Abstract

BackgroundAs poor diet quality is a significant risk factor for multiple noncommunicable diseases prevalent in the United States, it is important that methods be developed to accurately capture eating behavior data. There is growing interest in the use of ecological momentary assessments to collect data on health behaviors and their predictors on a micro timescale (at different points within or across days); however, documenting eating behaviors remains a challenge.ObjectiveThis pilot study (N=48) aims to examine the feasibility—usability and acceptability—of using smartphone-captured and crowdsource-labeled images to document eating behaviors in real time.MethodsParticipants completed the Block Fat/Sugar/Fruit/Vegetable Screener to provide a measure of their typical eating behavior, then took pictures of their meals and snacks and answered brief survey questions for 7 consecutive days using a commercially available smartphone app. Participant acceptability was determined through a questionnaire regarding their experiences administered at the end of the study. The images of meals and snacks were uploaded to Amazon Mechanical Turk (MTurk), a crowdsourcing distributed human intelligence platform, where 2 Workers assigned a count of food categories to the images (fruits, vegetables, salty snacks, and sweet snacks). The agreement among MTurk Workers was assessed, and weekly food counts were calculated and compared with the Screener responses.ResultsParticipants reported little difficulty in uploading photographs and remembered to take photographs most of the time. Crowdsource-labeled images (n=1014) showed moderate agreement between the MTurk Worker responses for vegetables (688/1014, 67.85%) and high agreement for all other food categories (871/1014, 85.89% for fruits; 847/1014, 83.53% for salty snacks, and 833/1014, 81.15% for sweet snacks). There were no significant differences in weekly food consumption between the food images and the Block Screener, suggesting that this approach may measure typical eating behaviors as accurately as traditional methods, with lesser burden on participants.ConclusionsOur approach offers a potentially time-efficient and cost-effective strategy for capturing eating events in real time.

Highlights

  • BackgroundPoor diet quality is a significant risk factor for multiple noncommunicable diseases, including diabetes, certain cancers, and cardiovascular disease [1,2,3]; effective strategies for promoting healthful dietary behavior changes remain elusive

  • Images could be processed in a timely manner, and there was high agreement in the Mechanical Turk (MTurk) Worker count responses, for fruits, salty snacks, and sweet snacks images, thereby supporting the feasibility of using MTurk for image classification

  • The benefits of documenting portion size versus the time and costs of collecting and processing these data require further consideration depending upon the study aims. This pilot study demonstrates the feasibility of using participant-captured images categorized through a crowdsourcing platform to accurately depict eating events

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Summary

Introduction

BackgroundPoor diet quality is a significant risk factor for multiple noncommunicable diseases, including diabetes, certain cancers, and cardiovascular disease [1,2,3]; effective strategies for promoting healthful dietary behavior changes remain elusive. Changing eating behaviors is challenging, partly because of the multifactorial influences on eating decisions These range from individual and family-level beliefs, preferences, and constraints to larger social, physical, environmental, and temporal and situational cues [6,7,8,9]. EMAs involve repeatedly sampling participants’ behaviors and experiences in real time within their natural environments [11] This typically involves administering surveys several times throughout the day using SMS text messaging or a smartphone app. EMA has been used in several studies to evaluate the predictors of intraindividual changes in eating behaviors throughout the day or across days [12,13,14] This timescale and the widespread use of smartphones simplify the evaluation across a wide range of predictors, including stress, social and physical environments, and time of day. Conclusions: Our approach offers a potentially time-efficient and cost-effective strategy for capturing eating events in real time

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