title: Improving dietary self-monitoring and adherence with hand-held computers: a pilot study.
abstract: 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.
authors.affiliation: Cancer Research Center of Hawaii, University of Hawaii, Honolulu, Hawaii, USA. kglanz@sph.emory.edu
authors.forename: Karen
authors.initials: K
authors.lastname: Glanz
authors.forename: Suzanne
authors.initials: S
authors.lastname: Murphy
authors.forename: Joanne
authors.initials: J
authors.lastname: Moylan
authors.forename: Diana
authors.initials: D
authors.lastname: Evensen
authors.forename: J David
authors.initials: JD
authors.lastname: Curb
mesh_terms: 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