title: Is a Picture Worth a Thousand Words? Few Evidence-Based Features of Dietary Interventions Included in Photo Diet Tracking Mobile Apps for Weight Loss.
abstract: Apps using digital photos to track dietary intake and provide feedback are common, but currently there has been no research examining what evidence-based strategies are included in these apps.
  
  
  
  A content analysis of mobile apps for photo diet tracking was conducted, including whether effective techniques for interventions promoting behavior change, including self-regulation, for healthy eating (HE) are targeted. An initial search of app stores yielded 34 apps (n = 8 Android and Apple; n = 11 Android; n = 15 Apple). One app was removed (unable to download), and other apps (n = 4) were unable to be rated (no longer available). Remaining apps (n = 29) were downloaded, reviewed, and coded by 2 independent reviewers to determine the number of known effective self-regulation and other behavior change techniques included. The raters met to compare their coding of the apps, calculate interrater agreement, resolve any discrepancies, and come to a consensus.
  
  
  
  Six apps (21%) did not utilize any of the behavior change techniques examined. Three apps (10%) provided feedback to users via crowdsourcing or collective feedback from other users and professionals, 7 apps (24%) used crowdsourcing or collective feedback, 1 app (3%) used professionals, and 18 apps (62%) did not provide any dietary feedback to users.
  
  
  
  Few photo diet-tracking apps include evidence-based strategies to improve dietary intake. Use of photos to self-monitor dietary intake and receive feedback has the potential to reduce user burden for self-monitoring, yet photo diet tracking apps need to incorporate known effective behavior strategies for HE, including self-regulation.
authors.affiliation: Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, USA bridges5@email.sc.edu.
authors.forename: Sarah
authors.initials: S
authors.lastname: Hales
authors.affiliation: Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, USA.
authors.forename: Caroline
authors.initials: C
authors.lastname: Dunn
authors.affiliation: Department of Exercise Science, USC Prevention Research Center, University of South Carolina, Columbia, SC, USA.
authors.forename: Sara
authors.initials: S
authors.lastname: Wilcox
authors.affiliation: Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, USA.
authors.forename: Gabrielle M
authors.initials: GM
authors.lastname: Turner-McGrievy
mesh_terms: D000072001:Diet, Healthy / Q000295:instrumentation* / Q000379:methods*; D004038:Diet, Reducing / Q000295:instrumentation* / Q000379:methods*; D019317:Evidence-Based Medicine; D006801:Humans; D063731:Mobile Applications
keywords: mobile app; nutrition; obesity; photograph; self-monitoring