Improving dietary self-monitoring and adherence with hand-held computers: a pilot study.
OBJECTIVE
Innovations in information technology offer new opportunities for creative application of personalized, tailored feedback strategies for improving dietary adherence. We developed and tested a real-time diet-monitoring and feedback system using hand-held computers. The goals were to increase diet self-monitoring, reduce the burden of monitoring food intake, and increase adherence to dietary goals within a clinical trial.


METHODS
Participants were 33 women in the Diet Modification arm of the Women's Health Initiative (WHI). After using focus groups to determine system features, women used the Personal Digital Assistant (PDA)-based system for 1 month and received immediate and weekly tailored feedback. The process and outcomes were evaluated using real-time food records collected through the PDAs; surveys; and self-reported food frequency questionnaires.


RESULTS
Participants significantly increased self-monitoring, improved their attitudes toward self-monitoring, and met their dietary goals more often. Reported total fat intake and percent energy from fat decreased significantly. There was a modest decrease in mean caloric intake.


CONCLUSIONS
The pilot study findings support the largely untapped potential of hand-held computers for improving diet monitoring and diet adherence, particularly within a clinical trial.
Glanz
Karen
K
Cancer Research Center of Hawaii, University of Hawaii, Honolulu, Hawaii, USA. kglanz@sph.emory.edu
Murphy
Suzanne
S
Moylan
Joanne
J
Evensen
Diana
D
Curb
J David
JD
D000368:Aged; D000369:Aged, 80 and over; D034201:Computers, Handheld / Q000706:statistics & numerical data*; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008875:Middle Aged; D010349:Patient Compliance; D010865:Pilot Projects