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Arthurs N, Browne S, Boardman R, O'Donnell S, Doyle G, Kechadi T, Shahid A, Tully L, O’Malley G. Usability of the BigO system in pediatric obesity treatment: A mixed-methods evaluation of clinical end-users. Comput Struct Biotechnol J 2024; 24:507-522. [PMID: 39184872 PMCID: PMC11342072 DOI: 10.1016/j.csbj.2024.06.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Revised: 06/25/2024] [Accepted: 06/26/2024] [Indexed: 08/27/2024] Open
Abstract
Objective To assess technical usability of the BigO app and clinical portal among diverse participants and explore the overall user experiences of both. Methods Methods included technical usability testing by measuring the relative user efficiency score (RUS) for the app and measuring Relative User Efficiency (RUE) using the 'think aloud' method with the clinical portal. Qualitative approaches involved focus groups with adolescent app users and semi-structured one-to-one interviews with clinician participants. Thematic analysis was applied to analyze qualitative data. Participants Clinical participants consisted of adolescents seeking treatment for severe obesity and were invited via telephone/face to face to attend technical usability testing and a focus group. Healthcare professionals (HCPs) and researchers using the BigO clinical portal interface were invited to participate in usability testing and semi-structured interviews. Results From 14 families invited to attend, seven consented to join the study and four adolescents (mean age=13.8 (SD 0.8) years) participated. Additionally, six HCPs and one pediatric obesity researcher took part. RUS for adolescents indicated that the tasks required of them via myBigO app were feasible, and technically efficient. No user-related errors were observed during tasks. Technical barriers reported by adolescents included notifications of battery optimization, misunderstanding image annotation language, and compatibility challenges with certain phone models. RUS for the HCPs and researcher indicated that basic technical skills are a potential barrier for clinical portal use and qualitative findings revealed that clinical users wanted a logging option for monitoring goals and providing feedback on the portal. Conclusion Our study provided valuable formative findings from clinical end-users in Ireland indicating that adolescents being treated for obesity rated myBigO app as usable, acceptable and that it may assist other key stakeholders to understand food marketing and to monitor dietary and physical activity behaviors. Several key suggestions for future iterations of the clinical portal were provided to enhance its value in pediatric obesity treatment.
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Affiliation(s)
- Niamh Arthurs
- Child and Adolescent Obesity Service, Children’s Health Ireland (CHI) at Temple Street Children’s Hospital, Dublin, Ireland
- Obesity Research and Care Group, School of Physiotherapy, RCSI University of Medicine and Health Sciences, Royal College of Surgeons in Ireland, Ireland
- School of Public Health, Physiotherapy & Sports Science, University College Dublin, Dublin 4, Ireland
| | - Sarah Browne
- Obesity Research and Care Group, School of Physiotherapy, RCSI University of Medicine and Health Sciences, Royal College of Surgeons in Ireland, Ireland
- School of Public Health, Physiotherapy & Sports Science, University College Dublin, Dublin 4, Ireland
| | - Rebekah Boardman
- School of Public Health, Physiotherapy & Sports Science, University College Dublin, Dublin 4, Ireland
| | - Shane O'Donnell
- Insight Centre for Data Analytics, School of Computer Science, University College Dublin, Dublin 4, Ireland
| | - Gerardine Doyle
- UCD College of Business, Michael Smurfit Graduate Business School, University College Dublin, Dublin 4, Ireland
- UCD Geary Institute for Public Policy, University College Dublin, Dublin 4, Ireland
| | - Tahar Kechadi
- Insight Centre for Data Analytics, School of Computer Science, University College Dublin, Dublin 4, Ireland
| | - Arsalan Shahid
- Insight Centre for Data Analytics, School of Computer Science, University College Dublin, Dublin 4, Ireland
| | - Louise Tully
- Obesity Research and Care Group, School of Physiotherapy, RCSI University of Medicine and Health Sciences, Royal College of Surgeons in Ireland, Ireland
| | - Grace O’Malley
- Child and Adolescent Obesity Service, Children’s Health Ireland (CHI) at Temple Street Children’s Hospital, Dublin, Ireland
- Obesity Research and Care Group, School of Physiotherapy, RCSI University of Medicine and Health Sciences, Royal College of Surgeons in Ireland, Ireland
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König LM, Van Emmenis M, Nurmi J, Kassavou A, Sutton S. Characteristics of smartphone-based dietary assessment tools: a systematic review. Health Psychol Rev 2022; 16:526-550. [PMID: 34875978 DOI: 10.1080/17437199.2021.2016066] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Smartphones have become popular in assessing eating behaviour in real-life and real-time. This systematic review provides a comprehensive overview of smartphone-based dietary assessment tools, focusing on how dietary data is assessed and its completeness ensured. Seven databases from behavioural, social and computer science were searched in March 2020. All observational, experimental or intervention studies and study protocols using a smartphone-based assessment tool for dietary intake were included if they reported data collected by adults and were published in English. Out of 21,722 records initially screened, 117 publications using 129 tools were included. Five core assessment features were identified: photo-based assessment (48.8% of tools), assessed serving/ portion sizes (48.8%), free-text descriptions of food intake (42.6%), food databases (30.2%), and classification systems (27.9%). On average, a tool used two features. The majority of studies did not implement any features to improve completeness of the records. This review provides a comprehensive overview and framework of smartphone-based dietary assessment tools to help researchers identify suitable assessment tools for their studies. Future research needs to address the potential impact of specific dietary assessment methods on data quality and participants' willingness to record their behaviour to ultimately improve the quality of smartphone-based dietary assessment for health research.
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Affiliation(s)
- Laura M König
- Faculty of Life Sciences: Food, Nutrition and Health, University of Bayreuth, Kulmbach, Germany.,Behavioural Science Group, Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Miranda Van Emmenis
- Behavioural Science Group, Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Johanna Nurmi
- Behavioural Science Group, Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.,Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Aikaterini Kassavou
- Behavioural Science Group, Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Stephen Sutton
- Behavioural Science Group, Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
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Hattab S, Badrasawi M, Anabtawi O, Zidan S. Development and validation of a smartphone image-based app for dietary intake assessment among Palestinian undergraduates. Sci Rep 2022; 12:15467. [PMID: 36104377 PMCID: PMC9472744 DOI: 10.1038/s41598-022-19545-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 08/30/2022] [Indexed: 11/09/2022] Open
Abstract
AbstractAccurate dietary assessment is required in a variety of research fields and clinical settings. Image-based dietary assessment using smartphones applications offer the opportunity to reduce both researcher and participant burden compared to traditional dietary assessment methods. The current study, conducted in Palestine, aimed to design an image-based dietary assessment application, to assess the relative validity of the application as a dietary assessment tool for energy and macronutrient intake using the 3-Day Food Record (3-DFR) as a reference method, and to test its usability among a sample of Palestinian university students. The development of a smartphone application (Ghithaona) designed to assess energy and macronutrient intake is reported. The application validity was tested among a sample of Palestinian undergraduates from An-Najah National University. Participants recorded their dietary intake using the Ghithaona application over 2 consecutive days and 1 weekend day. Intake from the Ghithaona application were compared to intake collected from 3-DFR, taken on 2 consecutive weekdays and 1 weekend day, in the second week following the Ghithaona application. At the end of the study, participants completed an exit survey to test assess application usability and to identify barriers to its use. Mean differences in energy, and macronutrients intake were evaluated between the methods using paired t-tests or Wilcoxon signed-rank tests. Agreement between methods was ascertained using Pearson correlations and Bland–Altman plots. The Ghithaona application took 6 months to develop. The validation test was completed by 70 participants with a mean age of 21.0 ± 2.1 years. No significant differences were found between the two methods for mean intakes of energy or macronutrients (p > 0.05). Significant correlations between the two methods were observed for energy, and all macronutrients (r = 0.261–0.58, p ≤ 0.05). Bland–Altman plots confirmed wide limits of agreement between the methods with no systematic bias. According to the exit survey, it was found that majority of participants strongly agreed and agreed that the application saves time (94.2%), helps the participant to pay attention to their dietary habits (87.2%), and is easy to use (78.6%). The Ghithaona application showed relative validity for assessment of nutrient intake of Palestinian undergraduates.
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Precision Nutrient Management Using Artificial Intelligence Based on Digital Data Collection Framework. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12094167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
(1) Background: Nutritional intake is fundamental to human growth and health, and the intake of different types of nutrients and micronutrients can affect health. The content of the diet affects the occurrence of disease, with the incidence of many diseases increasing each year while the age group at which they occur is gradually decreasing. (2) Methods: An artificial intelligence model for precision nutritional analysis allows the user to enter the name and serving size of a dish to assess a total of 24 nutrients. A total of two AI models, including semantic and nutritional analysis models, were integrated into the Precision Nutritional Analysis. A total of five different algorithms were used to identify the most similar recipes and to determine differences in text using cosine similarity. (3) Results: This study developed two models to form a precision nutrient analysis model. The 2013–2016 Taiwan National Nutrition Health Status Change Survey (NNHS) was used for model verification. The model’s accuracy was determined by comparing the results of the model with the NNHS. The results show that the AI model has very little error and can significantly improve the efficiency of the analysis. (4) Conclusions: This study proposed an Intelligence Precision Nutrient Analysis Model based on a digital data collection framework, where the nutrient intake was analyzed by entering dietary recall data. The AI model can be used as a reference for nutrition surveys and personal nutrition analysis.
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Ploderer B, Rezaei Aghdam A, Burns K. Patient-Generated Health Photos and Videos Across Health and Well-being Contexts: Scoping Review. J Med Internet Res 2022; 24:e28867. [PMID: 35412458 PMCID: PMC9044143 DOI: 10.2196/28867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 10/15/2021] [Accepted: 02/28/2022] [Indexed: 11/13/2022] Open
Abstract
Background Patient-generated health data are increasingly used to record health and well-being concerns and engage patients in clinical care. Patient-generated photographs and videos are accessible and meaningful to patients, making them especially relevant during the current COVID-19 pandemic. However, a systematic review of photos and videos used by patients across different areas of health and well-being is lacking. Objective This review aims to synthesize the existing literature on the health and well-being contexts in which patient-generated photos and videos are used, the value gained by patients and health professionals, and the challenges experienced. Methods Guided by a framework for scoping reviews, we searched eight health databases (CINAHL, Cochrane Library, Embase, PsycINFO, PubMed, MEDLINE, Scopus, and Web of Science) and one computing database (ACM), returning a total of 28,567 studies. After removing duplicates and screening based on the predefined inclusion criteria, we identified 110 relevant articles. Data were charted and articles were analyzed following an iterative thematic approach with the assistance of NVivo software (version 12; QSR International). Results Patient-generated photos and videos are used across a wide range of health care services (39/110, 35.5% articles), for example, to diagnose skin lesions, assess dietary intake, and reflect on personal experiences during therapy. In addition, patients use them to self-manage health and well-being concerns (33/110, 30%) and to share personal health experiences via social media (36/110, 32.7%). Photos and videos create significant value for health care (59/110, 53.6%), where images support diagnosis, explanation, and treatment (functional value). They also provide value directly to patients through enhanced self-determination (39/110, 35.4%), social (33/110, 30%), and emotional support (21/110, 19.1%). However, several challenges emerge when patients create, share, and examine photos and videos, such as limited accessibility (16/110, 14.5%), incomplete image sets (23/110, 20.9%), and misinformation through photos and videos shared on social media (17/110, 15.5%). Conclusions This review shows that photos and videos engage patients in meaningful ways across different health care activities (eg, diagnosis, treatment, and self-care) for various health conditions. Although photos and videos require effort to capture and involve challenges when patients want to use them in health care, they also engage and empower patients, generating unique value. This review highlights areas for future research and strategies for addressing these challenges.
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Affiliation(s)
- Bernd Ploderer
- School of Computer Science, Queensland University of Technology, Brisbane, Australia
| | - Atae Rezaei Aghdam
- School of Information Systems, Queensland University of Technology, Brisbane, Australia
| | - Kara Burns
- Centre for Digital Transformation of Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
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Caon M, Prinelli F, Angelini L, Carrino S, Mugellini E, Orte S, Serrano JCE, Atkinson S, Martin A, Adorni F. PEGASO e-Diary: User Engagement and Dietary Behavior Change of a Mobile Food Record for Adolescents. Front Nutr 2022; 9:727480. [PMID: 35369096 PMCID: PMC8970185 DOI: 10.3389/fnut.2022.727480] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 02/07/2022] [Indexed: 11/13/2022] Open
Abstract
Background Obesity amongst children and adolescents is becoming a major health problem globally and mobile food records can play a crucial role in promoting healthy dietary habits. Objective To describe the methodology for the implementation of the e-Diary mobile food record, to assess its capability in promoting healthy eating habits, to evaluate the factors associated with its usage and engagement. Methods This is a descriptive study that compared the characteristics of participants engaged in the e-Diary, which was part of the PEGASO project in which an app to provide proactive health promotion was given to 365 students at 4 European sites enrolled during October to December 2016: England (UK), Scotland (UK), Lombardy (Italy), and Catalonia (Spain). The e-Diary tracked the users' dietary habits in terms of food groups, dietary indexes, and 6 dietary target behaviors relating to consumption of: fruit; vegetable; breakfast; sugar-sweetened beverages; fast-food; and snacks. The e-Diary provided also personalized suggestions for the next meal and gamification. Results The e-Diary was used for 6 months by 357 adolescents (53.8% females). The study showed that females used the e-Diary much more than males (aOR 3.8, 95% CI 1.6-8.8). Participants aged 14 years were more engaged in the e-Diary than older age groups (aOR 5.1, 95% CI 1.4-18.8) as were those with a very good/excellent self-perceived health status compared to their peers with fair/poor health perception (aOR 4.2, 95% CI 1.3-13.3). Compared to the intervention sites, those living in Catalonia (aOR 13.2 95% CI 2.5-68.8) were more engaged. In terms of behavior change, a significant positive correlation between fruit (p < 0.0001) and vegetables (p = 0.0087) intake was observed in association with increased engagement in the e-Diary. Similarly, adolescents who used the app for more than 2 weeks had significantly higher odds of not skipping breakfast over the study period (aOR 2.5, 95% CI 1.0-6.3). Conclusions The users highly engaged with the e-Diary were associated with improved dietary behaviors: increased consumption of fruit and vegetables and reduced skipping of breakfast. Although the overall usage of the e-Diary was high during the first weeks, it declined thereafter. Future applications should foster user engagement, particularly targeting adolescents at high risk. Clinical Trial Registration https://www.clinicaltrials.gov/, identifier: NCT02930148.
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Affiliation(s)
- Maurizio Caon
- School of Management, University of Applied Sciences and Arts Western Switzerland (HES-SO), Fribourg, Switzerland,*Correspondence: Maurizio Caon
| | - Federica Prinelli
- Institute of Biomedical Technologies, National Research Council, Segrate, Italy
| | - Leonardo Angelini
- School of Management, University of Applied Sciences and Arts Western Switzerland (HES-SO), Fribourg, Switzerland,College of Engineering, University of Applied Sciences and Arts Western Switzerland (HES-SO), Fribourg, Switzerland
| | - Stefano Carrino
- Haute Ecole Arc Ingénierie, University of Applied Sciences and Arts Western Switzerland (HES-SO), St. Imier, Switzerland
| | - Elena Mugellini
- College of Engineering, University of Applied Sciences and Arts Western Switzerland (HES-SO), Fribourg, Switzerland
| | - Silvia Orte
- eHealth Unit, Center Tecnològic de Catalunya (Eurecat), Barcelona, Spain
| | | | - Sarah Atkinson
- Human Factors Research Group, University of Nottingham, Nottingham, United Kingdom
| | - Anne Martin
- United Kingdom Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom
| | - Fulvio Adorni
- Institute of Biomedical Technologies, National Research Council, Segrate, Italy
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7
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Saronga N, Mosha IH, Stewart SJ, Bakar S, Sunguya BF, Burrows TL, Leyna GH, Adam MTP, Collins CE, Rollo ME. A Mixed-Method Study Exploring Experiences and Perceptions of Nutritionists Regarding Use of an Image-Based Dietary Assessment System in Tanzania. Nutrients 2022; 14:nu14030417. [PMID: 35276775 PMCID: PMC8838775 DOI: 10.3390/nu14030417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 01/10/2022] [Accepted: 01/13/2022] [Indexed: 11/16/2022] Open
Abstract
Due to global advances in technology, image-based food record methods have emerged as an alternative to traditional assessment methods. The use of image-based food records in low and lower-middle income countries such as Tanzania is limited, with countries still using traditional methods. The current study aimed to determine the feasibility of using a new voice and image-based dietary assessment system (VISIDA) in Dar es Salaam, Tanzania. This mixed-method study recruited 18 nutritionists as participants who collected image-based records of food and drinks they consumed using the VISIDA smartphone app. Participants viewed an online demonstration of the VISIDA web platform and the analysis process for intake data collected using the VISIDA app. Then, participants completed an online survey and were interviewed about the VISIDA app and web platform for food and nutrient intake analysis. The method was reported as being acceptable and was found to be easy to use, although technical challenges were experienced by some participants. Most participants indicated a willingness to use the VISIDA app again for one week or longer and were interested in using the VISIDA system in their current role. Participants acknowledged that the VISIDA web platform would simplify some aspects of their current job. Image-based food records could potentially be used in Tanzania to improve the assessment of dietary intake by nutritionists in urban areas. Participants recommended adding sound-on notifications, using the VISIDA app in both Apple and Android phones, enabling installation from the app store, and improving the quality of the fiducial markers.
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Affiliation(s)
- Naomi Saronga
- Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW 2308, Australia; (N.S.); (S.J.S.); (T.L.B.); (M.T.P.A.); (C.E.C.)
- School of Health Sciences, College of Health, Medicine & Wellbeing, The University of Newcastle, Callaghan, NSW 2308, Australia
- Department of Community Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam P. O. Box 65015, Tanzania; (S.B.); (B.F.S.)
| | - Idda H. Mosha
- Department of Behaviour Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam P. O. Box 65015, Tanzania;
| | - Samantha J. Stewart
- Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW 2308, Australia; (N.S.); (S.J.S.); (T.L.B.); (M.T.P.A.); (C.E.C.)
- School of Health Sciences, College of Health, Medicine & Wellbeing, The University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Saidah Bakar
- Department of Community Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam P. O. Box 65015, Tanzania; (S.B.); (B.F.S.)
| | - Bruno F. Sunguya
- Department of Community Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam P. O. Box 65015, Tanzania; (S.B.); (B.F.S.)
| | - Tracy L. Burrows
- Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW 2308, Australia; (N.S.); (S.J.S.); (T.L.B.); (M.T.P.A.); (C.E.C.)
- School of Health Sciences, College of Health, Medicine & Wellbeing, The University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Germana H. Leyna
- Tanzania Food and Nutrition Centre, Dar es Salaam P.O. Box 977, Tanzania;
- Department of Epidemiology & Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam P. O. Box 65015, Tanzania
| | - Marc T. P. Adam
- Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW 2308, Australia; (N.S.); (S.J.S.); (T.L.B.); (M.T.P.A.); (C.E.C.)
- School of Information and Physical Sciences, College of Engineering, Science and Environment, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Clare E. Collins
- Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW 2308, Australia; (N.S.); (S.J.S.); (T.L.B.); (M.T.P.A.); (C.E.C.)
- School of Health Sciences, College of Health, Medicine & Wellbeing, The University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Megan E. Rollo
- Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW 2308, Australia; (N.S.); (S.J.S.); (T.L.B.); (M.T.P.A.); (C.E.C.)
- School of Health Sciences, College of Health, Medicine & Wellbeing, The University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
- Correspondence:
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Szymczak H, Keller L, Debbeler LJ, Kollmann J, Lages NC, Sproesser G, Gollwitzer PM, Schupp HT, Renner B. “I’m eating healthy now”: The relationship between perceived behavior change and diet. Food Qual Prefer 2021. [DOI: 10.1016/j.foodqual.2020.104142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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9
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Ziesemer K, König LM, Boushey CJ, Villinger K, Wahl DR, Butscher S, Müller J, Reiterer H, Schupp HT, Renner B. Occurrence of and Reasons for "Missing Events" in Mobile Dietary Assessments: Results From Three Event-Based Ecological Momentary Assessment Studies. JMIR Mhealth Uhealth 2020; 8:e15430. [PMID: 33052123 PMCID: PMC7593856 DOI: 10.2196/15430] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 03/16/2020] [Accepted: 08/03/2020] [Indexed: 01/24/2023] Open
Abstract
Background Establishing a methodology for assessing nutritional behavior comprehensively and accurately poses a great challenge. Mobile technologies such as mobile image-based food recording apps enable eating events to be assessed in the moment in real time, thereby reducing memory biases inherent in retrospective food records. However, users might find it challenging to take images of the food they consume at every eating event over an extended period, which might lead to incomplete records of eating events (missing events). Objective Analyzing data from 3 studies that used mobile image-based food recording apps and varied in their technical enrichment, this study aims to assess how often eating events (meals and snacks) were missed over a period of 8 days in a naturalistic setting by comparing the number of recorded events with the number of normative expected events, over time, and with recollections of missing events. Methods Participants in 3 event-based Ecological Momentary Assessment (EMA) studies using mobile image-based dietary assessments were asked to record all eating events (study 1, N=38, 1070 eating events; study 2, N=35, 934 eating events; study 3, N=110, 3469 eating events). Study 1 used a basic app; study 2 included 1 fixed reminder and the possibility to add meals after the actual eating events occurred instead of in the moment (addendum); and study 3 included 2 fixed reminders, an addendum feature, and the option to record skipped meals. The number of recalled missed events and their reasons were assessed by semistructured interviews after the EMA period (studies 1 and 2) and daily questionnaires (study 3). Results Overall, 183 participants reported 5473 eating events. Although the momentary adherence rate as indexed by a comparison with normative expected events was generally high across all 3 studies, a differential pattern of results emerged with a higher rate of logged meals in the more technically intensive study 3. Multilevel models for the logging trajectories of reported meals in all 3 studies showed a significant, albeit small, decline over time (b=−.11 to −.14, Ps<.001, pseudo-R²=0.04-0.06), mainly because of a drop in reported snacks between days 1 and 2. Intraclass coefficients indicated that 38% or less of the observed variance was because of individual differences. The most common reasons for missing events were competing activities and technical issues, whereas situational barriers were less important. Conclusions Three different indicators (normative, time stability, and recalled missing events) consistently indicated missing events. However, given the intensive nature of diet EMA protocols, the effect sizes were rather small and the logging trajectories over time were remarkably stable. Moreover, the individual’s actual state and context seemed to exert a greater influence on adherence rates than stable individual differences, which emphasizes the need for a more nuanced understanding of the factors that affect momentary adherence.
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Affiliation(s)
- Katrin Ziesemer
- Psychological Assessment & Health Psychology, Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Laura Maria König
- Psychological Assessment & Health Psychology, Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Carol Jo Boushey
- University of Hawaii Cancer Center, University of Hawaii, Honolulu, HI, United States
| | - Karoline Villinger
- Psychological Assessment & Health Psychology, Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Deborah Ronja Wahl
- Psychological Assessment & Health Psychology, Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Simon Butscher
- Human-Computer Interaction Group, Department of Computer and Information Science, University of Konstanz, Konstanz, Germany
| | - Jens Müller
- Human-Computer Interaction Group, Department of Computer and Information Science, University of Konstanz, Konstanz, Germany
| | - Harald Reiterer
- Human-Computer Interaction Group, Department of Computer and Information Science, University of Konstanz, Konstanz, Germany
| | - Harald Thomas Schupp
- General Psychology, Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Britta Renner
- Psychological Assessment & Health Psychology, Department of Psychology, University of Konstanz, Konstanz, Germany
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10
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Höchsmann C, Martin CK. Review of the validity and feasibility of image-assisted methods for dietary assessment. Int J Obes (Lond) 2020; 44:2358-2371. [PMID: 33033394 DOI: 10.1038/s41366-020-00693-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 09/02/2020] [Accepted: 09/26/2020] [Indexed: 11/09/2022]
Abstract
Accurately quantifying dietary intake is essential to understanding the effect of diet on health and evaluating the efficacy of dietary interventions. Self-report methods (e.g., food records) are frequently utilized despite evident inaccuracy of these methods at assessing energy and nutrient intake. Methods that assess food intake via images of foods have overcome many of the limitations of traditional self-report. In cafeteria settings, digital photography has proven to be unobtrusive and accurate and is the method of choice for assessing food provision, plate waste, and food intake. In free-living conditions, image capture of food selection and plate waste via the user's smartphone, is promising and can produce accurate energy intake estimates, though accuracy is not guaranteed. These methods foster (near) real-time transfer of data and eliminate the need for portion size estimation by the user since the food images are analyzed by trained raters. A limitation that remains, similar to self-report methods where participants must truthfully record all consumed foods, is intentional and/or unintentional underreporting of foods due to social desirability or forgetfulness. Methods that rely on passive image capture via wearable cameras are promising and aim to reduce user burden; however, only pilot data with limited validity are currently available and these methods remain obtrusive and cumbersome. To reduce analysis-related staff burden and to allow real-time feedback to the user, recent approaches have aimed to automate the analysis of food images. The technology to support automatic food recognition and portion size estimation is, however, still in its infancy and fully automated food intake assessment with acceptable precision not yet a reality. This review further evaluates the benefits and challenges of current image-assisted methods of food intake assessment and concludes that less burdensome methods are less accurate and that no current method is adequate in all settings.
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Affiliation(s)
| | - Corby K Martin
- Pennington Biomedical Research Center, Baton Rouge, LA, USA.
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11
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Ahmed M, Oh A, Vanderlee L, Franco-Arellano B, Schermel A, Lou W, L'Abbé MR. A randomized controlled trial examining consumers' perceptions and opinions on using different versions of a FoodFlip© smartphone application for delivery of nutrition information. Int J Behav Nutr Phys Act 2020; 17:22. [PMID: 32050996 PMCID: PMC7017573 DOI: 10.1186/s12966-020-0923-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 02/03/2020] [Indexed: 01/28/2023] Open
Abstract
Background Food labelling is a common intervention to improve diets, where the back-of-pack Nutrition Information Panel (or Nutrition Facts table (NFt)) provides comprehensive nutrition information on food packages. However, many consumers find it difficult and time-consuming to identify healthier foods using the NFt. As a result, different interpretative nutrition rating systems (INRS) may enable healthier food choices and it is essential that consumers have the tools to allow for easily accessible nutrition information. The objective of this study was to examine consumers’ perceptions of different (INRS) for delivery of nutrition information using different versions of a smartphone app, FoodFlip©. Methods This study was part of a larger randomized controlled trial examining consumer perceptions of different INRS on food products. A nationally representative commercial sample of 2008 Canadians were randomized to one of four INRS intervention groups: 1) traffic light, 2) health star rating, 3) ‘high-in’ warning labels or 4) no INRS (NFt only; control) and asked to scan or enter 20 products into FoodFlip© from a list of food products provided to them with varying levels of healthfulness. After completing the app task, participants were asked a series of 7-point Likert-scale and open-ended questions to provide opinions on the usability and functionality of the app. Results Of the survey sample of 1997 participants, 95% (n = 1907) completed the app task, with similar number of participants in each treatment group. The mean age was 40 ± 12 years with no differences in sociodemographic characteristics between treatment groups. The health star rating ranked significantly lower in comparison to the other treatment groups in terms of usefulness (OR, 95% CI -0.67, 0.52–0.85), believability (0.59, 0.46–0.75), and understanding (0.55, 0.44–0.71) (p < 0.001). The health star rating (1.20, 0.94–1.53) and control (NFt) (1,1,1) ranked significantly lower than the traffic light or the ‘high-in’ warning labels for their ability to compare the healthfulness of products (p < 0.001). Conclusion This study demonstrated Canadian consumers’ preference for a nutrient-specific system (i.e. traffic light or ‘high-in’ warning labels). The app, which was liked by majority of the participants for its functionality and usability, has the potential to support healthy dietary decision making and may also encourage reformulation. Trial registration NCT03290118 (Clinicaltrials.gov).
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Affiliation(s)
- Mavra Ahmed
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Medical Science Building, 1 King's College Circle, Room 5368, Toronto, ON, M5S 1A8, Canada
| | - Angela Oh
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Medical Science Building, 1 King's College Circle, Room 5368, Toronto, ON, M5S 1A8, Canada
| | - Lana Vanderlee
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Medical Science Building, 1 King's College Circle, Room 5368, Toronto, ON, M5S 1A8, Canada.,School of Public Health and Health Systems, University of Waterloo, Waterloo, N2L 3G1, Canada
| | - Beatriz Franco-Arellano
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Medical Science Building, 1 King's College Circle, Room 5368, Toronto, ON, M5S 1A8, Canada
| | - Alyssa Schermel
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Medical Science Building, 1 King's College Circle, Room 5368, Toronto, ON, M5S 1A8, Canada
| | - Wendy Lou
- Dalla Lana School of Public Health, University of Toronto, Toronto, M5T 3M2, Canada
| | - Mary R L'Abbé
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Medical Science Building, 1 King's College Circle, Room 5368, Toronto, ON, M5S 1A8, Canada.
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12
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Kim SU, Martinović I, Katavić SS. The use of mobile devices and applications for health information: A survey of Croatian students. JOURNAL OF LIBRARIANSHIP AND INFORMATION SCIENCE 2019. [DOI: 10.1177/0961000619880937] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study aims to understand the information behaviours of youth seeking health information on mobile devices and to explore differences by prior knowledge, gender and grade level. A survey was conducted in two high schools in Osijek, Croatia. Results indicate that among the total 408 participants, 84.3% reported having used mobile devices for health information and 54.7% reported having used applications for health information. Students seek health information about physical activity and eating issues/nutrition mostly on mobile devices. Students with more prior medical knowledge tend to have more information needs, perceive mobile devices as more beneficial, search health information and use health-related applications more frequently, and consider the tracking/recording/monitoring feature of applications more useful. Students with less prior medical knowledge tend to consider the video feature of applications more useful. Students rely heavily on searching health topics in search engines on mobile devices, rather than browsing or using applications. This study provides implications to better assist young people in using mobile devices and applications to manage their health issues.
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Affiliation(s)
- Sung Un Kim
- Catholic University of America, Washington, DC, USA
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13
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Dunn CG, Turner-McGrievy GM, Wilcox S, Hutto B. Dietary Self-Monitoring Through Calorie Tracking but Not Through a Digital Photography App Is Associated with Significant Weight Loss: The 2SMART Pilot Study—A 6-Month Randomized Trial. J Acad Nutr Diet 2019; 119:1525-1532. [DOI: 10.1016/j.jand.2019.03.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 03/13/2019] [Indexed: 11/26/2022]
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14
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Bereznay M, Kopp C, Nyakwol A, Howe CJ. Promoting Food Literacy in Teens. J Pediatr Nurs 2019; 47:171-172. [PMID: 31101362 DOI: 10.1016/j.pedn.2019.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Megan Bereznay
- Cook Children's, Fort Worth, TX, United States of America
| | - Caitlin Kopp
- Children's Health Dallas, Heart Center, United States of America
| | - Anna Nyakwol
- HCA Houston Healthcare-Kingwood, Houston, TX, United States of America
| | - Carol J Howe
- Texas Christian University, Fort Worth, TX, United States of America.
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15
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Halse RE, Shoneye CL, Pollard CM, Jancey J, Scott JA, Pratt IS, Dhaliwal SS, Norman R, Straker LM, Boushey CJ, Delp EJ, Zhu F, Harray AJ, Szybiak MA, Finch A, McVeigh JA, Mullan B, Collins CE, Mukhtar SA, Edwards KN, Healy JD, Kerr DA. Improving Nutrition and Activity Behaviors Using Digital Technology and Tailored Feedback: Protocol for the Tailored Diet and Activity (ToDAy) Randomized Controlled Trial. JMIR Res Protoc 2019; 8:e12782. [PMID: 30801257 PMCID: PMC6409509 DOI: 10.2196/12782] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 01/12/2019] [Accepted: 01/20/2019] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Excess weight is a major risk factor for chronic diseases. In Australia, over 60% of adults are overweight or obese. The overconsumption of energy-dense nutrient-poor (EDNP) foods and low physical activity (PA) levels are key factors contributing to population obesity. New cost-effective approaches to improve population diet and PA behaviors are needed. OBJECTIVE This 1-year randomized controlled trial (6-month intervention and 6-month follow-up) aims to investigate whether a tailored intervention using mobile technology can improve diet and PA behaviors leading to weight loss in adults (aged 18-65 years) who are overweight or obese and recruited through a social marketing campaign (LiveLighter). METHODS All eligible participants will provide data on demographics and lifestyle behaviors online at baseline, 6 months, and 12 months. Using two-stage randomization, participants will be allocated into one of three conditions (n=200 per group): tailored feedback delivered via email at seven time points, informed by objective dietary (mobile food record app) and activity (wearable activity monitor) assessment; active control receiving no tailored feedback, but undergoing the same objective assessments as tailored feedback; and online control receiving no tailored feedback or objective assessments. Primary outcome measures at 6 and 12 months are changes in body mass, EDNP food and beverage consumption, and daily moderate-to-vigorous PA (measured via accelerometry). Secondary outcomes include change in fruit and vegetable consumption, daily sedentary behaviors, and cost effectiveness. RESULTS Enrolment commenced in August 2017. Primary outcomes at 12 months will be available for analysis from September 2019. CONCLUSIONS Tailored email feedback provided to individuals may deliver a cost-effective strategy to overcome existing barriers to improving diet and PA. If found to be successful and cost effective, upscaling this intervention for inclusion in larger-scale interventions is highly feasible. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12617000554369; https://www.anzctr.org.au /Trial/Registration/TrialReview.aspx?id=371325&isReview=true. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/12782.
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Affiliation(s)
- Rhiannon E Halse
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Charlene L Shoneye
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Christina M Pollard
- School of Public Health, Curtin University, Perth, Western Australia, Australia.,East Metropolitan Health Service, Perth, Western Australia, Australia
| | - Jonine Jancey
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Jane A Scott
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Iain S Pratt
- Cancer Council WA, Perth, Western Australia, Australia.,Health Psychology & Behavioural Medicine Research Group, School of Psychology, Curtin University, Perth, Western Australia, Australia
| | | | - Richard Norman
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Leon M Straker
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Carol J Boushey
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, United States.,Department of Nutrition, Purdue University, West Lafayette, IN, United States
| | - Edward J Delp
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, United States
| | - Fengqing Zhu
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, United States
| | - Amelia J Harray
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | | | - Anne Finch
- Cancer Council WA, Perth, Western Australia, Australia
| | - Joanne A McVeigh
- School of Occupational Therapy, Speech Therapy & Social Work, Curtin University, Perth, Western Australia, Australia.,Movement Physiology Laboratory, University of Witwatersrand, Johannesburg, South Africa
| | - Barbara Mullan
- Health Psychology & Behavioural Medicine Research Group, School of Psychology, Curtin University, Perth, Western Australia, Australia
| | - Clare E Collins
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia
| | - Syed Aqif Mukhtar
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Kieran N Edwards
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Janelle D Healy
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Deborah A Kerr
- School of Public Health, Curtin University, Perth, Western Australia, Australia.,Curtin Institute of Computation, Curtin University, Perth, Western Australia, Australia
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16
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Shoneye CL, Dhaliwal SS, Pollard CM, Boushey CJ, Delp EJ, Harray AJ, Howat PA, Hutchesson MJ, Rollo ME, Zhu F, Wright JL, Pratt IS, Jancey J, Halse RE, Scott JA, Mullan B, Collins CE, Kerr DA. Image-Based Dietary Assessment and Tailored Feedback Using Mobile Technology: Mediating Behavior Change in Young Adults. Nutrients 2019; 11:E435. [PMID: 30791502 PMCID: PMC6412987 DOI: 10.3390/nu11020435] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 02/05/2019] [Accepted: 02/13/2019] [Indexed: 01/02/2023] Open
Abstract
Assessing the implementation of nutrition interventions is important to identify characteristics and dietary patterns of individuals who benefit most. The aim was to report on young adults' experiences of receiving dietary feedback text messaging intervention. Diet was captured using an image-based 4-day mobile food recordTM application (mFRTM) and assessed to formulate two tailored feedback text messages on fruit and vegetables and energy-dense nutrient-poor (EDNP) foods and beverages. At 6-months 143 participants completed a second mFRTM and a questionnaire evaluating the dietary feedback. Participants who agreed the text messages made them think about how much vegetables they ate were more likely to increase their intake by at least half a serve than those who disagreed [odds ratio (OR) = 4.28, 95% Confidence Interval (CI): 1.76 to 10.39]. Those who agreed the text messages made them think about how much EDNP foods they ate, were twice as likely to decrease their intake by over half a serve (OR = 2.39, 95%CI: 1.12 to 5.25) than those who disagreed. Undertaking detailed dietary assessment ensured the tailored feedback was constructive and relevant. Personal contemplation about vegetable and EDNP food intake appears to be a mediator of dietary change in young adults.
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Affiliation(s)
| | | | - Christina M Pollard
- School of Public Health, Curtin University, Perth, WA 6845, Australia.
- East Metropolitan Health Service, Perth, WA 6845, Australia.
| | - Carol J Boushey
- Epidemiology Program, University of Hawaii Cancer Centre, Honolulu, HI 96813, USA.
- Department of Nutrition, Purdue University, West Lafayette, IN 47907, USA.
| | - Edward J Delp
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN 47907, USA.
| | - Amelia J Harray
- School of Public Health, Curtin University, Perth, WA 6845, Australia.
| | - Peter A Howat
- School of Public Health, Curtin University, Perth, WA 6845, Australia.
| | - Melinda J Hutchesson
- School of Health Sciences and Priority Research Centre in Physical Activity and Nutrition, Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW 2308, Australia.
| | - Megan E Rollo
- School of Health Sciences and Priority Research Centre in Physical Activity and Nutrition, Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW 2308, Australia.
| | - Fengqing Zhu
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN 47907, USA.
| | - Janine L Wright
- School of Public Health, Curtin University, Perth, WA 6845, Australia.
| | - Iain S Pratt
- Cancer Council Western Australia, Subiaco, WA 6008, Australia.
- Western Australian Cancer Prevention Research Unit (WACPRU), School of Psychology, Curtin University, Perth, WA 6845, Australia.
| | - Jonine Jancey
- School of Public Health, Curtin University, Perth, WA 6845, Australia.
| | - Rhiannon E Halse
- School of Public Health, Curtin University, Perth, WA 6845, Australia.
| | - Jane A Scott
- School of Public Health, Curtin University, Perth, WA 6845, Australia.
| | - Barbara Mullan
- Health Psychology & Behavioural Medicine Research Group, School of Psychology, Curtin University, Perth, WA 6845, Australia.
| | - Clare E Collins
- School of Health Sciences and Priority Research Centre in Physical Activity and Nutrition, Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW 2308, Australia.
| | - Deborah A Kerr
- School of Public Health, Curtin University, Perth, WA 6845, Australia.
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17
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Eldridge AL, Piernas C, Illner AK, Gibney MJ, Gurinović MA, de Vries JHM, Cade JE. Evaluation of New Technology-Based Tools for Dietary Intake Assessment-An ILSI Europe Dietary Intake and Exposure Task Force Evaluation. Nutrients 2018; 11:E55. [PMID: 30597864 PMCID: PMC6356426 DOI: 10.3390/nu11010055] [Citation(s) in RCA: 112] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 12/20/2018] [Accepted: 12/25/2018] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND New technology-based dietary assessment tools, including Web-based programs, mobile applications, and wearable devices, may improve accuracy and reduce costs of dietary data collection and processing. The International Life Sciences Institute (ILSI) Europe Dietary Intake and Exposure Task Force launched this project to evaluate new tools in order to recommend general quality standards for future applications. METHODS A comprehensive literature search identified technology-based dietary assessment tools, including those published in English from 01/2011 to 09/2017, and providing details on tool features, functions and uses. Each of the 43 tools identified (33 for research and 10 designed for consumer use) was rated on 25 attributes. RESULTS Most of the tools identified (79%) relied on self-reported dietary intakes. Most (91%) used text entry and 33% used digital images to help identify foods. Only 65% had integrated databases for estimating energy or nutrients. Fewer than 50% contained any features of customization and about half generated automatic reports. Most tools reported on usability or reported validity compared with another assessment method (77%). A set of Best Practice Guidelines was developed for reporting dietary assessment tools using new technology. CONCLUSIONS Dietary assessment methods that utilize technology offer many advantages for research and are often preferable to consumers over more traditional methods. In order to meet general quality standards, new technology tools require detailed publications describing tool development, food identification and quantification, customization, outputs, food composition tables used, and usability/validity testing.
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Affiliation(s)
- Alison L Eldridge
- Nestlé Research, Vers-chez-les-Blanc, 1000 Lausanne 26, Switzerland.
| | - Carmen Piernas
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK.
| | - Anne-Kathrin Illner
- College of Health Sciences, Polytechnic Institute UniLaSalle Beauvais, 60026 Beauvais, France.
| | - Michael J Gibney
- Institute of Food and Health, University College Dublin, Dublin D04 V1W8, Ireland.
| | - Mirjana A Gurinović
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Belgrade 11000, Serbia.
| | - Jeanne H M de Vries
- Division of Human Nutrition and Health, Wageningen University, 6708WE Wageningen, The Netherlands.
| | - Janet E Cade
- School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK.
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Chib A, Lin SH. Theoretical Advancements in mHealth: A Systematic Review of Mobile Apps. JOURNAL OF HEALTH COMMUNICATION 2018; 23:909-955. [PMID: 30449261 DOI: 10.1080/10810730.2018.1544676] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
There are now few hundred thousand healthcare apps, yet there is a gap in our understanding of the theoretical mechanisms for which, and how, technological features translate into improved healthcare outcomes. In particular, the technological convergence, within mobile health (mHealth) apps, of the processes of mass and interpersonal communication, and human-computer interaction requires greater parsing in the literature. This paper analyzed 85 empirical studies on mHealth apps using the Input-Mechanism-Output model. We found in the literature that, firstly, there is a greater emphasis on technological inputs (87%) of accessibility, usability, usage, and data quality, than health outputs (52%) such as system process efficiencies and individual level behavioral or health outcomes. Secondly, there is little evidence of explanatory mechanisms (19%) of how the effects of mHealth apps are achieved. While we believe that successful apps would require research that incorporates technological inputs, theoretical mechanisms and health outputs, such studies are a rarity (n = 3). There is a minor increase in rigor with randomized control trials (n = 5), and a preponderance of discussion around social influence (n = 8) and gamification (n = 7), albeit in a scattered manner. We discuss the implications of the trend towards socialization and gamification findings in terms of future research, particularly in terms of study design guided by theoretical mechanisms.
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Affiliation(s)
- Arul Chib
- a Wee Kim Wee School of Communication and Information , Nanyang Technological University , Singapore
| | - Sapphire H Lin
- a Wee Kim Wee School of Communication and Information , Nanyang Technological University , Singapore
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19
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Polfuss M, Moosreiner A, Boushey CJ, Delp EJ, Zhu F. Technology-Based Dietary Assessment in Youth with and Without Developmental Disabilities. Nutrients 2018; 10:E1482. [PMID: 30314313 PMCID: PMC6213225 DOI: 10.3390/nu10101482] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 10/03/2018] [Accepted: 10/08/2018] [Indexed: 01/23/2023] Open
Abstract
Obesity prevalence is higher in children with developmental disabilities as compared to their typically developing peers. Research on dietary intake assessment methods in this vulnerable population is lacking. The objectives of this study were to assess the feasibility, acceptability, and compare the nutrient intakes of two technology-based dietary assessment methods in children with-and-without developmental disabilities. This cross-sectional feasibility study was an added aim to a larger pilot study. Children (n = 12; 8⁻18 years) diagnosed with spina bifida, Down syndrome, or without disability were recruited from the larger study sample, stratified by diagnosis. Participants were asked to complete six days of a mobile food record (mFR™), a 24-h dietary recall via FaceTime® (24 HR-FT), and a post-study survey. Analysis included descriptive statistics for survey results and a paired samples t-test for nutrient intakes. All participants successfully completed six days of dietary assessment using both methods and acceptability was high. Energy (kcal) and protein (g) intake was significantly higher for the mFR™ as compared to the 24 HR-FT (p = 0.041; p = 0.014, respectively). Each method had strengths and weaknesses. The two technology-based dietary assessment tools were well accepted and when combined could increase accuracy of self-reported dietary assessment in children with-and-without disability.
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Affiliation(s)
- Michele Polfuss
- University of Wisconsin-Milwaukee, College of Nursing, Milwaukee, WI 53211, USA.
- Children's Hospital of Wisconsin, Department of Nursing Research, Milwaukee, WI 53226, USA.
| | - Andrea Moosreiner
- Medical College of Wisconsin-Clinical and Translational Science Institute, Milwaukee, WI 53226, USA.
| | - Carol J Boushey
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI 96789, USA.
| | - Edward J Delp
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN 47907, USA.
| | - Fengqing Zhu
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN 47907, USA.
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20
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Beltran A, Dadabhoy H, Ryan C, Dholakia R, Jia W, Baranowski J, Sun M, Baranowski T. Dietary Assessment with a Wearable Camera among Children: Feasibility and Intercoder Reliability. J Acad Nutr Diet 2018; 118:2144-2153. [PMID: 30115556 DOI: 10.1016/j.jand.2018.05.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 05/14/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND The eButton, a multisensor device worn on the chest, uses a camera to passively capture images of everything in front of the child throughout the day. These images can be analyzed to provide a passive method of dietary intake assessment. OBJECTIVE This study assessed the eButton's feasibility and intercoder reliability for dietary intake assessment. DESIGN Children were recruited in the summer and fall of 2015, in Houston, TX, to wear the eButton to take 2 full days of dietary images, and the child-parent dyad participated in a following-day interview to verify what dietitians recorded from the images. PARTICIPANTS/SETTING Thirty 9- to 13-year-old children participated during days convenient to them. MAIN OUTCOME MEASURES Two dietitians independently manually reviewed the images to identify eating events, foods in those events, and portion sizes. STATISTICAL ANALYSES PERFORMED Descriptive statistics of agreements and disagreements were calculated between dietitians and with children; t tests and Bland-Altman plots of differences in total kilocalories were calculated between dietitians and between initial dietitian estimates and those finalized after the verification interviews. RESULTS The dietitians agreed on the identity of 60.5% of the 1,026 foods but disagreed on 28.6% of the foods and on the names for 10.8% of the foods. After the verification interviews, the dietitians agreed with the child-parent dyads on the identity of 77.0% of the 921 foods; the child-parent dyad identified 12.4% of the day's foods when images were not available or not clear; the child-parent dyad clarified that 5.4% of the foods identified were not consumed by the child; and the child-parent dyad clarified the identity of 5.2% of the foods. A software-based approach (three-dimensional wire mesh) could be used to estimate portion size on 24% of the foods, and professional judgment was required for 67.8%. Mean caloric intakes per day were not statistically significantly different between dietitians but were different between dietitians and child-parent dyads in total and on day 2. CONCLUSIONS An early test of intercoder reliability of an all-day image method of dietary intake assessment obtained intercoder agreement between the two dietitians processing these images of intraclass correlation coefficient=0.67. A following-day verification interview with the child and parent was necessary to ensure completeness of estimates. Several feasibility problems occurred, which may be remedied with additional participant and dietitian training and further technological development.
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21
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Warren J, Guelinckx I, Livingstone B, Potischman N, Nelson M, Foster E, Holmes B. Challenges in the assessment of total fluid intake in children and adolescents: a discussion paper. Eur J Nutr 2018; 57:43-51. [PMID: 29923117 PMCID: PMC6008368 DOI: 10.1007/s00394-018-1745-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 06/07/2018] [Indexed: 11/30/2022]
Abstract
Purpose In recent years, evidence has emerged about the importance of healthy fluid intake in children for physical and mental performance and health, and in the prevention of obesity. Accurate data on water intake are needed to inform researchers and policymakers and for setting dietary reference values. However, to date, there are few published data on fluid or water intakes in children. This is due partly to the fact that drinking water is not always reported in dietary surveys. The aim of this paper is to review the current status of the literature and highlight the challenges of assessing total fluid intake in children and adolescents. Results From the dietary assessment literature it is apparent that children present unique challenges to assessing intake due to ongoing cognitive capacity development, limited literacy skills, difficulties in estimating portion sizes and multiple caregivers during any 1 day making it difficult to track intakes. As such, many issues should be considered when assessing total fluid intakes in children or adolescents. Various methods to assess fluid intakes exist, each with its own strengths and weaknesses; the ultimate choice of method depends on the research question and resources available. Based on the literature review, it is apparent that if the research focus is to assess only fluid intake, a fluid-specific method, such as a diary or record, appears to be a feasible approach to provide an accurate estimate of intakes.
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Affiliation(s)
| | - Isabelle Guelinckx
- Danone Nutricia Research, Route Départementale 128, 91767, Palaiseau, France.
| | - Barbara Livingstone
- Nutrition Innovation Centre for Food and Health, Ulster University, Coleraine, UK
| | - Nancy Potischman
- Office of Dietary Supplements, National Institutes of Health, Bethesda, USA
| | - Michael Nelson
- Public Health Nutrition Research Ltd, King's College London, London, UK
| | - Emma Foster
- Human Nutrition Research Centre, Newcastle University, Newcastle, UK
| | - Bridget Holmes
- Danone Nutricia Research, Route Départementale 128, 91767, Palaiseau, France
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E Silva BVR, Rad MG, Cui J, McCabe M, Pan K. A Mobile-Based Diet Monitoring System for Obesity Management. ACTA ACUST UNITED AC 2018; 9. [PMID: 30416865 DOI: 10.4172/2157-7420.1000307] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Personal diet management is key to fighting the obesity epidemic. Recent advances in smartphones and wearable sensor technologies have empowered automated food monitoring through food image processing and eating episode detection, with the goal to conquer drawbacks of traditional food journaling that is labour intensive, inaccurate, and low adherent. In this paper, we present a new interactive mobile system that enables automated food recognition and assessment based on user food images and provides dietary intervention while tracking users' dietary and physical activities. In addition to using techniques in computer vision and machine learning, one unique feature of this system is the realization of real-time energy balance monitoring through metabolic network simulation. As a proof of concept, we have demonstrated the use of this system through an Android application.
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Affiliation(s)
| | - Milad Ghiasi Rad
- Department of Computer Science and Engineering at University of Nebraska, Lincoln, USA
| | - Juan Cui
- Department of Computer Science and Engineering at University of Nebraska, Lincoln, USA
| | - Megan McCabe
- Department of Complex Bio Systems at UNL, Lincoln, USA
| | - Kaiyue Pan
- Department of Computer Science at McGill University, Canada
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Traditional methods v. new technologies - dilemmas for dietary assessment in large-scale nutrition surveys and studies: a report following an international panel discussion at the 9th International Conference on Diet and Activity Methods (ICDAM9), Brisbane, 3 September 2015. J Nutr Sci 2018; 7:e11. [PMID: 29686860 PMCID: PMC5906559 DOI: 10.1017/jns.2018.4] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 02/08/2018] [Indexed: 11/07/2022] Open
Abstract
The aim of the present paper is to summarise current and future applications of dietary assessment technologies in nutrition surveys in developed countries. It includes the discussion of key points and highlights of subsequent developments from a panel discussion to address strengths and weaknesses of traditional dietary assessment methods (food records, FFQ, 24 h recalls, diet history with interviewer-assisted data collection) v. new technology-based dietary assessment methods (web-based and mobile device applications). The panel discussion 'Traditional methods v. new technologies: dilemmas for dietary assessment in population surveys', was held at the 9th International Conference on Diet and Activity Methods (ICDAM9), Brisbane, September 2015. Despite respondent and researcher burden, traditional methods have been most commonly used in nutrition surveys. However, dietary assessment technologies offer potential advantages including faster data processing and better data quality. This is a fast-moving field and there is evidence of increasing demand for the use of new technologies amongst the general public and researchers. There is a need for research and investment to support efforts being made to facilitate the inclusion of new technologies for rapid, accurate and representative data.
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Key Words
- AES, Australian Eating Survey
- AHS, Australian Health Survey
- AMPM, Automated Multiple-Pass Method
- ASA24, Automated Self-Administered 24-hour Recall
- DNFCS, Dutch National Food Consumption Survey
- Dietary assessment technologies
- ICDAM9, 9th International Conference on Diet and Activity Methods
- MRC, Medical Research Council
- Mobile applications
- NDNS, National Diet and Nutrition Survey
- NHANES, National Health and Nutrition Examination Survey
- Nutrition surveys
- RP, Rolling Programme
- Web-based tools
- WebDASC, Web-based Dietary Assessment Software for Children
- mFR, mobile food record
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White BK, Burns SK, Giglia RC, Scott JA. Designing evaluation plans for health promotion mHealth interventions: a case study of the Milk Man mobile app. Health Promot J Austr 2018; 27:198-203. [PMID: 27784506 DOI: 10.1071/he16041] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 09/07/2016] [Indexed: 01/31/2023] Open
Abstract
Evaluating complex health promotion interventions that use mobile apps requires comprehensive and adaptive evaluation plans. As mobile usage becomes increasingly sophisticated and personalised, broad evaluation plans are important in determining the impact and efficacy of a mobile health (mHealth) app. Evaluation should consider user feedback and outcome measures, as well as examine elements such as the robustness of the technology, the intervention principles and engagement strategies, and the interaction of the user with the technology. This paper introduces four mHealth evaluation models and tools and describes the evaluation plan that has been developed for Milk Man, a breastfeeding app targeting new and expectant fathers. Milk Man is a socially connected, gamified app that is being tested in a large Randomised Control Trial (RCT). While there is a need for mobile apps to be evaluated in adequately powered RCTs, trialling mobile apps over a long period of time presents challenges. Incorporating robust evaluation design will help ensure that technological performance, app intervention principles, as well as health and behavioural outcomes are measured. The detail and scope of the Milk Man app evaluation plan will ensure the findings add to the evidence base and have broad relevance to health promotion practitioners. So what? Evidence about the efficacy of mHealth interventions is an emerging area and appropriate evaluation skills are needed. This paper illustrates an evaluation planning approach for mHealth interventions that could be adapted for use by health promotion practitioners and researchers.
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Affiliation(s)
- Becky K White
- School of Public Health, Curtin University, GPO Box U1987, Bentley, Perth, WA 6845, Australia
| | - Sharyn K Burns
- School of Public Health, Curtin University, GPO Box U1987, Bentley, Perth, WA 6845, Australia
| | - Roslyn C Giglia
- School of Public Health, Curtin University, GPO Box U1987, Bentley, Perth, WA 6845, Australia
| | - Jane A Scott
- School of Public Health, Curtin University, GPO Box U1987, Bentley, Perth, WA 6845, Australia
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Abstract
Healthy diet with balanced nutrition is key to the prevention of life-threatening diseases such as obesity, cardiovascular disease, and cancer. Recent advances in smartphone and wearable sensor technologies have led to a proliferation of food monitoring applications based on automated food image processing and eating episode detection, with the goal to conquer drawbacks of the traditional manual food journaling that is time consuming, inaccurate, underreporting, and low adherent. In order to provide users feedback with nutritional information accompanied by insightful dietary advice, various techniques in light of the key computational learning principles have been explored. This survey presents a variety of methodologies and resources on this topic, along with unsolved problems, and closes with a perspective and boarder implications of this field.
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Affiliation(s)
- Vieira Bruno
- Department of Computer Science and Engineering, University of Nebraska-Lincoln, NE, USA
| | - Silva Resende
- Department of Computer Science and Engineering, University of Nebraska-Lincoln, NE, USA
| | - Cui Juan
- Department of Computer Science and Engineering, University of Nebraska-Lincoln, NE, USA
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Perception v. actual intakes of junk food and sugar-sweetened beverages in Australian young adults: assessed using the mobile food record. Public Health Nutr 2017; 20:2300-2307. [DOI: 10.1017/s1368980017000702] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
AbstractObjectiveTo determine perception v. actual intakes of energy-dense nutrient-poor ‘junk food’ (JF) and sugar-sweetened beverages (SSB) in young adults, using the mobile food record (mFR).DesignBefore-and-after eating images using a 4 d mFR were assessed for standardised 600 kJ (143 kcal) servings of JF and SSB (excluding diet drinks). Participants reported their concern about the health aspects of their diet, perceptions and intentions regarding JF and SSB.SettingPerth, Western Australia.SubjectsAdults (n 246) aged 18–30 years.ResultsThe mean (sd) intake of JF+SSB was 3·7 (2·0) servings/d. Women thinking about drinking less SSB consumed more SSB servings/d (1·5 (1·2)) than men (0·7 (0·5); P<0·05) who were thinking about drinking less. Men not thinking about cutting down JF consumed more servings/d (4·6 (2·4)) than women (2·5 (0·7); P<0·01) who were not thinking about cutting down. Those who paid a lot of attention to the health aspects of their diet consumed less JF+SSB than those who took only a bit of notice (P<0·001), were not really thinking much about it (P<0·001) or who didn’t think at all about the health aspects of food (P<0·01).ConclusionsPerceptions and attitudes regarding JF and SSB were associated with level of consumption. Those not thinking about cutting down their intake of these foods represent an important target group as they consume more than their peers. Further research is needed to identify how amenable young adults are to changing their intake, particularly given the lack of attention paid to the health aspects of their diet.
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Boushey CJ, Spoden M, Delp EJ, Zhu F, Bosch M, Ahmad Z, Shvetsov YB, DeLany JP, Kerr DA. Reported Energy Intake Accuracy Compared to Doubly Labeled Water and Usability of the Mobile Food Record among Community Dwelling Adults. Nutrients 2017; 9:E312. [PMID: 28327502 PMCID: PMC5372975 DOI: 10.3390/nu9030312] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 03/02/2017] [Accepted: 03/17/2017] [Indexed: 11/16/2022] Open
Abstract
The mobile Food Record (mFR) is an image-based dietary assessment method for mobile devices. The study primary aim was to test the accuracy of the mFR by comparing reported energy intake (rEI) to total energy expenditure (TEE) using the doubly labeled water (DLW) method. Usability of the mFR was assessed by questionnaires before and after the study. Participants were 45 community dwelling men and women, 21-65 years. They were provided pack-out meals and snacks and encouraged to supplement with usual foods and beverages not provided. After being dosed with DLW, participants were instructed to record all eating occasions over a 7.5 days period using the mFR. Three trained analysts estimated rEI from the images sent to a secure server. rEI and TEE correlated significantly (Spearman correlation coefficient of 0.58, p < 0.0001). The mean percentage of underreporting below the lower 95% confidence interval of the ratio of rEI to TEE was 12% for men (standard deviation (SD) ± 11%) and 10% for women (SD ± 10%). The results demonstrate the accuracy of the mFR is comparable to traditional dietary records and other image-based methods. No systematic biases could be found. The mFR was received well by the participants and usability was rated as easy.
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Affiliation(s)
- Carol J Boushey
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI 96813, USA.
| | - Melissa Spoden
- Department for Structural Advancement and Quality Management in Health Care, Technical University Berlin, Berlin 10632, Germany.
| | - Edward J Delp
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN 47907, USA.
| | - Fengqing Zhu
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN 47907, USA.
| | - Marc Bosch
- The Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723, USA.
| | - Ziad Ahmad
- Motorola Mobility LLC, Chicago, IL 60654, USA.
| | - Yurii B Shvetsov
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI 96813, USA.
| | - James P DeLany
- Department of Medicine, Division of Endocrinology and Metabolism, University of Pittsburgh, Pittsburgh, PA 15213, USA.
| | - Deborah A Kerr
- School of Public Health, Curtin University, Perth WA 6845, Australia.
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Feasibility of Assessing Diet with a Mobile Food Record for Adolescents and Young Adults with Down Syndrome. Nutrients 2017; 9:nu9030273. [PMID: 28335382 PMCID: PMC5372936 DOI: 10.3390/nu9030273] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 03/09/2017] [Indexed: 11/19/2022] Open
Abstract
Technology-based methods for assessing diet in those with disability remains largely unexplored. The aim was to assess the feasibility of assessing diet with an image-based mobile food record application (mFR) in 51 adolescents and young adults with Down syndrome (PANDs). Adherence was also assessed with the instruction to include a fiducial marker object in the before and after eating images. The PANDs sample completed a four-day mFR and results were compared with a sample of young adults from the Connecting Health and Technology study (CHAT, n = 244). Compared to the CHAT sample, PANDs participants reported more fruit (2.2 ± 1.8 versus 1.0 ± 0.9 serves respectively) and vegetables (2.4 ± 1.3 versus 1.9 ± 1.0 serves, respectively), but no differences in energy-dense nutrient-poor (EDNP) foods and beverages were observed. Compared to CHAT, PANDs participants captured fewer images with the mFR (4.9 ± 2.3 versus 4.0 ± 1.5 images, respectively). Adherence to the instruction to include the fiducial marker in images was lower for PANDs compared with the CHAT sample (90.3% versus 96.5%). Due to the quality of information captured in images and the high acceptability of the fiducial marker, the mFR shows great promise as a feasible method of assessing diet in adolescents and young adults with Down syndrome.
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29
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Kerr DA, Dhaliwal SS, Pollard CM, Norman R, Wright JL, Harray AJ, Shoneye CL, Solah VA, Hunt WJ, Zhu F, Delp EJ, Boushey CJ. BMI is Associated with the Willingness to Record Diet with a Mobile Food Record among Adults Participating in Dietary Interventions. Nutrients 2017; 9:E244. [PMID: 28272343 PMCID: PMC5372907 DOI: 10.3390/nu9030244] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 03/03/2017] [Indexed: 01/22/2023] Open
Abstract
Image-based dietary assessment methods have the potential to address respondent burden and improve engagement in the task of recording for dietary interventions. The aim of this study was to assess factors associated with the willingness of adults to take images of food and beverages using a mobile food record (mFR) application. A combined sample of 212 young adults and 73 overweight and obese adults completed a 4-day mobile food record on two occasions and a follow-up usability questionnaire. About 74% of participants stated they would record using the mFR for a longer period compared with a written record (29.4 ± 69.3 vs. 16.1 ± 42.6 days respectively; p < 0.0005). Multivariable logistic regression was used to identify those who were more likely to record mFR in the top tertile (≥14 days). After adjusting for age and gender, those with a BMI ≥ 25 were 1.68 times more likely (Odds Ratio 95% Confidence Interval: 1.02-2.77) than those with BMI < 25 to state a willingness to record with the mFR for ≥ 14 days. The greater willingness of overweight and obese individuals to record dietary intake using an mFR needs further examination to determine if this translates to more accurate estimates of energy intake.
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Affiliation(s)
- Deborah A Kerr
- School of Public Health, Curtin University, Perth 6845, Australia.
| | | | - Christina M Pollard
- School of Public Health, Curtin University, Perth 6845, Australia.
- Public Health Division, Department of Health in Western Australia, 189 Royal Street, East Perth 6004, Australia.
| | - Richard Norman
- School of Public Health, Curtin University, Perth 6845, Australia.
| | - Janine L Wright
- School of Public Health, Curtin University, Perth 6845, Australia.
| | - Amelia J Harray
- School of Public Health, Curtin University, Perth 6845, Australia.
| | | | - Vicky A Solah
- School of Public Health, Curtin University, Perth 6845, Australia.
| | - Wendy J Hunt
- School of Public Health, Curtin University, Perth 6845, Australia.
| | - Fengqing Zhu
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN 47907, USA.
| | - Edward J Delp
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN 47907, USA.
| | - Carol J Boushey
- Epidemiology Program, University of Hawaii Cancer Center, HI 96813, USA.
- Nutrition Program, Purdue University, West Lafayette, IN 47907, USA.
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30
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Wagner KA, Braun E, Armah SM, Horan D, Smith LG, Pike J, Tu W, Hamilton MT, Delp EJ, Campbell WW, Boushey CJ, Hannon TS, Gletsu-Miller N. Dietary Intervention for Glucose Tolerance In Teens (DIG IT): Protocol of a randomized controlled trial using health coaching to prevent youth-onset type 2 diabetes. Contemp Clin Trials 2017; 53:171-177. [PMID: 28011388 PMCID: PMC5322725 DOI: 10.1016/j.cct.2016.12.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 12/17/2016] [Accepted: 12/18/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Youth-onset type 2 diabetes (T2D) is a disease that is newly emerging and behavioral strategies for its prevention are limited. Interventions that target the lifestyle behaviors of adolescents, to improve poor dietary quality and reduce excessive sedentariness, promise to reduce the risk of developing T2D. Health coaching is effective for promoting healthy behaviors in patients who have chronic disease, but few experimental studies are in adolescents. This randomized controlled trial, in adolescents with prediabetes, will determine the effectiveness of a health coaching intervention to facilitate adoption of healthy diet and activity behaviors that delay or prevent development of T2D. METHODS/DESIGN The Dietary Intervention for Glucose Tolerance In Teens (DIG IT) trial will involve an evaluation of a health coaching intervention in adolescents with prediabetes. Eligible participants will be randomized to receive 6months of health coaching or a single dietary consultation that is standard-of-care. The primary outcome will be 2-hour oral glucose tolerance test concentration. Secondary outcomes will include measures of glycemia and insulin action as well as dietary, physical activity and sedentary behaviors measured using an electronic food record, and by inclinometer. Data will be collected before and after the intervention (at 6months) and at 12months (to assess sustainability). DISCUSSION This trial will determine whether a health coaching intervention, a personalized and low-cost approach to modify dietary and activity behaviors, is effective and sustainable for prevention of youth-onset T2D, relative to standard-of-care. Health coaching has the potential to be widely implemented in clinical or community settings.
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Affiliation(s)
- Kelly A Wagner
- Department of Nutrition Science, Purdue University, West Lafayette, IN 47907, United States
| | - Ethan Braun
- Department of Nutrition Science, Purdue University, West Lafayette, IN 47907, United States
| | - Seth M Armah
- Department of Nutrition Science, Purdue University, West Lafayette, IN 47907, United States
| | - Diarmuid Horan
- Department of Nutrition Science, Purdue University, West Lafayette, IN 47907, United States
| | - Lisa G Smith
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN 46202, United States
| | - Julie Pike
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN 46202, United States
| | - Wanzhu Tu
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN 46202, United States
| | - Marc T Hamilton
- Texas Obesity Research Center, University of Houston, Houston, TX 77204, United States
| | - Edward J Delp
- Department of Electrical and Computer Engineering Science, Purdue University, West Lafayette, IN 47907, United States
| | - Wayne W Campbell
- Department of Nutrition Science, Purdue University, West Lafayette, IN 47907, United States
| | - Carol J Boushey
- Epidemiology Program, University of Hawaii Cancer Center, University of Hawaii, Honolulu, HI 96813, United States
| | - Tamara S Hannon
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN 46202, United States
| | - Nana Gletsu-Miller
- Department of Nutrition Science, Purdue University, West Lafayette, IN 47907, United States.
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Can Malaysian Young Adults Report Dietary Intake Using a Food Diary Mobile Application? A Pilot Study on Acceptability and Compliance. Nutrients 2017; 9:nu9010062. [PMID: 28098770 PMCID: PMC5295106 DOI: 10.3390/nu9010062] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 01/07/2017] [Accepted: 01/10/2017] [Indexed: 11/27/2022] Open
Abstract
Mobile applications may improve dietary reporting among young adults due to their high accessibility and embedded camera function. This pilot study aimed to (i) evaluate users’ acceptability and compliance in reporting dietary intake using a newly developed food diary mobile application (food app); and (ii) identify issues and recommendations for improving dietary assessment using this food app via quantitative and qualitative protocols. Twenty-eight university students each used a food app for seven consecutive days and attended one of five focus group interviews. A 42% decrement in reporting compliance was observed throughout the seven-day recording period. An average of 5.9 recording days were reported and 4.8 occasions of meal data were uploaded each day. Based on questionnaires, high levels of agreement were reported in terms of perceived usefulness (69.3%), perceived ease of use (77.1%), attitude (73.6%), perceived enjoyment (62.6%), and smartphone experience (91.1%), but such agreement was not reported for intention to use (38.1%) and social influence (33.4%). Four major themes emerged from the focus group interviews, namely, (i) features; (ii) potential use; (iii) utility issues of the food app; and (iv) suggestions for improvements. While the food app was well-accepted by most of the young adults, the current prototype would benefit from incorporation of a barcode scanning function, customizable reminders, in-app tutorial, an entertainment component, and enhancement in overall appearance.
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New mobile methods for dietary assessment: review of image-assisted and image-based dietary assessment methods. Proc Nutr Soc 2016; 76:283-294. [DOI: 10.1017/s0029665116002913] [Citation(s) in RCA: 178] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
For nutrition practitioners and researchers, assessing dietary intake of children and adults with a high level of accuracy continues to be a challenge. Developments in mobile technologies have created a role for images in the assessment of dietary intake. The objective of this review was to examine peer-reviewed published papers covering development, evaluation and/or validation of image-assisted or image-based dietary assessment methods from December 2013 to January 2016. Images taken with handheld devices or wearable cameras have been used to assist traditional dietary assessment methods for portion size estimations made by dietitians (image-assisted methods). Image-assisted approaches can supplement either dietary records or 24-h dietary recalls. In recent years, image-based approaches integrating application technology for mobile devices have been developed (image-based methods). Image-based approaches aim at capturing all eating occasions by images as the primary record of dietary intake, and therefore follow the methodology of food records. The present paper reviews several image-assisted and image-based methods, their benefits and challenges; followed by details on an image-based mobile food record. Mobile technology offers a wide range of feasible options for dietary assessment, which are easier to incorporate into daily routines. The presented studies illustrate that image-assisted methods can improve the accuracy of conventional dietary assessment methods by adding eating occasion detail via pictures captured by an individual (dynamic images). All of the studies reduced underreporting with the help of images compared with results with traditional assessment methods. Studies with larger sample sizes are needed to better delineate attributes with regards to age of user, degree of error and cost.
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Segovia-Siapco G, Sabaté J. Using Personal Mobile Phones to Assess Dietary Intake in Free-Living Adolescents: Comparison of Face-to-Face Versus Telephone Training. JMIR Mhealth Uhealth 2016; 4:e91. [PMID: 27473291 PMCID: PMC4982913 DOI: 10.2196/mhealth.5418] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 04/25/2016] [Accepted: 06/25/2016] [Indexed: 12/14/2022] Open
Abstract
Background Traditional paper-based methods to assess food intake can be cumbersome for adolescents; use of mobile phones to track and photograph what they eat may be a more convenient, reliable, and compelling way to collect data. Objective Our aims were to determine (1) the feasibility of using personal mobile phones to send food records with digital images (FRDIs) among free-living adolescents and (2) whether the quality of food records differed between a high-level intervention group (ie, face-to-face training plus real-time support) and a low-level intervention group (ie, telephone training plus next-day follow-up). Methods Adolescents (N=42, 11 males and 31 females) aged 12-18 years who had a mobile phone with camera enrolled in the study via consecutive sampling. The first group (n=21) received face-to-face training while the second group (n=21) was trained via telephone. Participants received a fiducial marker (FM) and completed a 1-day FRDI using their mobile phones. At every eating occasion, participants were to (1) take clear images of their meals/food with a correctly placed fiducial marker before eating, (2) send the image immediately to a designated email address, (3) right after completing a meal, send a text message listing the time and name of the meal, foods eaten, and amounts eaten, and (4) before sleep, send an “end” text message to indicate completion of food recording. Those who received face-to-face training received real-time support during reporting; those trained by telephone received next-day follow-up. Descriptive statistics and comparison tests were used to determine performance of the groups. Results All participants (N=42) who underwent training completed their 1-day FRDI. A significantly greater proportion of the low-level intervention group compared to the high-level intervention group placed their FM correctly in the image (95% vs 43%, P<.001), had complete information for each meal in their food record (95% vs 71%, P=.04), and had a higher overall score in meeting the criteria for food recording (4.3 vs 3.4 out of 5 points). Both groups had energy intake values that moderately correlated with their estimated energy requirements: low-intervention r=.55; high-intervention r=.51. Conclusions Using personal mobile phones to report dietary intake via texting and digital images is feasible among free-living adolescents. Real-time support or high-level intervention does not guarantee better food recording quality among adolescents.
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Affiliation(s)
- Gina Segovia-Siapco
- Center for Nutrition, Healthy Lifestyle, and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, CA, United States.
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White BK, Martin A, White JA, Burns SK, Maycock BR, Giglia RC, Scott JA. Theory-Based Design and Development of a Socially Connected, Gamified Mobile App for Men About Breastfeeding (Milk Man). JMIR Mhealth Uhealth 2016; 4:e81. [PMID: 27349756 PMCID: PMC4940606 DOI: 10.2196/mhealth.5652] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 05/17/2016] [Accepted: 06/04/2016] [Indexed: 01/28/2023] Open
Abstract
Background Despite evidence of the benefits of breastfeeding, <15% of Australian babies are exclusively breastfed to the recommended 6 months. The support of the father is one of the most important factors in breastfeeding success, and targeting breastfeeding interventions to the father has been a successful strategy in previous research. Mobile technology offers unique opportunities to engage and reach populations to enhance health literacy and healthy behavior. Objective The objective of our study was to use previous research, formative evaluation, and behavior change theory to develop the first evidence-based breastfeeding app targeted at men. We designed the app to provide men with social support and information aiming to increase the support men can offer their breastfeeding partners. Methods We used social cognitive theory to design and develop the Milk Man app through stages of formative research, testing, and iteration. We held focus groups with new and expectant fathers (n=18), as well as health professionals (n=16), and used qualitative data to inform the design and development of the app. We tested a prototype with fathers (n=4) via a think-aloud study and the completion of the Mobile Application Rating Scale (MARS). Results Fathers and health professionals provided input through the focus groups that informed the app development. The think-aloud walkthroughs identified 6 areas of functionality and usability to be addressed, including the addition of a tutorial, increased size of text and icons, and greater personalization. Testers rated the app highly, and the average MARS score for the app was 4.3 out of 5. Conclusions To our knowledge, Milk Man is the first breastfeeding app targeted specifically at men. The development of Milk Man followed a best practice approach, including the involvement of a multidisciplinary team and grounding in behavior change theory. It tested well with end users during development. Milk Man is currently being trialed as part of the Parent Infant Feeding Initiative (ACTRN12614000605695).
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Affiliation(s)
- Becky K White
- School of Public Health, Curtin University, Perth, Australia
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Badawy SM, Thompson AA, Liem RI. Technology Access and Smartphone App Preferences for Medication Adherence in Adolescents and Young Adults With Sickle Cell Disease. Pediatr Blood Cancer 2016; 63:848-52. [PMID: 26844685 DOI: 10.1002/pbc.25905] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 12/21/2015] [Indexed: 11/09/2022]
Abstract
BACKGROUND Hydroxyurea is the only Food and Drug Administration approved medication for sickle cell disease (SCD) with short- and long-term benefits for both morbidity and mortality. However, hydroxyurea underutilization and adherence remain challenges for patients with SCD. The objectives of this study were to determine access to technology among adolescents and young adults (AYA) with SCD and to identify their preferred technology-based strategies for improving medication adherence. PROCEDURE A cross-sectional survey was administered in a variety of clinical settings from October 2014 through May 2015 to AYA (12-22 years) with SCD (all genotypes) followed in a Comprehensive Sickle Cell Program. RESULTS Eighty of 107 eligible participants completed the survey for a 75% response rate. Participants (51% female, 94% Black) had a mean age of 15.3 ± 2.8 years. Most participants (75%) were on a daily medication with about half on hydroxyurea. Forgetfulness (67%) was the most common barrier to medication adherence. The majority of participants (85%) owned smartphones and either owned or had access to electronic tablets (83%), laptops (72%), or desktops (70%). Of the proposed smartphone app features, daily medication reminders were ranked first most frequently, followed by education about SCD, adherence text prompts, education about SCD medications, and medication log. CONCLUSIONS The majority of our AYA with SCD owned smartphones and had access to other electronic devices. Our survey results provided valuable insight into the preferred app features and optimal strategies for developing technology-based interventions, such as a multicomponent app, to increase medication adherence for AYA with SCD or other chronic conditions.
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Affiliation(s)
- Sherif M Badawy
- Division of Hematology, Oncology and Stem Cell Transplant, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine at Northwestern University, Chicago, Illinois.,Division of Hematology and Oncology, Department of Pediatrics, Faculty of Medicine at Zagazig University, Zagazig, Egypt
| | - Alexis A Thompson
- Division of Hematology, Oncology and Stem Cell Transplant, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine at Northwestern University, Chicago, Illinois.,Pediatric Hematology/Oncology, Robert H. Lurie Cancer Center at Northwestern, Chicago, Illinois
| | - Robert I Liem
- Division of Hematology, Oncology and Stem Cell Transplant, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine at Northwestern University, Chicago, Illinois.,Pediatric Hematology/Oncology, Robert H. Lurie Cancer Center at Northwestern, Chicago, Illinois
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Kerr DA, Harray AJ, Pollard CM, Dhaliwal SS, Delp EJ, Howat PA, Pickering MR, Ahmad Z, Meng X, Pratt IS, Wright JL, Kerr KR, Boushey CJ. The connecting health and technology study: a 6-month randomized controlled trial to improve nutrition behaviours using a mobile food record and text messaging support in young adults. Int J Behav Nutr Phys Act 2016; 13:52. [PMID: 27098449 PMCID: PMC4839101 DOI: 10.1186/s12966-016-0376-8] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 04/13/2016] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Early adulthood represents the transition to independent living which is a period when changes in diet and body weight are likely to occur. This presents an ideal time for health interventions to reduce the effect of health problems and risk factors for chronic disease in later life. As young adults are high users of mobile devices, interventions that use this technology may improve engagement. The Connecting Health and Technology study aimed to evaluate the effectiveness of tailored dietary feedback and weekly text messaging to improve dietary intake of fruit, vegetables and junk food over 6 months among a population-based sample of men and women (aged 18-30 years). METHODS A three-arm, parallel, randomized control trial was conducted. After baseline assessments, participants were randomized to one of three groups: A) dietary feedback and weekly text messages, B) dietary feedback only or C) control group. Dietary intake was assessed using a mobile food record App (mFR) where participants captured images of foods and beverages consumed over 4-days at baseline and post-intervention. The primary outcomes were changes in serves of fruits, vegetables, energy-dense nutrient-poor (EDNP) foods and sugar-sweetened beverages (SSB). The intervention effects were assessed using linear mixed effect models for change in food group serves. RESULTS Young adults (n = 247) were randomized to group A (n = 82), group B (n = 83), or group C (n = 82). Overall, no changes in food group serves for either intervention groups were observed. An unanticipated outcome was a mean weight reduction of 1.7 kg (P = .02) among the dietary feedback only. Men who received dietary feedback only, significantly reduced their serves of EDNP foods by a mean of 1.4 serves/day (P = .02). Women who received dietary feedback only significantly reduced their intake of SSB (P = .04) by an average of 0.2 serves/day compared with controls. CONCLUSIONS Tailored dietary feedback only resulted in a decrease in EDNP foods in men and SSB in women, together with a reduction in body weight. Using a mobile food record for dietary assessment and tailored feedback has great potential for future health promotion interventions targeting diet and weight in young adults. TRIAL REGISTRATION Australian Clinical Trials Registry Registration number: ACTRN12612000250831 .
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Affiliation(s)
- Deborah A Kerr
- School of Public Health, Curtin University, GPO Box U1987, Bentley, Perth, WA, 6845, Australia.
| | - Amelia J Harray
- School of Public Health, Curtin University, GPO Box U1987, Bentley, Perth, WA, 6845, Australia
| | - Christina M Pollard
- School of Public Health, Curtin University, GPO Box U1987, Bentley, Perth, WA, 6845, Australia.,Public Health Division, Department of Health In Western Australia, 189 Royal Street, East Perth, 6004, WA, Australia
| | - Satvinder S Dhaliwal
- School of Public Health, Curtin University, GPO Box U1987, Bentley, Perth, WA, 6845, Australia
| | - Edward J Delp
- Video and Image Processing Laboratory, School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, USA
| | - Peter A Howat
- School of Public Health, Curtin University, GPO Box U1987, Bentley, Perth, WA, 6845, Australia
| | - Mark R Pickering
- School of Engineering and Information Technology, The University of New South Wales at the Australian Defence Force Academy, Canberra, Australia
| | - Ziad Ahmad
- Video and Image Processing Laboratory, School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, USA
| | - Xingqiong Meng
- School of Medicine, Flinders University, Bedford Park, Australia
| | - Iain S Pratt
- Cancer Council Western Australia, Subiaco, WA, Australia
| | - Janine L Wright
- School of Public Health, Curtin University, GPO Box U1987, Bentley, Perth, WA, 6845, Australia
| | - Katherine R Kerr
- School of Public Health, Curtin University, GPO Box U1987, Bentley, Perth, WA, 6845, Australia
| | - Carol J Boushey
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA.,Department of Nutrition Science, Purdue University, West Lafayette, IN, USA
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Spruijt-Metz D, Wen CKF, O'Reilly G, Li M, Lee S, Emken BA, Mitra U, Annavaram M, Ragusa G, Narayanan S. Innovations in the Use of Interactive Technology to Support Weight Management. Curr Obes Rep 2015; 4:510-9. [PMID: 26364308 PMCID: PMC4699429 DOI: 10.1007/s13679-015-0183-6] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
New and emerging mobile technologies are providing unprecedented possibilities for understanding and intervening on obesity-related behaviors in real time. However, the mobile health (mHealth) field has yet to catch up with the fast-paced development of technology. Current mHealth efforts in weight management still tend to focus mainly on short message systems (SMS) interventions, rather than taking advantage of real-time sensing to develop just-in-time adaptive interventions (JITAIs). This paper will give an overview of the current technology landscape for sensing and intervening on three behaviors that are central to weight management: diet, physical activity, and sleep. Then five studies that really dig into the possibilities that these new technologies afford will be showcased. We conclude with a discussion of hurdles that mHealth obesity research has yet to overcome and a future-facing discussion.
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Affiliation(s)
- D Spruijt-Metz
- University of Southern California, Los Angeles, CA, USA.
| | - C K F Wen
- University of Southern California, Los Angeles, CA, USA.
| | - G O'Reilly
- University of Southern California, Los Angeles, CA, USA.
| | - M Li
- University of Southern California, Los Angeles, CA, USA.
- SYSU-CMU Joint Institute of Engineering, Sun Yat-sen University, Guangzhou, China.
| | - S Lee
- University of Southern California, Los Angeles, CA, USA.
| | - B A Emken
- University of Southern California, Los Angeles, CA, USA.
| | - U Mitra
- University of Southern California, Los Angeles, CA, USA.
| | - M Annavaram
- University of Southern California, Los Angeles, CA, USA.
| | - G Ragusa
- University of Southern California, Los Angeles, CA, USA.
| | - S Narayanan
- University of Southern California, Los Angeles, CA, USA.
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Rangan AM, O'Connor S, Giannelli V, Yap ML, Tang LM, Roy R, Louie JCY, Hebden L, Kay J, Allman-Farinelli M. Electronic Dietary Intake Assessment (e-DIA): Comparison of a Mobile Phone Digital Entry App for Dietary Data Collection With 24-Hour Dietary Recalls. JMIR Mhealth Uhealth 2015; 3:e98. [PMID: 26508282 PMCID: PMC4704908 DOI: 10.2196/mhealth.4613] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Revised: 06/16/2015] [Accepted: 08/18/2015] [Indexed: 11/20/2022] Open
Abstract
Background The electronic Dietary Intake Assessment (e-DIA), a digital entry food record mobile phone app, was developed to measure energy and nutrient intake prospectively. This can be used in monitoring population intakes or intervention studies in young adults. Objective The objective was to assess the relative validity of e-DIA as a dietary assessment tool for energy and nutrient intakes using the 24-hour dietary recall as a reference method. Methods University students aged 19 to 24 years recorded their food and drink intake on the e-DIA for five days consecutively and completed 24-hour dietary recalls on three random days during this 5-day study period. Mean differences in energy, macro-, and micronutrient intakes were evaluated between the methods using paired t tests or Wilcoxon signed-rank tests, and correlation coefficients were calculated on unadjusted, energy-adjusted, and deattenuated values. Bland-Altman plots and cross-classification into quartiles were used to assess agreement between the two methods. Results Eighty participants completed the study (38% male). No significant differences were found between the two methods for mean intakes of energy or nutrients. Deattenuated correlation coefficients ranged from 0.55 to 0.79 (mean 0.68). Bland-Altman plots showed wide limits of agreement between the methods but without obvious bias. Cross-classification into same or adjacent quartiles ranged from 75% to 93% (mean 85%). Conclusions The e-DIA shows potential as a dietary intake assessment tool at a group level with good ranking agreement for energy and all nutrients.
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Affiliation(s)
- Anna M Rangan
- School of Molecular Bioscience, Charles Perkins Centre, University of Sydney, Camperdown, Australia.
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Thompson FE, Kirkpatrick SI, Subar AF, Reedy J, Schap TE, Wilson MM, Krebs-Smith SM. The National Cancer Institute's Dietary Assessment Primer: A Resource for Diet Research. J Acad Nutr Diet 2015; 115:1986-95. [PMID: 26422452 DOI: 10.1016/j.jand.2015.08.016] [Citation(s) in RCA: 191] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 08/11/2015] [Indexed: 11/17/2022]
Abstract
This monograph describes the National Cancer Institute's Dietary Assessment Primer, a web resource developed to help researchers choose the best available dietary assessment approach to achieve their research objective. All self-report instruments have error, but understanding the nature of that error can lead to better assessment, analysis, and interpretation of results. The Primer includes profiles of the major self-report dietary assessment instruments, including guidance on the best uses of each instrument; discussion of validation and measurement error generally and with respect to each instrument; guidance for choosing a dietary assessment approach for different research questions; and additional resources, such as a glossary, references, and overviews of specific/important issues in the field. This monograph also describes some future research needs in the field of dietary assessment.
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