow-up (p < 0.0001), consumption frequency decreased from beginning of programme (p < 0.0001). No change in frequency of sugar-sweetened drinks.	Unknown what the ideal time for follow-up is; the demographic characteristics of those completing the follow-up questionnaires are different.
Dumont, C 2021 Effectiveness of Foodbank Western Australia’s Food Sensations ® for Adults food literacy program in regional Australia [27]	Cross-sectional Determine if there are differences in the effectiveness of FSA in regional and metropolitan (metro) participants	n = 1849					Significant ↑ in post-programme scores for all three FL domains for metro and regional (p < 0.0001). Regional significantly ↑ in selection behaviours compared to metro (p < 0.01). No significant difference between metro and regional in other 2 domains	Significant ↑ (p < 0.0001) in fruit and vegetable serving intake for metro and regional. Fast food meal and sweetened beverage intake significantly decreased pre- and post-programme for metro (p < 0.0001), but not for regional.	May not have captured the full range of disadvantage in regional areas in Western Australia
Bomfim 2020 Food Literacy while Shopping: Motivating Informed Food Purchasing Behaviour with a Situated Gameful App [16] Canada	Other: Exploratory Field Study To investigate the effectiveness of a gameful-situated app ‘Pirate Bri’s Grocery Adventure’ (PBGA) to promote FL in young adults	University students 18–31 Y n = 24: 2x cohorts of 12 Use of app during shopping trips for groceries	Nutrition: concepts and controversies (4th ed) (Sizer et al.), Meaningful gamification, slow technology, Health Belief Model	I = PBGA app C = My Food Guide app Both groups used app to plan and select foods for 3 weeks on minimum 3 different days 3 weeks	General Nutrition Knowledge Questionnaire (GNKQ) and Health Belief Model Survey (HBMS)	Food Purchases	GNKQ: Average scores ↑ 55.17/88 to 59.38/88 from pre- to post-intervention, p = 0.001. No differences in post-intervention scores between I and C (p> 0.005). HBMS: ↑ from pre- to post-intervention scores for self-efficacy (p = 0.004) and perceived susceptibility (p = 0.015). No significant difference between scores for I and C for all sections of HBMS.	↑ in fruit and veg (p = 0.004) purchased compared to what was planned, no difference between I and C. ↑ in ultra-processed foods bought compared to planned for C (p = 0.13), but not for I.	Does not provide insight into clinical effectiveness to promote FL; budgeting not addressed
Tartaglia 2023 Effectiveness of a food literacy and positive feeding practices program for parents of 0 to 5 years olds in Western Australia [20] Australia	Pre-post study To describe the development and evaluation of an innovative programme that combines FL with positive parent feeding practises, targeting parents indisadvantaged areas of Western Australia	Parents of children 0–5 years in Western Australia, particularly those in socially disadvantaged areas >18 Y n = 224 Community and online group sessions	Vidgen and Gallegos FL model (Vidgen and Gallegos, 2014), Satter eating competence model, division of responsibility framework, self-determination theory framework, social cognitive theory (SCT)	I = Weekly education and cooking sessions on basic nutrition principles for the whole family, child-feeding development stages, strategies to overcome fussy eating, food safety, label reading, meal planning, food shopping and budgeting. Includes 60 min hands-on learning, 60 min cooking and 30 min eating. Face-to-face: 5 weeks Online: 4 weeks	Pre- and post-questionnaire comprised 13 items from a 15-item validated FL tool	Positive parent feeding practises: 10 questions from validated child-feeding questionnaires, including the Feeding Practices and Structure Questionnaire. Typical vegetable intake over previous month	Statistically significant ↑ in all FL behaviours (p ≤ 0.001)	Significant ↑ in all positive parent feeding practises (p ≤ 0.001–0.003). Significant mean ↑ in vegetable intake (p = 0.001)	Higher rate of females (98%); change to online delivery may have resulted in people from higher socioeconomic areas being recruited.
Morgan 2023 Assessing food security through cooking and food literacy among students enrolled in a basic food science lab at Appalachian State University [18] United States	Pre-post study Implement a FL-based curriculum to increase FL-based skills and self-efficacy and combat food insecurity among undergraduate students enrolled in an already-established Basic Food Science Laboratory course at a rural university located in the Appalachian region	University students n = 39 University course	SCT, experiential learning theory	I = University food science course including labs involving observation and hands-on food preparation, food safety, budgeting education and eating 11 weeks	Purpose-developed questionnaire based on a variety of validated instruments	Food security: modified version of the USDA Six Item Food Security Short Form	Significant ↑ from pre- to post-assessment for FL-based behaviours (p < 0.05): preparing and cooking a meal with raw ingredients (p = 0.039), proper food storage (p = 0.046) and FL-based self-efficacy: Using different cooking methods, (p = 0.037), cooking with raw or basic ingredients (p = 0.003), preparing a well-balanced meal (p = 0.018), using substitutions in recipes (p = 0.000) and meal planning (p = 0.009). Two FL skills and three self-efficacy factors did not see a significant improvement.	No significant improvement in food security indicators	Short study length, small sample size, generalizability not tested, low number of behaviour-focused questions, self-report measures, significant proportion of included participants were dietitian (DT) and fermentation students
Mitsis 2019 Evaluation of a Serious Game promoting Nutrition and Food Literacy: Experiment Design and Preliminary Results [21] Greece	Quasi-experimental trial Present the experiment design and the obtained preliminary results from the evaluation of Express Cooking Train, a serious game that focuses on promoting nutrition literacy (NL) and FL	University students n = 29: Group A 9, Group B 10, Control 10 Trial of computer game	World Health Organisation and the American Heart Association fact sheets	I = FL game with two stages. User experiments with ingredients and progresses in the game when preparing healthy meals. C = Reading nutrition fact sheets 20 min	Knowledge questionnaire based on the (GNKQ) and a validated food safety knowledge questionnaire.	NA	Significant ↑ in pre- to post-intervention knowledge questionnaire scores (p = 0.002). No significant difference between C and I group post-intervention scores.	NA	Small sample size, control game was a different format
Ng 2022 Assessing the effectiveness of a 4-week online intervention on food literacy and fruit and vegetable consumption in Australian adults: The online MedDiet challenge [19] Australia	Pre-post study Develop and trial an online intervention programme to improve FL and fruit and vegetable intake through the use of MedDiet principles	Members of the GMHBA private health insurance provider from Victoria >18 Y n = 29 Facebook group	NA	I = Moderators shared nutrition education and encouraged Mediterranean-style eating via infographics 3x per week, how-to-videos 1x per week and recipes 1x per week. Fortnightly Q&A with nutrition experts on a Facebook group. Participants received a box of MedDiet staple ingredients, recipes and cooking ideas. 28 days	Modified version of validated 11-item FL questionnaire from the EFNEP	Average daily fruit and veg consumption: two questions from the National Nutrition Survey	Percentage of participants ↑ in all 11 FL components ranging from 20.7 to 44.8%: comparing prices (20.7%), changing recipes (24.1%), trying a new recipe (24.1%), confidence with cooking variety (31%), food labels (27.6%), nutrition information panel (34.5%), managing money to buy healthy food (31%), consideration of healthy choices (27.6%), including food groups (44.8%), making shopping lists (27.6%), planning meals (20.7%)	Statistically significant ↑ in mean fruit (p = 0.021) and veg intake (p = 0.007).	Small sample size compared to power calculation, majority tertiary-educated population, sample recruited from staff/members of private health insurer, self-report bias
Meyn 2022 Food Literacy and Dietary Intake in German Office Workers: A Longitudinal Intervention Study [17] Germany	Longitudinal Intervention Study Investigate the 1.5-year long-term effectiveness of a 3-week full-time workplace health-promotion programme (WHPP) regarding FL and dietary intake (DI), as well as therelation between FL and DI of German office workers using four measurement time points.	Adult office workers n = 144 WHPP based at a hotel	FL definition by Krause et al. 2018, Information–motivation–behaviour skills model	I = Groups provided initial and long-term goal-setting with a DT, provided meals with nutrition information and portion sizing guide with DT present, 4 hr nutrition education workshop and individual sessions by DT, behaviour change and health risk presentations, nutrient tables and recipes to take home 3 weeks	Short Food Literacy Questionnaire (SFLQ) adapted to German. Measured pre- (T0) and post (T1)-intervention, 6 (T2) and 18 months (T3) post-intervention	DI: German Food Frequency Questionnaire (GFFQ)	Strong ↑ in FL at T1 (β = 0.52, p < 0.0001), T2 (β = 0.60, p < 0.0001) and T3 (β = 0.55, p < 0.0001).	DI scores ↑ from 13.7 at T0 to 19.3 at T1, then decreased to 15.4 at T2 and 15.3 at T3. Significant ↑ at T1 (β = 0.63, p < 0.0001) and weak ↑ at T2 (β = 0.10, p < 0.05) and T3 (β = 0.10, p < 0.05)	No control/comparison, self-reported measures, T3 and T4 recorded during COVID-19, primarily highly educated population, narrow focus on FL for their specific study aim

Key: I = intervention, C = control, FL = food literacy, Y = age in years, ↑ = increase, DT = dietitian, SCT = social cognitive theory.