Collaborative ECHO research led by Traci Bekelman, PhD, MPH and Dana Dabelea, MD, PhD of the University of Colorado, Anschutz Medical Campus, analyzed parents’ experiences with two parent-reported diet assessments: the Remote Food Photography Method (RFPM)—which involves parents taking pictures of their child’s meals using a smartphone app—and the Automated Self-Administered 24-hour Dietary Assessment Tool (ASA24)—which involves parents filling out daily recalls of their child’s meals.

One of their studies, titled “A Qualitative Analysis of the Remote Food Photography Method and the Automated Self-Administered 24-hour Dietary Assessment Tool for Assessing Children’s Food Intake Reported by Parent Proxy,” is published in the Journal of the Academy of Nutrition and Dietetics.

This research compared parents’ experience with the RFPM and ASA24. While parents found the RFPM easier to use, they also reported difficulties with missing or forgetting meal photos. Parents appreciated the consolidated workload of the ASA24, but reported that the time commitment was difficult to manage and the food database left out some foods from diverse cuisines.

During the study, researchers collected child diet data from the parents of 40 children aged seven or eight from an ECHO cohort in Colorado and an IDeA States Pediatric Clinical Trials Network site in Louisiana. Parents tracked their child’s diet for three days using either the RFPM or the ASA24 and then for an additional three days using the other method. Afterwards, parents were given surveys on their experience with these tools, and 32 parents participated in focus group discussions.

The insights of parents participating in this study revealed some of the key strengths and weaknesses associated with these tools that may impact participant burden and the accuracy of parent-reported child diet data. “This study has practical implications because researchers have multiple options when selecting a dietary assessment tool,” said Dr. Bekelman, “and must therefore weigh the relative strengths and weaknesses of each method.”

An additional study from this research team compared the accuracy and effectiveness of the RFPM and ASA24 for child dietary assessment by parent-proxy. Caregivers who participated in the study were generally happy with both methods, but each method had drawbacks. The team’s research, titled “A comparison of the Remote Food Photography Method and the Automated Self-Administered 24-hour Dietary Assessment Tool for measuring full day dietary intake among school-aged children,” is published in the British Journal of Nutrition.

For this study, the research team recruited participants from the same population in the aforementioned study and asked them to try two ways of measuring what and how much their child ate using the RFPM and ASA24. Participants completed a survey providing information on satisfaction, ease of use, and burdens for each tool.

The team found that most caregivers were happy with both methods. However, some of the main drawbacks that caregivers reported with the ASA24 included challenges using the website and difficulty estimating how much their child ate. On the other hand, the caregivers’ main difficulty with the RFPM was underreporting due to missing photos. These findings will help researchers improve these methods to increase the accuracy of measuring what children eat and reduce participant burden.

Read the research summaries.