A Web-Based Time-Use Application to Assess Diet and Movement Behavior in Asian Schoolchildren: Development and Usability Study of My E-Diary for Activities and Lifestyle (MEDAL) (Preprint)

Abstract

BACKGROUND Web-based time-use diaries for schoolchildren are limited and exiting studies focus mostly on capturing physical activities and sedentary behaviours, but less comprehensively on dietary behaviours. OBJECTIVE In this study, we described the development of MEDAL—a self-administered, web-based time-use application to assess diet and movement behaviour, and evaluated its usability in schoolchildren in Singapore. METHODS MEDAL was developed through formative research and an iterative user-centric design approach involving small groups of schoolchildren (ranging from n=5 to 15, aged 7-13 years). To test the usability, children aged 10-11 years were recruited from two primary schools in Singapore to complete MEDAL for 2 weekdays and 2 weekend days, and a 10-item usability questionnaire. RESULTS The development process revealed that younger children (<9 years) were less able to complete MEDAL independently. Of 204 participants (58% boys and 15% overweight) in the usability study, 58% of them completed 3-4 days of recording while the rest recorded 2 days or less. The median time taken to complete MEDAL was 14.2 min/day. Majority agreed that instructions were clear (95%), that MEDAL was easy to use (85%), that they liked the application (85%), and preferred recording their activities online than on paper (83%). Recording for 4 days was the least satisfactory component reported. Compared to boys, girls reported better recall ability and agreed that the time spent on completing 1-day entry was appropriate. CONCLUSIONS MEDAL appears to be a feasible application to capture diet and movement behaviours for children aged 10 years and above, particularly in the Asian context. Some gender differences in usability performance were observed but the majority of the participants had a positive experience using MEDAL. Validation of data collected through the application is in progress.

Validation of a Web-Based, Time-Use Application to Assess Children’s School Meal Intakes: My E-Diary for Activities and Lifestyle (MEDAL)

“…The conceptualisation, design, and usability of MEDAL were described elsewhere [16]. In brief, MEDAL is a self-administered, web-based application that captures information on multiple lifestyle behaviours of children through the completion of a four-day, time-use diet and activity diary.…”

“…When participants chose "Eat & Drink", they were prompted to select the food they consumed from 88 food and drink icons available [16]. This list of food and drink items was compiled from food/drink items frequently consumed by children and mothers from the GUSTO mother-offspring birth cohort in Singapore, as well as based on consultations with experts in dietary assessment [16]. Participants were also allowed to manually enter foods that are not listed in the application [16].…”

“…Nutrients 2021, 13, 3790 2 of 16 Information technology presents a promising opportunity to circumvent the challenges of collecting self-reported dietary intake information from children. Interactive and animated features can facilitate engagement and influence the child's interest and motivation to complete the assessment [3].…”

“…To bridge this gap, a web-based diet and activity diary, named My E-Diary for Activities and Lifestyle (MEDAL), was developed to potentiate the collection of time-use information from children at least 10 years of age. It prompts users to recall and report dietary intakes and activities in a 24-h day and collects data over multiple days [16]. Usability tests have demonstrated that MEDAL is acceptable for use among 10 to 11-year-old children in Singapore [16].…”

“…It prompts users to recall and report dietary intakes and activities in a 24-h day and collects data over multiple days [16]. Usability tests have demonstrated that MEDAL is acceptable for use among 10 to 11-year-old children in Singapore [16].…”