Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Interventions and public health nutrition

Promoting healthy lifestyle in Chinese college students: evaluation of a social media-based intervention applying the RE-AIM framework



A health program aiming at college students is pressingly needed to improve their lifestyle and prevent diseases. However, a health intervention often requires health facilities and the many efforts of health workers. This project attempts to evolve traditional health intervention by using integrated methods based on social media and multiple mobile tools.


A total of 110 undergraduates from Zhejiang University were recruited. In all, 87 participants volunteered to enroll in the intervention group, whereas 23 stayed in a control group. Fifteen staff (dietitians, health assistants and a sports coach) used the WeChat app and its plugin Zhishi mini-program for health education, diet and physical activity (PA) supervision during 21 days. Pre-to-post changes of eating habits, physical fitness tests and anthropometry data were measured. The RE-AIM framework was employed to evaluate the intervention, dimensions of which were Reach, Effectiveness, Adoption, Implementation, and Maintenance.


The recruitment rate of students was 79.1%. The intervention group showed significant progress in terms of healthy food intake (all P < 0.05), and an improvement in PA level (P = 0.004) over 21 days. About 60.9% subjects were satisfied with the whole program and 64.4% would like to join the program again.


This intervention showed a great improvement in healthy behavior with great feasibility for further dissemination.

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.


  1. 1.

    Martinez-Lacoba R, Pardo-Garcia I, Amo-Saus E. Escribano-Sotos F. Socioeconomic, demographic and lifestyle-related factors associated with unhealthy diet: a cross-sectional study of university students. BMC Public Health. 2018;18:1241.

    Article  Google Scholar 

  2. 2.

    Irwin JD. Prevalence of university students’ sufficient physical activity: a systematic review. Percept Mot Skills. 2004;98(3 Pt 1):927–43.

    Article  Google Scholar 

  3. 3.

    Thanawala N, Rubinow DA, Roga Z, Liou H. Measuring health of college students: food security, diet quality, and physical activity. 2018;1–17.

  4. 4.

    Wang D, Ou CQ, Chen MY, Duan N. Health-promoting lifestyles of university students in mainland China. BMC Public Health. 2009;9:379.

    CAS  Article  Google Scholar 

  5. 5.

    Zhang HL, Li GY, Zhang BR, Dai GS, Wu CH, Fan L. Descriptive study on the health-harmed behaviors of the college students. J Langfang Teach Coll. 2002;18:92–4. (Chinese).

    Google Scholar 

  6. 6.

    Liang W, Duan YP, Shang BR, Wang YP, Hu C, Lippke S. A web-based lifestyle intervention program for Chinese college students: study protocol and baseline characteristics of a randomized placebo-controlled trial. BMC Public Health. 2019;19:1097.

    Article  Google Scholar 

  7. 7.

    Chinese State Council’s General Office. Healthy China action (2019–2030). (Chinese). Accessed 11 Dec 2019.

  8. 8.

    Wang D, Xing XH, Wu XB. Healthy lifestyles of university students in China and influential factors. ScientificWorldJournal 2013;2013:412950.

    PubMed  PubMed Central  Google Scholar 

  9. 9.

    Korda H, Itani Z. Harnessing social media for health promotion and behavior change. Health Promot Pract. 2013;14:15–23.

    Article  Google Scholar 

  10. 10.

    Gabarron E, Bradway M, Fernandez-Luque L, Chomutare T, Hansen AH, Wynn R, et al. Social media for health promotion in diabetes: study protocol for a participatory public health intervention design. BMC Health Serv Res. 2018;18:414.

    CAS  Article  Google Scholar 

  11. 11.

    CNNIC. The 44th China statistical report on Internet development. (Chinese). Accessed 11 Dec 2019.

  12. 12.

    Glasgow RE, Vogt TM, Boles SM. Evaluating the public health impact of health promotion interventions: The RE-AIM framework. Am J Public Health. 1999;89:1322–7.

    CAS  Article  Google Scholar 

  13. 13.

    Lewis ZH, Ottenbacher KJ, Fisher SR, Jennings K, Brown AF, Swartz MC, et al. The feasibility and RE-AIM evaluation of the TAME health pilot study. Int J Behav Nutr Phys Act. 2017;14:106.

    Article  Google Scholar 

  14. 14.

    Schwingel A, Galvez P, Linares D, Sebastiao E. Using a mixed-methods RE-AIM framework to evaluate community health programs for older latinas. J Aging Health. 2017;29:551–93.

    Article  Google Scholar 

  15. 15.

    Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35:1381–95.

    Article  Google Scholar 

  16. 16.

    Ye YL, Wang PG, Qu GC, Yuan S, Phongsavan P, He QQ. Associations between multiple health risk behaviors and mental health among Chinese college students. Psychol Health Med. 2016;21:377–85.

    Article  Google Scholar 

  17. 17.

    Ha EJ, Caine-Bish N. Effect of nutrition intervention using a general nutrition course for promoting fruit and vegetable consumption among college students. J Nutr Educ Behav. 2009;41:103–9.

    Article  Google Scholar 

  18. 18.

    Mitchell SJ. Changes after taking a college basic nutrition course. J Am Diet Assoc. 1990;90:955–61.

    CAS  PubMed  Google Scholar 

  19. 19.

    Gow RW, Trace SE, Mazzeo SE. Preventing weight gain in first year college students: an online intervention to prevent the “freshman fifteen”. Eat Behav 2010;11:33–9.

    Article  Google Scholar 

  20. 20.

    Yan AF, Stevens P, Wang Y, Weinhardt L, Holt CL, O’Connor C, et al. mHealth text messaging for physical activity promotion in college students: a formative participatory approach. Am J Health Behav. 2015;39:395–408.

    Article  Google Scholar 

  21. 21.

    Mora-Gonzalez J, Perez-Lopez IJ, Delgado-Fernandez M. The “$in TIME” gamification project: using a mobile app to improve cardiorespiratory fitness levels of college students. Games Health J. 2019;9:37–44.

    Article  Google Scholar 

  22. 22.

    Wahl C, Gregoire JP, Teo K, Beaulieu M, Labelle S, Leduc B, et al. Concordance, compliance and adherence in healthcare: closing gaps and improving outcomes. Health Q. 2005;8:65–70.

    Article  Google Scholar 

  23. 23.

    McKay HG, King D, Eakin EG, Seeley JR, Glasgow RE. The diabetes network internet-based physical activity intervention: a randomized pilot study. Diabetes Care 2001;24:1328–34.

    CAS  Article  Google Scholar 

  24. 24.

    Leslie E, Marshall AL, Owen N, Bauman A. Engagement and retention of participants in a physical activity website. Prev Med. 2005;40:54–9.

    CAS  Article  Google Scholar 

  25. 25.

    Pomerleau J, Lock K, Knai C, McKee M. Interventions designed to increase adult fruit and vegetable intake can be effective: a systematic review of the literature. J Nutr. 2005;135:2486–95.

    CAS  Article  Google Scholar 

  26. 26.

    Nour M, Chen J, Allman-Farinelli M. Efficacy and external validity of electronic and mobile phone-based interventions promoting vegetable intake in young adults: systematic review and meta-analysis. J Med Internet Res. 2016;18:e58.

    Article  Google Scholar 

  27. 27.

    Ulla Diez SM, Fortis AP, Franco SF. Efficacy of a health-promotion intervention for college students: a randomized controlled trial. Nurs Res. 2012;61:121–32.

    Article  Google Scholar 

Download references


Tons of thanks to Ying Chen, Ao Li, Yixin Jiang, Kaixin Pan, Yutao Ni, Yulian Yang, Jingyi Jin, Shannan Tong, Lina Ma. As staff members, their hard work in this intervention project would always be appreciated.


There was no financial support for this project.

Author information




MY conceived the idea. MW created the first manuscript. YG was the main contributor in manuscript writing. YZ executed the project. SX and ZY worked as dietitians. XL, JL, and DZ contributed to statistical analysis. ZM developed the social media AI based food tracking and analysis app and collected the participants’ dietary and nutrition intake data. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Min Yang.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Wang, M., Guo, Y., Zhang, Y. et al. Promoting healthy lifestyle in Chinese college students: evaluation of a social media-based intervention applying the RE-AIM framework. Eur J Clin Nutr 75, 335–344 (2021).

Download citation


Quick links