Lessons Learned in Using the Automated Self-Administered 24-Hour Dietary Assessment (ASA24) System Among Chinese American Adults

Abstract

ObjectivesThe Automated Self-Administered 24-hour Dietary Assessment (ASA24) is a web-based tool that enables automatically coded 24-hour dietary recalls and food records. We summarize lessons learned from using the ASA24 to measure dietary intake within a Chinese American population based on our experience conducting a validation study. MethodsChinese American adults were recruited from the community and through ResearchMatch. Participants completed paper food records on a weekday and a weekend day of their choice. Data from the paper food records were entered into the ASA24 platform by community health workers. Missing data were obtained during follow-up phone interviews. ResultsThirty-three Chinese American adults were recruited from the community (n = 22, 67%) and ResearchMatch (n = 11, 33%). Mean age was 40 (SD = 12) years and 36% were men. Almost all participants (84.8%) reported Chinese food items in their food records. The lack of culturally appropriate foods in the ASA24 database made it difficult to report dietary intake as provided by participants. Items that were not available were placed under a generic category (e.g., pork (other cut) for pork belly) whenever possible, substituted (e.g., potato for taro), or written in manually. Dishes were recreated by entering individual ingredients, a process that was time-consuming and frequently missed the “flavor” of traditional Chinese cooking due to missing sauces that were not available on the ASA24. Community health workers’ knowledge of the population and their diets was crucial, especially during phone interviews. Sufficient experience with the ASA24 platform was necessary to become familiar with its limitations and to standardize methods for capturing intake of food items not available in its database. ConclusionsThe utility of the ASA24 as a self-administered tool is limited for Chinese Americans whose diets are less acculturated. The ASA24 system would benefit from modifications to accommodate the diversifying population of the United States, such as adding culturally-specific ingredients and foods and providing the platform in additional languages. Funding SourcesThis study was funded by the NYU Center for the Study of Asian American Health, the National, Heart, Lung, and Blood Institute, and the National Institute of Diabetes and Digestive Kidney Diseases.