Online dietary assessment tools offer a convenient, low cost alternative to traditional dietary assessment methods such as weighed records and face-to-face interviewer-led 24-h recalls. INTAKE24 is an online multiple pass 24-h recall tool developed for use with 11–24 year-old. The aim of the study was to undertake a comparison of INTAKE24 (the test method) with interviewer-led multiple pass 24-h recalls (the comparison method) in 180 people aged 11–24 years. Each participant completed both an INTAKE24 24-h recall and an interviewer-led 24-h recall on the same day on four occasions over a one-month period. The daily energy and nutrient intakes reported in INTAKE24 were compared to those reported in the interviewer-led recall. Mean intakes reported using INTAKE24 were similar to the intakes reported in the interviewer-led recall for energy and macronutrients. INTAKE24 was found to underestimate energy intake by 1% on average compared to the interviewer-led recall with the limits of agreement ranging from minus 49% to plus 93%. Mean intakes of all macronutrients and micronutrients (except non-milk extrinsic sugars) were within 4% of the interviewer-led recall. Dietary assessment that utilises technology may offer a viable alternative and be more engaging than paper based methods, particularly for children and young adults.
We describe a qualitative study investigating the acceptability of the Google Glass eyewear computer to people with Parkinson's disease (PD). We held a workshop with 5 PD patients and 2 carers exploring perceptions of Glass. This was followed by 5-day field trials of Glass with 4 PD patients, where participants wore the device during everyday activities at home and in public. We report generally positive responses to Glass as a device to instil confidence and safety for this potentially vulnerable group. We also raise concerns related to the potential for Glass to reaffirm dependency on others and stigmatise wearers.
Online self-reported 24-h dietary recall systems promise increased feasibility of dietary assessment. Comparison against interviewer-led recalls established their convergent validity; however, reliability and criterion-validity information is lacking. The validity of energy intakes (EI) reported using Intake24, an online 24-h recall system, was assessed against concurrent measurement of total energy expenditure (TEE) using doubly labelled water in ninety-eight UK adults (40–65 years). Accuracy and precision of EI were assessed using correlation and Bland–Altman analysis. Test–retest reliability of energy and nutrient intakes was assessed using data from three further UK studies where participants (11–88 years) completed Intake24 at least four times; reliability was assessed using intra-class correlations (ICC). Compared with TEE, participants under-reported EI by 25 % (95 % limits of agreement −73 % to +68 %) in the first recall, 22 % (−61 % to +41 %) for average of first two, and 25 % (−60 % to +28 %) for first three recalls. Correlations between EI and TEE were 0·31 (first), 0·47 (first two) and 0·39 (first three recalls), respectively. ICC for a single recall was 0·35 for EI and ranged from 0·31 for Fe to 0·43 for non-milk extrinsic sugars (NMES). Considering pairs of recalls (first two v. third and fourth recalls), ICC was 0·52 for EI and ranged from 0·37 for fat to 0·63 for NMES. EI reported with Intake24 was moderately correlated with objectively measured TEE and underestimated on average to the same extent as seen with interviewer-led 24-h recalls and estimated weight food diaries. Online 24-h recall systems may offer low-cost, low-burden alternatives for collecting dietary information.
Dietary intake is a complex behaviour to accurately measure (1) . Twenty-four hour recalls are a popular choice for dietary surveys as they are quick to administer, do not require the participant to be literate (2) and are less burdensome to complete compared to other dietary assessment methods (3) . Technology offers the potential to make dietary assessment more convenient, intuitive and engaging for users. It also ensures consistency of coding and significantly reduces the cost as nutritional output can be generated without the need for manual coding and data entry.INTAKE24 is an online multiple pass 24hr dietary recall developed for use with 11-24 year olds in Scottish food and nutrition surveys.INTAKE24 was developed from an original prototype tool called SCRAN24 (4) . The system development was an iterative process involving four cycles of user interaction, evaluation and further development. Evaluation focussed mainly on the usability of the system (e.g. how easy it is to learn and use) and on the users experience while interacting with the system (e.g. how satisfying, enjoyable and motivating the system is to use) (5) . User evaluation was conducted with 80 participants; 20 at each stage. Researcher observation, 'think aloud' techniques, and eye tracking, were used to identify aspects of the system users found confusing. Feedback was gathered using semi-structured interviews and a system usability scale. In addition, each participant completed an interviewer led recall after completing INTAKE24 in order to identify any food and drink items missed. This fed into the development of the prompts within the system and served to gauge accuracy.In response to user feedback and observations during user testing the system interface was flattened so a single interface screen handled all aspects of the recall (e.g. free text entry, looking up foods in the database, portion size estimation). Improved search functionality and navigation around the system were also influenced through feedback from users at each stage. The time taken to complete the system reduced significantly throughout the user testing and accuracy of reported intakes improved for all nutrients except Vitamin C as can be seen in the table below.Integrating observation and post-completion interviews allowed us to obtain maximum information to feed into the design process; refining the system to have the best possible tool for use in the field.This work was funded by the Food Standards Agency, Scotland.
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