title: A mobile phone food record app to digitally capture dietary intake for adolescents in a free-living environment: usability study.
abstract: BACKGROUND
  Mobile technologies are emerging as valuable tools to collect and assess dietary intake. Adolescents readily accept and adopt new technologies; thus, a food record app (FRapp) may be a useful tool to better understand adolescents' dietary intake and eating patterns.
  
  
  OBJECTIVE
  We sought to determine the amenability of adolescents, in a free-living environment with minimal parental input, to use the FRapp to record their dietary intake.
  
  
  METHODS
  Eighteen community-dwelling adolescents (11-14 years) received detailed instructions to record their dietary intake for 3-7 days using the FRapp. Participants were instructed to capture before and after images of all foods and beverages consumed and to include a fiducial marker in the image. Participants were also asked to provide text descriptors including amount and type of all foods and beverages consumed.
  
  
  RESULTS
  Eight of 18 participants were able to follow all instructions: included pre- and post-meal images, a fiducial marker, and a text descriptor and collected diet records on 2 weekdays and 1 weekend day. Dietary intake was recorded on average for 3.2 (SD 1.3 days; 68% weekdays and 32% weekend days) with an average of 2.2 (SD 1.1) eating events per day per participant. A total of 143 eating events were recorded, of which 109 had at least one associated image and 34 were recorded with text only. Of the 109 eating events with images, 66 included all foods, beverages and a fiducial marker and 44 included both a pre- and post-meal image. Text was included with 78 of the captured images. Of the meals recorded, 36, 33, 35, and 39 were breakfasts, lunches, dinners, and snacks, respectively.
  
  
  CONCLUSIONS
  These data suggest that mobile devices equipped with an app to record dietary intake will be used by adolescents in a free-living environment; however, a minority of participants followed all directions. User-friendly mobile food record apps may increase participant amenability, increasing our understanding of adolescent dietary intake and eating patterns. To improve data collection, the FRapp should deliver prompts for tasks, such as capturing images before and after each eating event, including the fiducial marker in the image, providing complete and accurate text information, and ensuring all eating events are recorded and should be customizable to individuals and to different situations.
  
  
  BACKGROUND
  Clinicaltrials.gov NCT01803997. http://clinicaltrials.gov/ct2/show/NCT01803997 (Archived at: http://www.webcitation.org/6WiV1vxoR).
authors.affiliation: Grand Forks Human Nutrition Research Center, Agricultural Research Service, United States Department of Agriculture, Grand Forks, ND, United States. shanon.casperson@ars.usda.gov.
authors.forename: Shanon L
authors.identifier: http://orcid.org/0000-0002-6954-9523
authors.initials: SL
authors.lastname: Casperson
authors.forename: Jared
authors.identifier: http://orcid.org/0000-0002-2514-636X
authors.initials: J
authors.lastname: Sieling
authors.forename: Jon
authors.identifier: http://orcid.org/0000-0002-2339-7130
authors.initials: J
authors.lastname: Moon
authors.forename: LuAnn
authors.identifier: http://orcid.org/0000-0001-9225-4320
authors.initials: L
authors.lastname: Johnson
authors.forename: James N
authors.identifier: http://orcid.org/0000-0002-6270-9678
authors.initials: JN
authors.lastname: Roemmich
authors.forename: Leah
authors.identifier: http://orcid.org/0000-0002-5376-8967
authors.initials: L
authors.lastname: Whigham
keywords: adolescents; dietary assessment; dietary food records; food record app; smartphone app