Use of the Remote Food Photography Method by young pregnant women: a feasibility study

Abstract

Pregnancy is considered an underutilised opportunity for promoting lifestyle changes that have health benefits for a woman and her developing child. Changes to maternal diet during pregnancy have, to date, been assessed primarily by food frequency questionnaires which may be inaccurate. We have tested the feasibility of using a validated method of dietary data capture, using a smartphone application (app), in young (aged 23-25), UK-based, pregnant women.The Remote Food Photography Method (RFPM) collects dietary data using the SmartIntake app (1,2) . This method has been previously validated against doubly labelled water in 50 free-living US adults and underestimated energy intake by only 3·7 %(1) . Our study fieldworkers were trained in use of the app and practiced capturing dietary data themselves for at least 2 full days prior to training participants. Women were asked to record 6 full days of dietary intake by taking a photo before and after each eating/drinking occasion, and providing a brief text description of items they thought might be hard to identify from the image. The photos were sent, via e-mail, to a server for analysis by experts. Automatic reminder e-mails, at times of the participant's choosing, were generated and sent to the smartphone. Real-time monitoring of the quality of the photos and feedback to participants occurred for the first day. Data collection began in October 2015 and is on-going. We present usability findings from the first 6 months.Seventy-three participants were invited to use SmartIntake of which 25 (34%) agreed, with one participant withdrawing consent before capturing any photos. Fieldworkers estimated that training took around 20 minutes. Most participants found installation and set-up (95%), taking photos of meals (70%) and receiving reminders (81 %) easy or very easy. Twenty-one (84%) provided enough dietary data for analysis. The median number of days on which participants used the app was 6 (IQR 4-6): 14 (58%) women recorded at least one eating/drinking occasion on 6 days, although 4 (17%) used the app on 3 days or fewer. The women captured a total of 484 eating/drinking occasions; 66% of these included a text description. The total median number of photos taken/person was 42 (IQR 19-61) with a median 7 (IQR 5-11) photos/day. The maximum number of photos taken by a single participant was 94. 75% of eating/ drinking occasions were captured in 2 photos, with only 41 (8%) occasions taking 4 or more photos. The maximum number of photos for one meal was 12 (starter, main course, pudding, drinks).Fieldworkers reported that the main reasons for refusing to use the app were that the women were unable to use a phone at work or were too busy. Of the participants who provided fewer than 4 days, three reported that it was too difficult due to family commitments and one gave no reason. Nine other women provided comments on use; all found data capture inconvenient but 10 women (out of 18 who answered) indicated that they would use the method again.These results show that the phone a...

Measuring lunchtime consumption in school cafeterias: a validation study of the use of digital photography

“…Many studies have used image-assisted visual estimation without reporting the validity or reliability of this method (6,7) , but several validation reports have also appeared in the literature. Some of these publications have examined the reliability of image-based visual estimation methods (8)(9)(10) , but seldom do they examine the method's accuracy against a criterion measure.…”

The second generation of The Avon Longitudinal Study of Parents and Children (ALSPAC-G2): a cohort profile

“…We collect a range of environmental, social, lifestyle, clinical and biological data on all family members repeatedly ( Figure 3 analyses have been performed on these samples (we would be keen to speak to any collaborators who would like to use these samples). We have also collected, or are collecting, intensive repeat or continuously measured data, using novel methods on subgroups, including continuously measured glucose on mothers during pregnancy 8 , videos of parent-child interactions from head-worn and home-based cameras 9 , and dietary intake from smart-phone photographs of meals 10 .…”

“…We are one of the first studies to explore the feasibility of using a smartphone food-photography application to assess dietary intake in a general population of young pregnant women 10 . The Remote Food Photography Method (RFPM) collects dietary data using the SmartIntake phone application 14 .…”

“…Of those using the RFPM, most found installation and set-up (95%), taking photos of meals (70%) and receiving reminders (81%) easy or very easy 10 .…”