JMIR Publications

ABSTRACT

Given prior research demonstrating that family meals are associated with positive health outcomes for children and adolescents, researchers have begun using direct observational methods to understand key aspects of family meals such as meal healthfulness and frequency of family meals that may explain the protective nature of family meals. However, there is a paucity of information regarding how many family meals are needed to typify family meal healthfulness when using direct observational methods. The current methodological study evaluated if the timing of measurement and the duration of the measurement period affects sample estimates of meal healthfulness measured using direct-observational methods. Families (N=120; 89% African American children) were recruited between 2012-2013 from primary care clinics in the Minneapolis-St. Paul metropolitan area. A total of n=800 meals were collected as part of the Family Meals LIVE! mixed-methods study. The Healthfulness of Meal Index (HOM index) was used to evaluate meal dietary healthfulness of foods served at eight family meal occasions. Results showed: (1) weekend and weekday meals differed in their measurement of meal healthfulness, indicating that at least one weekday and one weekend day are necessary to approximate meal healthfulness; (2) single-day measurement mischaracterized the strength of the relationship between quality of what was served and intake by almost 50% and (3) three to four observation days were sufficient to characterize typical weekly meal healthfulness (r = 0.94). Findings from the current study may inform future direct observational study designs to reduce both research costs and participant burden.