Iterative development of an online dietary recall tool, INTAKE24

Abstract

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.

Validity and reliability of an online self-report 24-h dietary recall method (Intake24): a doubly labelled water study and repeated-measures analysis

“…These have previously been criterion-validated in a feeding study and also evaluated for convergent validity against weighed food diaries with children aged 18 months to 16 years and their parents (11,12) . Intake24 was developed through four cycles of user-testing and feedback (13) . Convergent validity testing of Intake24 against interviewer-led 24-h recalls found that the two methods yielded comparable estimates (14) ; however, the instrument has not yet been criterion-validated against objective measures of energy, nor has reliability been examined.…”

The NoHoW protocol: a multicentre 2×2 factorial randomised controlled trial investigating an evidence-based digital toolkit for weight loss maintenance in European adults

“…Four consecutive 24-hour-web-based dietary recalls, including at least 1 weekend day, are collected within 7 days of each visit using INTAKE 24 57. Psychometric measures of eating behaviour are assessed at each visit using the Three Factor Eating Questionnaire-51,58 the Problematic Eating Patterns Scale (unpublished scale), Eating in the Absence of Hunger Scale,59 Intuitive Eating Scale-260 and the Binge Eating Scale 61…”

Validation of a recommender system for prompting omitted foods in online dietary assessment surveys

“…The involvement of skilled professionals in the collection and analysis of complex dietary data has both economic implications and implications for scalability. To address these issues a number of systems have been developed that replace an interviewer in the 24hour recall method with an online survey [9,31,32]. For researchers, such systems provide tools to administer surveys and collect dietary records from participants with a detailed breakdown of the foods and drinks consumed, to enable the estimation of energy intake and intakes of macro-and micro-nutrients.…”

“…Those challenges motivated us to develop a recommender system that extracts food associations in an automated manner [25]. The recommender algorithm was developed for Intake24, open-source dietary assessment system for conducting large-scale population 24-hour multiple-pass recall surveys online [31].…”

“…This has resulted in an ongoing endeavor of various research teams to computerize paperbased dietary assessment tools (e.g. food frequency questionnaires and 24-hour recalls) [9,31,32]. Such instruments equip dietary assessment with flexibility, wider coverage and remote collection of responses.…”