The Provision of Assistance Does Not Substantially Impact the Accuracy of 24-Hour Dietary Recalls Completed Using the Automated Self-Administered 24-H Dietary Assessment Tool among Women with Low Incomes

Abstract

Background Evidence is lacking informing the use of the Automated Self-Administered 24-h Dietary Assessment Tool (ASA24) with populations characterized by low income. Objective This study was conducted among women with low incomes to evaluate the accuracy of ASA24 recalls completed independently and with assistance. Methods Three hundred and two women, aged ≥18 y and with incomes below the Supplemental Nutrition Assistance Program thresholds, served themselves from a buffet; amounts taken as well as plate waste were unobtrusively weighed to enable calculation of true intake for 3 meals. The following day, women completed ASA24-2016 independently (n = 148) or with assistance from a trained paraprofessional in a small group (n = 154). Regression modeling examined differences by condition in agreement between true and reported foods; energy, nutrient, and food group intakes; and portion sizes. Results Participants who completed ASA24 independently and those who received assistance reported matches for 71.9% and 73.5% (P = 0.56) of items truly consumed, respectively. Exclusions (consumed but not reported) were highest for lunch (at which participants consumed approximately 2 times the number of distinct foods and beverages compared with breakfast and dinner). Commonly excluded foods were additions to main dishes (e.g., tomatoes in salad). On average, excluded foods contributed 43.6 g (46.2 kcal) and 40.1 g (43.2 kcal) among those in the independent and assisted conditions, respectively. Gaps between true and reported intake were different between conditions for folate and iron. Within conditions, significant gaps were observed for protein, vitamin D, and meat (both conditions); vitamin A, iron, and magnesium (independent); and folate, calcium, and vegetables (assisted). For foods and beverages for which matches were reported, no difference in the gap between true and reported portion sizes was observed by condition (P = 0.22). Conclusions ASA24 performed relatively well among women with low incomes; however, accuracy was somewhat lower than previously observed among adults with a range of incomes. The provision of assistance did not significantly impact accuracy.

Respondent Characteristics and Dietary Intake Data Collected Using Web-Based and Traditional Nutrition Surveillance Approaches: Comparison and Usability Study

“…Ryan et al [35] noted that there are complex barriers hindering male recruitment to health studies, particularly web-based, and that strategies that involve friends and family to aid recruitment can be successful. The difference in social class and education level observed between the web-based study and NANS is consistent with previous reports, which highlight that individuals with lower education level [36] and social class [37] were less likely to complete web-based surveys, potentially because of computer literacy issues. A higher level of education was also observed in those who completed all aspects of the Foodbook24 web-based study compared with those who dropped out.…”

“…A higher level of education was also observed in those who completed all aspects of the Foodbook24 web-based study compared with those who dropped out. Kirkpatrick et al [37] recently demonstrated that women with low incomes reported dietary intake data relatively well using ASA24-2016; however, their data were less accurate, relative to women with a higher income. Concentrated efforts to ensure representative samples from all population groups are engaged in future web-based surveys and that training and support are available to those less familiar with technology are warranted [38].…”

Automated Self-Administered 24-Hour Dietary Assessment Tool (ASA24) Recalls for Parent Proxy-Reporting of Children’s Intake (>4 Years Of Age): A Feasibility Study

“…These differences create the potential for selection bias, which can reduce generalizability and, in studies evaluating associations between diet and health outcomes, can lead to biased measures of association. This nding is consistent with previous research that has identi ed lack of completion of the ASA24 among low-income adults, as well as adults from certain ethnic groups (38,39); however, this has not been found in all studies (40). Although we observed differences between the characteristics of respondents and non-respondents, estimated nutrient intakes were very similar to national estimates from the CCHS, which is a large, nationally representative survey.…”

Use of Online Dietary Recalls among Older UK Adults: A Feasibility Study of an Online Dietary Assessment Tool

“…We are not aware of any studies that have been designed to compare participation rates of older adults in online dietary recalls under varying levels of support. Therefore the prospect of higher participation rates with greater in-person support is speculative, and evidence from other populations has indicated that the provision of assistance did not improve the validity of data from online recalls [33]. In addition to research into improving participation rates, the validity of myfood24 among older adults is yet to be established.…”