Connecting Health and Technology (CHAT): protocol of a randomized controlled trial to improve nutrition behaviours using mobile devices and tailored text messaging in young adults

Abstract

BackgroundIncreasing intakes of fruits and vegetables intake, in tandem with reducing consumption of energy-dense and nutrient poor foods and beverages are dietary priorities to prevent chronic disease. Although most adults do not eat enough fruit and vegetables, teenagers and young adults tend to have the lowest intakes. Young adults typically consume a diet which is inconsistent with the dietary recommendations. Yet little is known about the best approaches to improve dietary intakes and behaviours among this group. This randomised controlled trial aims to evaluate the effectiveness of using a mobile device to assess dietary intake, provide tailored dietary feedback and text messages to motivate changes in fruit, vegetable and junk food consumption among young adults.Methods/designThe CHAT project will involve the development of the mobile device food record (MDFR), and evaluation of dietary feedback and implementation of a 6-month intervention in young adults aged 18 to 30 years. The participants will be randomly assigned to one of three groups (1) Intervention Group 1: MDFR + Text Messages + Dietary Feedback; (2) Intervention Group 2: MDFR + Dietary Feedback; (3) Control Group 3: MDFR, no feedback. All groups will undertake a 3-day dietary record using the MDFR but only the Intervention Groups 1 and 2 will receive tailored dietary feedback at baseline and at 6-months which will consist of assessment of serves of fruits, vegetables and junk food in comparison to dietary recommendations. Tailored nutrition text messages will be sent to Intervention Group 1 over the 6 months. Data will be collected at baseline and again at the 6-month completion.DiscussionThis trial will test if applications running on mobile devices have potential to assess diet, provide tailored feedback and nutrition messages as an effective way of improving fruit and vegetable consumption and reducing energy-dense nutrient poor foods in young adults. The CHAT project will assess the impact of the intervention on behavioural intention to eat a more healthful diet. This innovative approach if successful may provide a means to deliver a low cost health promotion program that has the potential to reach large groups, particularly young adults.Trial registrationAustralian and New Zealand Clinical Trials Registry ACTRN12612000250831

Use of electronic visual recording to aid assessment of dietary intake of Australian Aboriginal children living in remote communities

“…Cost savings could also be achieved through using innovative data upload techniques where a mobile device captures before and after images of food and drinks consumed and is automatically uploaded to a server for analysis. 8 However, findings from the current study show that visuals were mostly recorded in the first two days, even with a research team member visiting the house at least once a day. Other activities also prevented three of the eight children from having complete food records for more than one day.…”

Personalised nutrition: the role of new dietary assessment methods

“…These instruments are being increasingly utilised in intervention studies to provide personalised or tailored feedback, with numerous randomised controlled trials demonstrating this personalised advice to be more effective than generic advice in improving selected dietary outcomes (17,62,63) . As illustrated in Table 2, PDA, online FFQ and webbased dietary questionnaires have all been utilised for providing personalised dietary advice, with studies in recent years also examining the potential for smartphone app to provide tailored or personalised feedback advice (15,16) . A smartphone app that can capture dietary and physical activity information and provide personalised recommendations has been developed for use in the EVIDENT II trial (16) .…”

“…This app encompasses a food diary to enable users to record their daily food intake, evaluates the user's food intake, and provides personalised recommendations to help facilitate changes in dietary habits (16) . In addition, smartphones applying image-based assessment (requiring input from trained analysts) have recently been used in the Connecting Health and Technology project to assess nutritional intake and provide tailored feedback advice and text messages to young adults to promote changes in consumption of fruit, vegetables and junk food (15) . Results regarding the efficacy of utilising these smartphone-based tools to provide personalised advice are yet to be published.…”

“…However, with advances in technology and growth of consumer interest in personal health, there is increasing research into the application of new technology-based dietary assessment methods for providing personalised dietary advice more efficiently (3,(15)(16)(17) . Compared with traditional dietary assessment methods, these instruments can collect dietary intake data more easily across large geographically dispersed populations (18) , and therefore have greater potential to provide personalised dietary advice on the large scale.…”

Scope of mobile health in Indian health care system – the way forward

“…Increasing burden of obesity is adding to the already prevailing burden of under-nutrition. 47,48 Through mHealth, citizens become more empowered and informed of their health and wellbeing. Communication ties and health knowledge between patients and healthcare providers and even amongst healthcare providers would be enhanced greatly.…”