Abstract
Background (Background, Rationale, Prior Research, and/or Theory): Within childcare settings, it is estimated children consume up to 75% of daily calories, making food consumed within childcare environments a key component of children's daily nutrition. To assess children's nutritional intake in childcare settings, direct observation by weighing each food item before and after consumption is considered the gold standard. However, this method can be disruptive in the classroom and resource-intensive. Therefore, a simple and accurate method to estimate children's dietary intake is needed. Objective: The objective of this study was to assess the feasibility of using digital template photos to estimate children's dietary intake in childcare settings. Study Design, Setting, Participants, Intervention: Photos of preschool children's meals were taken before consumption, when any additional servings were provided, and after consumption. Weights and template photos of each meal component were taken separately, at decreasing portion sizes beginning with the serving size given during mealtime and ending at approximately one-quarter to one-eighth of the original serving size, such that if any more were eaten, it would be considered finished. Three trained undergraduate research assistant coders compared photos of actual mealtime plates with the digital template photos side by side on a split screen. Coders used the digital template photos to visually estimate the portion size of each meal component as it had been served and consumed. Outcome Measures and Analysis: Preliminary data from ongoing data collection consisting of 10 mealtimes composed of 35 food and beverage components in total were independently coded. Inter-rater reliability was evaluated by intra-class correlation coefficient (ICC). Results: Across the 10 preliminary trials, ICC was 0.931 suggesting trained coders can reliably estimate food quantities using digital template photos. Conclusions and Implications: As a feasible and cost-effective method, digital template photos may create opportunities for assessing children's dietary intake in research and intervention projects where it has been otherwise prohibitive to do so. Funding: USDA.
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