JMIR Publications

ABSTRACT

Background:

Technology-assisted 24-hour dietary recall (24HR) methods offer the potential for scalable population dietary assessment, but current challenges include balancing accuracy and cost against participant burden and acceptability of these methods. Qualitative methods present a novel approach to understanding potential barriers and enablers to acceptability of 24-hour dietary recall (24HR) methods but remain relatively unexplored.

Objective:

to explore users’ experience, acceptability and preferences for three technology-assisted 24-hour dietary recall (24HR) methods.

Methods:

Participants in a cross-over controlled feeding study were invited to undertake a post-study interview. Initially, feeding study participants were randomized into one of three separate feeding days where they consumed breakfast, lunch and dinner on a single day. On the following day, they undertook a 24HR via the Automated Self-Administered 24-hour Dietary Assessment Tool (ASA24), Intake24, or an Image-Assisted Interviewer-Administered 24HR (IA-24HR). When assigned to IA-24HR, participants viewed the images they captured with a mobile Food Record (mFR) app on the feeding day during the interview. On completing all three methods, 26 participants (21 to 56 years) undertook semi-structured interviews. Inductive content analysis was conducted using the transcribed audio recordings.

Results:

Overall, participants wanted the 24HR methods to be easy, with the technology features of all methods considered helpful. Five content categories described users’ experiences of the three 24HR methods: 1) “Put [my food] in the list”; 2) “It’s really hard to know portions”; 3) ASA24 “was a painful process”; 4) access to “images helped jog my memory”; and 5) Intake24 is “fairly quick”. Participants expressed a preference for taking images with the mFR app and having access to images during the recall process. IA-24HR helped participants recall food and beverages consumed and increased perceptions of recall accuracy.

Conclusions:

This novel qualitative research found 24HR methods need to be as easy as possible for users. The participant burden of food and beverage identification and portion size estimation was evident across methods. Findings highlight the importance of using qualitative methods to explore user preferences for dietary assessment methods and confirm the need to reduce user burden associated with 24HR methods. Clinical Trial: Australia New Zealand Clinical Trials Registry Number ACTRN12621000209897.