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Rashid AFA, Syed Saadun Tarek Wafa SWW, Talib RA, Bakar NMA. Interactive Malaysian Childhood Healthy Lifestyle (i-MaCHeL) programme: a single-arm pilot study. Pilot Feasibility Stud 2024; 10:80. [PMID: 38762727 PMCID: PMC11102176 DOI: 10.1186/s40814-024-01483-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 03/16/2024] [Indexed: 05/20/2024] Open
Abstract
BACKGROUND The growing obesity epidemic in Malaysia presents a public health challenge that requires innovative intervention strategies. In an effort to address this problem, an Interactive Malaysian Childhood Healthy Lifestyle (i-MaCHeL) programme, which is a web-based initiative designed for preschool child-parent dyads offers a novel approach. Nevertheless, the success of such a web-based intervention depends on several interrelated factors. This research aims to examine the feasibility of i-MaCHeL in the Malaysian context, its usability for preschool child-parent dyads, and the acceptability of the programme among these user groups. METHODS This was a single-arm pilot study involving 46 child-parent dyads recruited from six government preschools in Terengganu, Malaysia. The preschools were selected using a cluster random sampling technique at the preschool level. The intervention feasibility was determined based on the retention rate of participants in the pilot study. The System Usability Scale (SUS) and intervention process evaluation were used to assess the usability and acceptability of the web-based i-MaCHeL programme. RESULTS The retention data demonstrated that 42 out of 46 participants completed the 13-week intervention programme, which showed that the overall retention rate was 91.3%. A mean (SD) SUS score of 84.70 (13.82) was obtained from parents, indicating that the web-based i-MaCHeL had an acceptable usability level. The mean scores of the process evaluation items ranged from 4.52 (0.63) to 4.83 (0.38), demonstrating that the web-based i-MaCHeL was highly accepted by the parents. The acceptability data also indicated that at least 92.9% (39/42) of the parents agreed/strongly agreed that the web content, programme duration, intervention dose, WhatsApp group, and delivery mode were appropriate. CONCLUSIONS According to these findings, the i-MaCHeL intervention using a web-based approach was feasible, usable, and acceptable as part of a weight-related behaviour change intervention for preschool child-parent dyads. This pilot study demonstrated that the web-based i-MaCHeL was feasible and promising for delivering weight-related behavioural intervention to child-parent dyads. TRIAL REGISTRATION ClinicalTrials.gov, NCT04711525 . Registered on January 15, 2021.
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Affiliation(s)
- Ahmad Faezi Ab Rashid
- School of Nutrition and Dietetics, Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Kuala Nerus, Terengganu, Malaysia
- Faculty of Hospitality, Tourism, and Wellness, Universiti Malaysia Kelantan, Kota Bharu, Kelantan, Malaysia
| | | | - Ruzita Abd Talib
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Nor Mazlina Abu Bakar
- Faculty of Business and Management, Universiti Sultan Zainal Abidin, Kuala Nerus, Terengganu, Malaysia
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Chong KM, Chia A, Shah Budin NS, Poh BK, Jamil NA, Koh D, Chong MFF, Wong JE. Accuracy of a Web-Based Time-Use Diary (MEDAL) in Assessing Children's Meal Intakes With Food Photography by Parents as Reference: Instrument Validation Study. JMIR Pediatr Parent 2024; 7:e53461. [PMID: 38713499 PMCID: PMC11109862 DOI: 10.2196/53461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 03/08/2024] [Accepted: 03/26/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND My E-Diary for Activities and Lifestyle (MEDAL) is a web-based time-use diary developed to assess the diet and movement behaviors of Asian school children. OBJECTIVE This study aims to determine the accuracy of MEDAL in assessing the dietary intake of Malaysian school children, using photographs of the children's meals taken by their parents as an objective reference. METHODS A convenience sample of 46 children aged 10 to 11 years recorded their daily meals in MEDAL for 4 days (2 weekdays and 2 weekend days). Their parents took photographs of the meals and snacks of their children before and after consumption during the 4-day period and sent them along with a brief description of food and drinks consumed via an instant SMS text messaging app. The accuracy of the children's reports of the food they had consumed was determined by comparing their MEDAL reports to the photographs of the food sent by their parents. RESULTS Overall, the match, omission, and intrusion rates were 62% (IQR 46%-86%), 39% (IQR 16%-55%), and 20% (IQR 6%-44%), respectively. Carbohydrate-based items from the food categories "rice and porridge"; "breads, spreads, and cereals"; and "noodles, pasta, and potatoes" were reported most accurately (total match rates: 68%-76%). "Snack and dessert" items were omitted most often (omission rate: 54%). Furthermore, side dishes from "vegetables and mushrooms," "eggs and tofu," "meat and fish," and "curry" food groups were often omitted (omission rates: 42%-46%). Items from "milk, cheese, and yogurt"; "snacks and desserts"; and "drinks" food groups intruded most often (intrusion rates: 37%-46%). Compared to the items reported by the boys, those reported by the girls had higher match rates (69% vs 53%) and lesser omission rates (31% vs 49%; P=.03, respectively). CONCLUSIONS In conclusion, children aged 10 to 11 years can self-report all their meals in MEDAL, although some items are omitted or intruded. Therefore, MEDAL is a tool that can be used to assess the dietary intake of Malaysian school children.
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Affiliation(s)
- Kar Mun Chong
- Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Airu Chia
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Nur Syahirah Shah Budin
- Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Bee Koon Poh
- Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nor Aini Jamil
- Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Denise Koh
- Centre of Community Education & Wellbeing, Faculty of Education, Universiti Kebangsaan Malaysia, Selangor, Malaysia
| | - Mary Foong-Fong Chong
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Jyh Eiin Wong
- Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Chan CMJ, Müller-Riemenschneider F, Chia MYH, Hildon ZJL, Chong MFF. Promoting hEalthy Diet and Active Lifestyle (PEDAL): a protocol for the development and feasibility study of a multicomponent intervention among primary school children in Singapore. Pilot Feasibility Stud 2024; 10:52. [PMID: 38521958 PMCID: PMC10960416 DOI: 10.1186/s40814-024-01479-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 03/12/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Setting healthy lifestyle habits during the formative years of childhood is critical as habits can track to adulthood and help prevent obesity and chronic disease risks in later life. While multicomponent interventions have been shown to be effective in changing the lifestyle behaviours of children, there is a limited understanding of the feasibility of such interventions in primary schools in Singapore. A multiphase mixed method study was conducted to develop and examine the feasibility of a theory-based multicomponent school-based intervention-Promoting hEatlthy Eating and Active Lifestyle (PEDAL). METHODS Underpinned by Kincaid's ideation model, the PEDAL intervention was developed to increase fruit and vegetable consumption and decrease sedentary behaviours among children. This study consists of three phases. Phase 1 details the development of PEDAL, which consists of four components: (A) a series of interactive health education lessons, (B) actionable home activities to support habit formation, (C) parental/guardian engagement, and (D) optimising the school environment. In Phase 2, components A and B of PEDAL were implemented in two public, co-educational primary schools among Primary 5 students (aged 10-12 years) in Singapore. Data was collected quantitatively using questionnaires and qualitatively using focus group discussions (FGDs) with students and teachers. The feasibility dimensions of components A and B, including recruitment capability, data collection, social validity, and practicality were examined, and ideation on healthy eating and physical activity was explored. In Phase 3, the full PEDAL intervention was pilot-tested in two other public, co-education primary schools with the same target population, using a concurrent mixed method quasi-experimental study design. Feasibility dimensions and potential effectiveness of the intervention will be assessed. DISCUSSION This study will provide insights into the feasibility of PEDAL and inform its refinement. Findings from the pilot test will guide the planning of a larger-scale definitive trial. TRIAL REGISTRATION Registered with ISRCTN registry (ISRCTN16114046) on 16 October 2022.
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Affiliation(s)
- Cindy Mei Jun Chan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Tahir Foundation Building (MD1), 12 Science Drive 2, #09-01Q, Singapore, 117549, Singapore
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Tahir Foundation Building (MD1), 12 Science Drive 2, #09-01Q, Singapore, 117549, Singapore
- Center for Digital Health, Berlin Institute of Health (BIH), Charité-Universitatsmedizin Berlin, Berlin, Germany
| | - Michael Yong Hwa Chia
- Physical Education & Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore, Singapore
| | - Zoe Jane-Lara Hildon
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Tahir Foundation Building (MD1), 12 Science Drive 2, #09-01Q, Singapore, 117549, Singapore
| | - Mary Foong-Fong Chong
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Tahir Foundation Building (MD1), 12 Science Drive 2, #09-01Q, Singapore, 117549, Singapore.
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.
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van der Heijden Z, de Gooijer F, Camps G, Lucassen D, Feskens E, Lasschuijt M, Brouwer-Brolsma E. User Requirements in Developing a Novel Dietary Assessment Tool for Children: Mixed Methods Study. JMIR Form Res 2024; 8:e47850. [PMID: 38300689 PMCID: PMC10870213 DOI: 10.2196/47850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 11/10/2023] [Accepted: 12/08/2023] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND The prevalence of childhood obesity and comorbidities is rising alarmingly, and diet is an important modifiable determinant. Numerous dietary interventions in children have been developed to reduce childhood obesity and overweight rates, but their long-term effects are unsatisfactory. Stakeholders call for more personalized approaches, which require detailed dietary intake data. In the case of primary school children, caregivers are key to providing such dietary information. However, as school-aged children are not under the full supervision of one specific caregiver anymore, data are likely to be biased. Recent technological advancements provide opportunities for the role of children themselves, which would serve the overall quality of the obtained dietary data. OBJECTIVE This study aims to conduct a child-centered exploratory sequential mixed methods study to identify user requirements for a dietary assessment tool for children aged 5 to 6 years. METHODS Formative, nonsystematic narrative literature research was undertaken to delineate initial user requirements and inform prototype ideation in an expert panel workshop (n=11). This yielded 3 prototype dietary assessment tools: FoodBear (tangible piggy bank), myBear (smartphone or tablet app), and FoodCam (physical camera). All 3 prototypes were tested for usability by means of a usability task (video analyses) and user experience (This or That method) among 14 Dutch children aged 5 to 6 years (n=8, 57% boys and n=6, 43% girls). RESULTS Most children were able to complete FoodBear's (11/14, 79%), myBear's (10/14, 71%), and FoodCam's (9/14, 64%) usability tasks, but all children required assistance (14/14, 100%) and most of the children encountered usability problems (13/14, 93%). Usability issues were related to food group categorization and recognition, frustrations owing to unsatisfactory functioning of (parts) of the prototypes, recall of food products, and the distinction between eating moments. No short-term differences in product preference between the 3 prototypes were observed, but autonomy, challenge, gaming elements, being tablet based, appearance, social elements, and time frame were identified as determinants of liking the product. CONCLUSIONS Our results suggest that children can play a complementary role in dietary data collection to enhance the data collected by their parents. Incorporation of a training program, auditory or visual prompts, reminders and feedback, a user-friendly and intuitive interaction design, child-friendly food groups or icons, and room for children's autonomy were identified as requirements for the future development of a novel and usable dietary assessment tool for children aged 5 to 6 years. Our findings can serve as valuable guidance for ongoing innovations in the field of children's dietary assessment and the provision of personalized dietary support.
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Affiliation(s)
- Zoë van der Heijden
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, Netherlands
| | - Femke de Gooijer
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, Netherlands
| | - Guido Camps
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, Netherlands
| | - Desiree Lucassen
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, Netherlands
| | - Edith Feskens
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, Netherlands
| | - Marlou Lasschuijt
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, Netherlands
| | - Elske Brouwer-Brolsma
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, Netherlands
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Arts J, Chinapaw MJM, Gubbels JS, Verhoeff AP, Brons A, Veldman S, Lettink A, Altenburg TM. Development and content validity of an application to assess 24-hour movement behaviors in 0-4-year-old children involving end-users and key stakeholders: the My Little Moves app. Int J Behav Nutr Phys Act 2024; 21:2. [PMID: 38167442 PMCID: PMC10763169 DOI: 10.1186/s12966-023-01552-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 12/17/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Recently, research focus has shifted to the combination of all 24-h movement behaviors (physical activity, sedentary behavior and sleep) instead of each behavior separately. Yet, no reliable and valid proxy-report tools exist to assess all these behaviors in 0-4-year-old children. By involving end-users (parents) and key stakeholders (researchers, professionals working with young children), this mixed-methods study aimed to 1) develop a mobile application (app)-based proxy-report tool to assess 24-h movement behaviors in 0-4-year-olds, and 2) examine its content validity. METHODS First, we used concept mapping to identify activities 0-4-year-olds engage in. Parents (n = 58) and professionals working with young children (n = 21) generated a list of activities, sorted related activities, and rated the frequency children perform these activities. Second, using multidimensional scaling and cluster analysis, we created activity categories based on the sorted activities of the participants. Third, we developed the My Little Moves app in collaboration with a software developer. Finally, we examined the content validity of the app with parents (n = 14) and researchers (n = 6) using focus groups and individual interviews. RESULTS The app has a time-use format in which parents proxy-report the activities of their child, using eight activity categories: personal care, eating/drinking, active transport, passive transport, playing, screen use, sitting/lying calmly, and sleeping. Categories are clarified by providing examples of children's activities. Additionally, 1-4 follow-up questions collect information on intensity (e.g., active or calm), posture, and/or context (e.g., location) of the activity. Parents and researchers considered filling in the app as feasible, taking 10-30 min per day. The activity categories were considered comprehensive, but alternative examples for several activity categories were suggested to increase the comprehensibility and relevance. Some follow-up questions were considered less relevant. These suggestions were adopted in the second version of the My Little Moves app. CONCLUSIONS Involving end-users and key stakeholders in the development of the My Little Moves app resulted in a tailored tool to assess 24-h movement behaviors in 0-4-year-olds with adequate content validity. Future studies are needed to evaluate other measurement properties of the app.
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Affiliation(s)
- Jelle Arts
- Public and Occupational Health, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands.
- Health Behaviors and Chronic Diseases, Amsterdam Public Health, Amsterdam, The Netherlands.
| | - Mai J M Chinapaw
- Public and Occupational Health, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Health Behaviors and Chronic Diseases, Amsterdam Public Health, Amsterdam, The Netherlands
- Methodology, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Jessica S Gubbels
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, PO Box 616, Maastricht, 6200 MD, The Netherlands
| | - Arnoud P Verhoeff
- Public Health Service Amsterdam, Sarphati Amsterdam, 1018 WT, Amsterdam, The Netherlands
- Department of Sociology, University of Amsterdam, 1018 WV, Amsterdam, The Netherlands
| | - Annette Brons
- Digital Life Center, Amsterdam University of Applied Sciences, Wibautstraat 3B, Amsterdam, 1091 GM, The Netherlands
| | - Sanne Veldman
- Public and Occupational Health, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Health Behaviors and Chronic Diseases, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Annelinde Lettink
- Public and Occupational Health, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Health Behaviors and Chronic Diseases, Amsterdam Public Health, Amsterdam, The Netherlands
- Methodology, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Teatske M Altenburg
- Public and Occupational Health, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Health Behaviors and Chronic Diseases, Amsterdam Public Health, Amsterdam, The Netherlands
- Methodology, Amsterdam Public Health, Amsterdam, The Netherlands
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Tan SYX, Chia A, Tai BC, Natarajan P, Goh CMJL, Shek LP, Saw SM, Chong MFF, Müller-Riemenschneider F. A Web-Based, Time-Use App To Assess Children's Movement Behaviors: Validation Study of My E-Diary for Activities and Lifestyle (MEDAL). JMIR Pediatr Parent 2022; 5:e33312. [PMID: 35749208 PMCID: PMC9270708 DOI: 10.2196/33312] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 02/27/2022] [Accepted: 02/28/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Existing modes of collecting self-reported 24-hour movement information from children, including digital assessments, have not been demonstrated to be of acceptable validity when compared to objective measurements. My E-Diary for Activities and Lifestyle (MEDAL) is an interactive web-based diary developed to collect time-use information from children aged 10 years and older. OBJECTIVE This study evaluated the validity of MEDAL for assessing children's movement behaviors by comparing self-reported and accelerometer-measured time spent in movement behavior among children in Singapore aged 10-11 years. METHODS Funding for this study was obtained in October 2017, and data were collected between April and August 2020. Participants recorded their daily activities using MEDAL over 2 specified weekdays and 2 weekend days and wore an Actigraph accelerometer on their nondominant wrist throughout the study to objectively assess movement behaviors. Spearman correlation coefficient and intraclass correlation coefficient (ICC) were used to compare the accelerometer measurements and self-reports for each movement behavior. Bland-Altman plots were generated to investigate trends of bias in the self-reports. RESULTS Among the participants aged 10-11 years (29/49, 59% boys), we observed that children reported lower light physical activity (LPA) and higher moderate-to-vigorous physical activity (MVPA), inactivity, and night sleep than that measured by the accelerometer. There was a moderate-to-strong correlation between self-reported and accelerometer-measured MVPA (r=0.37; 95% CI 0.20-0.54), inactivity (r=0.36; 95% CI 0.18-0.54), and night sleep (r=0.58; 95% CI 0.43-0.74); the correlation for LPA was poor (r=0.19; 95% CI 0.02-0.36). Agreement was poor for all behaviors (MVPA: ICC=0.24, 95% CI 0.07-0.40; LPA: ICC=0.19, 95% CI 0.01-0.36; inactivity: ICC=0.29, 95% CI 0.11-0.44; night sleep: ICC=0.45, 95% CI 0.29-0.58). There was stronger correlation and agreement on weekdays for inactivity and night sleep; conversely, there was stronger correlation and agreement for MVPA and LPA on weekend days. Finally, based on Bland-Altman plots, we observed that with increasing MVPA, children tended to report higher MVPA than that measured by the accelerometer. There were no clear trends for the other behaviors. CONCLUSIONS MEDAL may be used to assess the movement behaviors of children. Based on self-reports, the children are able to estimate their time spent in MVPA, inactivity, and night sleep although actual time spent in these behaviors may differ from accelerometer-derived estimates; self-reported LPA warrant cautious interpretation. Observable differences in reporting accuracy exist between weekdays and weekend days.
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Affiliation(s)
- Sarah Yi Xuan Tan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Airu Chia
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Bee Choo Tai
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Padmapriya Natarajan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.,Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Claire Marie Jie Lin Goh
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Lynette P Shek
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Khoo Teck Puat - National University Children's Medical Institute, National University Health System, Singapore, Singapore
| | - Seang Mei Saw
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.,Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore
| | - Mary Foong-Fong Chong
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.,Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Validation of a Web-Based, Time-Use Application to Assess Children's School Meal Intakes: My E-Diary for Activities and Lifestyle (MEDAL). Nutrients 2021; 13:nu13113790. [PMID: 34836046 PMCID: PMC8624734 DOI: 10.3390/nu13113790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/07/2021] [Accepted: 10/14/2021] [Indexed: 11/18/2022] Open
Abstract
My E-Diary for Activities and Lifestyle (MEDAL), a web-based application, was developed to assess the diets of children. This study examined the validity of school recess meals reported by children on MEDAL, using meal photography as the reference. Recess meals were photographed by trained researchers, and food items and portion sizes of recess meals reported on MEDAL were compared to recess meal photos. Validity was assessed by percentages of match, omission and intrusion for food items and percentages of the match, underestimation and overestimation for portion sizes. The Mann–Whitney test and the Wilcoxon matched-pairs signed-rank test examined if sex, school and day of recording influenced the validity of food item reporting. We found that participants (n = 33, aged 10–11 years) recalled 60.2% of food items consumed at recess accurately (matches); omissions (24.6%) were more common than intrusions (15.2%). Omissions tended to be side dishes, and intrusions tended to be high-calorie items. Sex, school and day of recording did not influence validity. For food portion sizes, 58.3% of items were accurately reported. Overestimations (33.3%) were more common than underestimations (8.3%). In conclusion, these children were able to report food items consumed during school recess meals using MEDAL, albeit with limitations on the degree of accuracy.
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Dumuid D, Olds T, Sawyer SM. Moving beyond more: towards a healthy balance of daily behaviours. Lancet 2021; 398:373-374. [PMID: 34302761 DOI: 10.1016/s0140-6736(21)01600-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 07/06/2021] [Indexed: 01/04/2023]
Affiliation(s)
- Dorothea Dumuid
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, SA 5001, Australia.
| | - Tim Olds
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, SA 5001, Australia
| | - Susan M Sawyer
- Centre for Adolescent Health, Parkville, VIC, Australia; Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia; Murdoch Children's Research Institute, Parkville, VIC, Australia
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