JMIR Publications

ABSTRACT

Background:

Mobile Ecological Momentary Assessment (mEMA) is a powerful tool for collecting real-time and contextual data from individuals. As our reliance on online technologies to increase convenience accelerates, it is also changing the way we access food. Online food delivery services (OFDS) may further encourage unhealthy food consumption habits, given the high availability of energy-dense, nutrient-poor foods. We used mEMA to better understand the real-time effects of OFDS on individuals' food choices and consumption behaviours.

Objective:

The primary aims of this pilot study were to: assess the feasibility and acceptability of using mEMA in young users of OFDS, and; compare two different EMA sampling methods. The secondary aims were to: gather data on OFD events and their context; examine any correlations between demographics, lifestyle chronic disease risk factors, and; OFD use.

Methods:

This cross-sectional study used mEMA methods via a mobile application (mEMASense, ilumivu). Existing users of OFDS aged 16-35 years in Australia who had access to a smartphone were recruited. Participants were randomly assigned to one of two groups: signal-contingent or event-contingent. The signal-contingent group was monitored over three days, between 7:00am and 10:00pm. They received five prompts each day to complete mEMA surveys via the smartphone app. In contrast, the event-contingent group was monitored over seven days and were asked to self-report any instance of OFD through the mEMA app.

Results:

A total of 102 participants were analysed with 53 participants in the signal-contingent group and 49 participants in the event-contingent group. Compliance rates to signal-contingent and event-contingent protocols were similar at 72% and 73%. Participants in the event-contingent group were 7.31 times more likely to have had an OFD event captured during the study (95% CI: 2.69 to 19.84, P < .001). Of 124 OFD events, a bulk of orders consisted of pizza (19%) and fried chicken (15%). Most orders were placed at home (82%) for one person (58%). Zero-inflated negative binomial regression analysis showed age (IRR: 0.95, 95%CI: 0.91 to 0.99, P = .03) and dependents (IRR: 2.01, 95%CI: 1.16 to 3.49, P = .01) were significantly associated with number of OFD events in a week after adjusting for gender, socioeconomic status, diet quality score and perceived stress levels.

Conclusions:

This pilot study showed that mEMA using an event-contingent sampling approach may be a better method to capture OFD events and context than predetermined signal-contingent. Compliance rates showed both sampling methods to be feasible and acceptable. A high proportion of orders are unhealthy foods and those with dependents and of younger age were significantly associated with higher OFD use. The findings from this study are critical to understanding the consumption of OFD in young people, hence enabling the development of future targeted interventions.