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Evidence-Based Development of a Mobile Telephone Food Record

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Abstract

Mobile telephones with an integrated camera can provide a unique mechanism for collecting dietary information that reduces burden on record-keepers. Objectives for this study were to test whether participant's proficiency with the mobile telephone food record improved after training and repeated use and to measure changes in perceptions regarding use of the mobile telephone food record after training and repeated use. Seventy-eight adolescents (26 males, 52 females) ages 11 to 18 years were recruited to use the mobile telephone food record for one or two meals. Proficiency with the mobile telephone food record was defined as capturing a useful image for image analysis and self-reported ease of use. Positive changes in perceptions regarding use of the mobile telephone food record were assumed to equate to potentially improved proficiency with the mobile telephone food record. Participants received instruction for using the mobile telephone food record prior to their first meal, and captured an image of their meals before and after eating. Following the first meal, participants took part in an interactive session where they received additional training on capturing images in various snacking situations and responded to questions about user preferences. Changes in the participants' abilities to capture useful images and perceptions about the usability of the mobile telephone food record were examined using McNemar, Wilcoxon rank-sum test, and paired t test. After using the mobile telephone food record, the majority of participants (79%) agreed that the software was easy to use. Eleven percent of participants agreed taking images before snacking would be easy. After additional training, the percent increased significantly to 32% (P<0.0001). For taking images after snacking, there was also improvement (21% before training and 43% after; P<0.0001). Adolescents readily adopt new technologies; however, the mobile telephone food record design needs to accommodate the lifestyles of its users to ensure useful images and continuous use. Further, these results suggest that additional training in using a new technology may improve the accuracy among users.

Section snippets

System Design

The client−server configuration for the mobile telephone food record is in Figure 1. In this system, a mobile telephone with an integrated camera can be used to capture images of food before and after eating and sent to the server (Figure 1, #1). A digital image is different from a photograph in that useful information, called metadata, is captured that is not visible, such as the time stamp and digital codes. Image analysis uses metadata to automatically identify characteristic features in

Results and Discussion

A total of 78 participants (26 males, 52 females) ages 11 to 18 years used the mobile telephone food record for a first meal and 70 of those also used the mobile telephone food record again for a second meal. Characteristics of the samples are in Table 1. The participants were either in middle school or high school, and the mean age was 14.2 years. The participants were of diverse ethnic backgrounds.

With regard to being able to acquire a useful image, the majority of the participants saved

Conclusions

Evidence-based development entails a shift from focusing on the product to focusing on the process and the interaction of the user with the product. Using this process will allow the design of the mobile telephone food record from the perspective of the user or the client rather than the perspective of the engineer or RD. Formative evaluation outcomes and user feedback are important components of evidence-based development used when designing applications (11). In the same way that

B. L. Six and T. E. Schap are research assistants in the Department of Foods and Nutrition, Purdue University, West Lafayette, IN.

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B. L. Six and T. E. Schap are research assistants in the Department of Foods and Nutrition, Purdue University, West Lafayette, IN.

C. J. Boushey is an associate professor in the Department of Foods and Nutrition, Purdue University, West Lafayette, IN.

F. M. Zhu, A. Mariappan, and M. Bosch are research assistants at the School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN.

E. J. Delp is The Charles William Harrison Distinguished Professor of Electrical and Computer Engineering at the School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN.

D. S. Ebert is a professor at the School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN.

D. A. Kerr is an associate professor, Health Innovation Research Institute, School of Public Health, Curtin Institute of Technology, Bentley, WA, Australia.

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