title: Use of electronic dietary assessment tools in primary care: an interdisciplinary perspective.
abstract: BACKGROUND
  Dietary assessment can be challenging for many reasons, including the wide variety of foods, eating patterns and nutrients to be considered. In team-based primary care practice, various disciplines may be involved in assessing diet. Electronic-based dietary assessment (e-DA) instruments available now through mobile apps or websites can potentially facilitate dietary assessment. Providers views of facilitators and barriers related to e-DA instruments and their recommendations for improvement can inform the further development of these tools. The objective of this study was to explore provider perspectives on e-DA tools in mobile apps and websites.
  
  
  METHODS
  The exploratory sequential mixed methods design included interdisciplinary focus groups followed by a web-based survey sent to Family Health Teams throughout Ontario, Canada. Descriptive and bivariate analyses were completed. Focus group transcripts contributed to web-survey content, while interpretive themes added depth and context.
  
  
  RESULTS
  11 focus groups with 50 providers revealed varying perspectives on the use of e-DA for: 1) improving patients' eating habits; 2) improving the quality of dietary assessment; and, 3) integrating e-DA into the care process. In the web-survey 191 respondents from nine disciplines in 73 FHTs completed the survey. Dietitians reported greater use of e-DA than other providers (63% vs.19%; p = .000) respectively. There was strong interest among disciplines in the use of e-DA tools for the management of obesity, diabetes and heart disease, especially for patient self-monitoring. Barriers identified were: patients' lack of comfort with using technology, misinterpretation of e-DA results by patients, time and education for providers to interpret results, and time for providers to offer counselling.
  
  
  CONCLUSIONS
  e-DA tools in mobile apps and websites may improve dietary counselling over time. Addressing the identified facilitators and barriers can potentially promote the uptake of e-DA into clinical practice.
authors.affiliation: Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Canada. ibonilla@uoguelph.ca.
authors.forename: Carolina
authors.initials: C
authors.lastname: Bonilla
authors.affiliation: Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Canada.
authors.forename: Paula
authors.initials: P
authors.lastname: Brauer
authors.affiliation: Nutrition Research Consulting, Fergus, Canada.
authors.forename: Dawna
authors.initials: D
authors.lastname: Royall
authors.affiliation: Department of Kinesiology, University of Waterloo, Waterloo, Canada.
authors.forename: Heather
authors.initials: H
authors.lastname: Keller
authors.affiliation: School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada.
authors.forename: Rhona M
authors.initials: RM
authors.lastname: Hanning
authors.affiliation: School of Nursing and Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Canada.
authors.forename: Alba
authors.initials: A
authors.lastname: DiCenso
mesh_terms: D000328:Adult; D004035:Diet Therapy / Q000379:methods*; D005260:Female; D017144:Focus Groups; D006801:Humans; D020407:Internet; D008297:Male; D063731:Mobile Applications; D015596:Nutrition Assessment; D011320:Primary Health Care / Q000379:methods*