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Asuka Suzuki1, Benjamin T Pope2, Denise Roe2, Barron J Orr3,4, Nirav C Merchant5, Scott B Going1, Nobuko Hongu1,4

of Nutritional Sciences, 2Epidemiology and Biostatistics, Biostatistics, 3School of Natural Resources and the Environment, 4 Environment, Cooperative Extension, 5Arizona Research Laboratories, University of Arizona, Tucson, Tucson, AZ
1Department

Experimental Biology 2012, April 22nd, San Diego, CA

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Background

Dietary assessment is essential for understanding the relationship between diet and chronic diseases. All dietary assessment instruments have strengths and weaknesses. Mobile phone with digital photo and internet capability have been introduced and developed to enhance dietary assessment (Boushey et al. 2009) University of Arizona, Stealth Health Research Project Team (USDA, NIFA, NRI Grant S. Going, PI) developed a new web and mobile application suit, called ak ak-shen shen.
Reference: Boushey et al. Use of technology in childrens dietary assessment. Eur J. Clin Nutr 2009, 63 (suppl 1): S50-S57.

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USDA-funded research project Combination of informal learning + Mobile location-based communication technologies Physical activity and nutritional learning in youth at risk of obesity Without them knowing!

Find an alternative to the standard directive education approach, making nutritional physical activity part of the youth experience rather than asking them to change their lifestyle.
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Objectives
-Develop a new dietary instrument, using a smart phone with a camera and internet capability called, Recaller application (app) -Evaluate Recaller app usability and number of pictures taken by college students

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How the Recaller App Works?

3. Participant meets a dietitian for a 24 hour dietary recall They both can access the website, and the dietitian review the food pictures with the participant

2. Upload Picture Wirelessly

Dietitian

Participant

1. Mobile Phone with Recaller App

Hongu, et al (2011) Dietary Assessment Tools Using Mobile Technology, Top Clin Nut, Vol. 26 (4), 300-311,

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Akshen website: Recaller Group Data

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Participants

41 healthy college students between age 18-28 years old


Median age was 22.0 years
22 females; median BMI of 22.3 kg/m2 (BMI:

17.4 - 35.2)
19 males; median BMI of 24.6 kg/m2 (BMI: 19.7 35.0)

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Methods: Study Design


Procedure Anthropometric 24-hr recall (w/ and w/o Recaller app) FFQ (Food Frequency Questionnaire) Feedback Questionnaire
Week 1

Week 2

Week 3 x

x x x x x x

x x x

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Procedure 24-hr recall (w/ and w/o Recaller app)

Week 1

Week 2 x x x x

Week 3 x x

Meeting w/dietitian for 24-hr recall

Taking food pictures w/Recaller app

Review food pictures

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Methods: Study Design


Procedure Anthropometric 24-hr recall (w/ and w/o Recaller app) FFQ (Food Frequency Questionnaire) Feedback Questionnaire
Week 1

Week 2

Week 3 x

x x x x x x

x x x

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Feedback Questionnaire

On the scale 1-5, how difficult was it to use the Recaller app (taking pictures and sending them to the website).
1: Extremely Easy. 5: Extremely Difficult

If you had free, daily access to the Recaller app on your own mobile phone, do you think you would use it to track the foods you eat?
Yes or No

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Methods (cont.)

Measurement
Height, weight, BMI, age, gender Total # of pictures taken during the study period Time in hours between the first and last picture taken

Statistical Analysis
To test the differences between groups we used non parametric tests (Wilcoxon test) Tests were performed at the alpha= 0.05 significance level

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Assessment

A comparison between # of pictures taken and: Age Gender Day of week Motivation Time of the first and last pictures taken

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Results

Total 2,842 food pictures taken through whole study period by 41 participants Median; 79 pictures taken/person 12.5 pictures taken/day
13.2 pictures taken by female 10.8 pictures taken by male No significant different comparing the pictures taken and age/ gender

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Results: Usability and Willingness

Usability: most participants rated the Recaller app as extremely easy or easy to use. Willingness: 50% of participants said they would use the application daily to track the foods they eat.

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Results: Motivation

Number of Pictures by Motivation


No Yes

Total Number of Pictures

Yes means the participant would use the Recaller app p-value = 0.0355

Participants who said that they would use the application on their own phone took more food pictures.

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50

100

150

Results: Time between first and last photo taken

Total # of pictures
15 5
6

10

20

25

Average Pictures Per Day vs. Average Eating Hours

10 avghours Fitted values

12

14 avgpictures

16

(hours)

Spearman's rho = 0.4023 p-value = 0.0136

Participants who used Recaller app longer during one day took more pictures

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Conclusions

12.5 pictures (median) are taken per day. Most participants rated the Recaller as extremely easy to use Higher level of usability 50% of Participants said they would use the application daily to track the foods they eat. The number of pictures taken was associated with:
Eating hours Whether the participant would use the application in the future.

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Future Direction of the Recaller App

A nutrition assessment tool Keeping food records Potentially improve diet awareness of people

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Acknowledgements
This research was funded by the University of Arizona Foundation. Akshen.org and Recaller software development was supported by a USDANIFA-NRI grant #2009-55215-05187

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