Use of electronic dietary assessment tools in primary care: an interdisciplinary perspective

Abstract

BackgroundDietary assessment can be challenging for many reasons, including the wide variety of foods, eating patterns and nutrients to be considered. In team-based primary care practice, various disciplines may be involved in assessing diet. Electronic-based dietary assessment (e-DA) instruments available now through mobile apps or websites can potentially facilitate dietary assessment. Providers views of facilitators and barriers related to e-DA instruments and their recommendations for improvement can inform the further development of these tools. The objective of this study was to explore provider perspectives on e-DA tools in mobile apps and websites.MethodsThe exploratory sequential mixed methods design included interdisciplinary focus groups followed by a web-based survey sent to Family Health Teams throughout Ontario, Canada. Descriptive and bivariate analyses were completed. Focus group transcripts contributed to web-survey content, while interpretive themes added depth and context.Results11 focus groups with 50 providers revealed varying perspectives on the use of e-DA for: 1) improving patients’ eating habits; 2) improving the quality of dietary assessment; and, 3) integrating e-DA into the care process. In the web-survey 191 respondents from nine disciplines in 73 FHTs completed the survey. Dietitians reported greater use of e-DA than other providers (63% vs.19%; p = .000) respectively. There was strong interest among disciplines in the use of e-DA tools for the management of obesity, diabetes and heart disease, especially for patient self-monitoring. Barriers identified were: patients’ lack of comfort with using technology, misinterpretation of e-DA results by patients, time and education for providers to interpret results, and time for providers to offer counselling.Conclusionse-DA tools in mobile apps and websites may improve dietary counselling over time. Addressing the identified facilitators and barriers can potentially promote the uptake of e-DA into clinical practice.

Hospital staffs’ perceptions of an electronic program to engage patients in nutrition care at the bedside: a qualitative study

“…Any issues or barriers were outweighed by perceived benefits and were seen as manageable, with staff suggesting ways to facilitate the program’s implementation and use. The benefits of the EFS program staff perceived were comparable with another study on staffs’ perceptions on the use of electronic dietary assessment tools in primary care [47]. In that study, staff thought patient-generated dietary intake monitoring would increase patients’ awareness of what they were eating and motivate them to improve their dietary habits [47], consistent with staff perceptions in our study.…”

Comparison of an electronic versus traditional food diary for assessing dietary intake—A validation study

“…Electronic diaries, used in multiple healthrelated fields, have been shown to be valid and efficient methods of data collection, however, more research is warranted with respect to the validity of innovative dietary assessment tools [11,12]. Further, there may be added benefit in collecting data from participants in the form of pictures or visual representations rather than verbal or written data [13].…”

Feasibility study of an Online 24-hr Dietary Assessment Tool: myfood24, in a clinical population

“…Using self-administered dietary assessment technologies has been shown to be a more engaging and accurate way of capturing a diet history [5,14] and preferred to traditional methods in people with diabetes [30]. Women in our study commented that they began to consider changes in their food intake from performing the recalls and receiving the feedback; this has been observed in other populations [13,15] and has been shown to improve uptake of self- professional to advise on dietary changes and increasing knowledge and skills has been shown to increase an individual's sense of control. Receiving prompts as cues for action and receiving feedback on their nutritional intake alongside biofeedback through blood glucose levels are recognised behaviour change techniques that can support healthy behaviours [34].…”

“…Many of these are applicable to all dietary assessment tools/ food logging applications [6,15] and include improvements to speed up food data entry, extensions to the food database including ethnic foods; chain restaurant meals; popular homemade recipes and more support to estimate portion sizes.…”

“…This data can be instantly analysed and provide feedback to the user and health professional. These features can provide additional support and education outside of the clinic setting [13,15,16] and health professionals in primary care reported that technology-assisted dietary assessment may promote self-efficacy and a sense of control over ones health condition [15]. Such tools also enable remote monitoring and follow up, potentially reducing the number of face-to-face appointments.…”