The connecting health and technology study: a 6-month randomized controlled trial to improve nutrition behaviours using a mobile food record and text messaging support in young adults.
BACKGROUND
Early adulthood represents the transition to independent living which is a period when changes in diet and body weight are likely to occur. This presents an ideal time for health interventions to reduce the effect of health problems and risk factors for chronic disease in later life. As young adults are high users of mobile devices, interventions that use this technology may improve engagement. The Connecting Health and Technology study aimed to evaluate the effectiveness of tailored dietary feedback and weekly text messaging to improve dietary intake of fruit, vegetables and junk food over 6 months among a population-based sample of men and women (aged 18-30 years).


METHODS
A three-arm, parallel, randomized control trial was conducted. After baseline assessments, participants were randomized to one of three groups: A) dietary feedback and weekly text messages, B) dietary feedback only or C) control group. Dietary intake was assessed using a mobile food record App (mFR) where participants captured images of foods and beverages consumed over 4-days at baseline and post-intervention. The primary outcomes were changes in serves of fruits, vegetables, energy-dense nutrient-poor (EDNP) foods and sugar-sweetened beverages (SSB). The intervention effects were assessed using linear mixed effect models for change in food group serves.


RESULTS
Young adults (n = 247) were randomized to group A (n = 82), group B (n = 83), or group C (n = 82). Overall, no changes in food group serves for either intervention groups were observed. An unanticipated outcome was a mean weight reduction of 1.7 kg (P = .02) among the dietary feedback only. Men who received dietary feedback only, significantly reduced their serves of EDNP foods by a mean of 1.4 serves/day (P = .02). Women who received dietary feedback only significantly reduced their intake of SSB (P = .04) by an average of 0.2 serves/day compared with controls.


CONCLUSIONS
Tailored dietary feedback only resulted in a decrease in EDNP foods in men and SSB in women, together with a reduction in body weight. Using a mobile food record for dietary assessment and tailored feedback has great potential for future health promotion interventions targeting diet and weight in young adults.


BACKGROUND
Australian Clinical Trials Registry Registration number: ACTRN12612000250831 .
School of Public Health, Curtin University, GPO Box U1987, Bentley, Perth, WA, 6845, Australia. D.Kerr@curtin.edu.au.
Deborah A
DA
Kerr
School of Public Health, Curtin University, GPO Box U1987, Bentley, Perth, WA, 6845, Australia.
Amelia J
AJ
Harray
School of Public Health, Curtin University, GPO Box U1987, Bentley, Perth, WA, 6845, Australia.|Public Health Division, Department of Health In Western Australia, 189 Royal Street, East Perth, 6004, WA, Australia.
Christina M
CM
Pollard
School of Public Health, Curtin University, GPO Box U1987, Bentley, Perth, WA, 6845, Australia.
Satvinder S
SS
Dhaliwal
Video and Image Processing Laboratory, School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, USA.
Edward J
EJ
Delp
School of Public Health, Curtin University, GPO Box U1987, Bentley, Perth, WA, 6845, Australia.
Peter A
PA
Howat
School of Engineering and Information Technology, The University of New South Wales at the Australian Defence Force Academy, Canberra, Australia.
Mark R
MR
Pickering
Video and Image Processing Laboratory, School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, USA.
Ziad
Z
Ahmad
School of Medicine, Flinders University, Bedford Park, Australia.
Xingqiong
X
Meng
Cancer Council Western Australia, Subiaco, WA, Australia.
Iain S
IS
Pratt
School of Public Health, Curtin University, GPO Box U1987, Bentley, Perth, WA, 6845, Australia.
Janine L
JL
Wright
School of Public Health, Curtin University, GPO Box U1987, Bentley, Perth, WA, 6845, Australia.
Katherine R
KR
Kerr
Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA.|Department of Nutrition Science, Purdue University, West Lafayette, IN, USA.
Carol J
CJ
Boushey
D000328:Adult; D001315:Australia; D004032:Diet; D005246:Feedback; D005247:Feeding Behavior; D005260:Female; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D063731:Mobile Applications; D017216:Telemedicine; D060145:Text Messaging; D055815:Young Adult
Dietary assessment; Energy-dense nutrient poor foods; Fruit; Interventions; Junk food; Mobile food record; Novel technology; Sugar-sweetened beverages; Tailoring; Text messaging; Vegetables; Young adult