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Development and evaluation of a bilingual interactive multimedia computerized food recall

Abstract

The objective of this research was to utilize advancements in computer technology to develop and test a bilingual interactive multimedia (IMM) dietary assessment tool. During developmental testing 25 peer-reviewers rated characteristics of the program on a 5-point Likert scale. The mean score of each question received high ratings including introduction/directions helpful (M = 4.5), meal times understandable (M = 4.6), foods easy to identify (M = 3.9), portions easy to identify (M = 4.5), and computer food recall easy to use (M = 4.5). In the final format, the bilingual IMM recall represents a multiple-pass method in which users first report food choices from 167 graphically represented foods. After the development and formative evaluation, the IMM recall underwent comparative validity testing against an interview-administered dietary recall. This study was a two-period cross over design study with repeated measures. Subjects were randomly assigned to complete an IMM recall or interview-administered 24-hour recall first. The interview-administered recall was analyzed using the Food Intake Analysis System (FIRS) and the EFNEP Reporting System (ERS). The effect of substituting standardized portion sizes for reported portion sizes was examined. Of 80 adult Coloradoan participants, 71 (91%) were female, 45 (56%) had ≤12th grade education, 65 (81%) had ≤$15,000 annual income, and 21 (26%) completed the IMM recall in Spanish. Analysis of variance and unadjusted and energy-adjusted correlations were used for analysis. No significant group differences were found for order of administration or demographic characteristics. The only significant method effect found was between the IMM recall and FIRS for vitamin C (P = 0.025). The unadjusted correlations between the IMM recalls and interview-administered recalls analyzed using both FIRS and ERS were generally around 0.6. Energy-adjusted correlations consistently decreased. Substituting standardized portion sizes resulted in significant differences for six nutrients and caused all correlations to drop. Overall, the IMM recall was found to be valid for assessing dietary intake by groups of individuals. This IMM recall has been well received in the peer-review process and attracted the interest of nutrition educators. The results of comparative validity testing and positive reactions received from participants and nutrition educators indicate diet assessment utilizing IMM holds tremendous potential.

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Nutrition -- Study and teaching
Hispanic Americans -- Nutrition
Interactive multimedia

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