title: Design and Evaluation of a Training Protocol for a Photographic Method of Visual Estimation of Fruit and Vegetable Intake among Kindergarten Through Second-Grade Students.
abstract: To design a replicable training protocol for visual estimation of fruit and vegetable (FV) intake of kindergarten through second-grade students through digital photography of lunch trays that results in reliable data for FV served and consumed.
  
  
  
  Protocol development through literature and researcher input was followed by 3 laboratory-based trainings of 3 trainees. Lunchroom data collection sessions were done at 2 elementary schools for kindergarten through second-graders. Intraclass correlation coefficients (ICCs) were used.
  
  
  
  By training 3, ICC was substantial for amount of FV served and consumed (0.86 and 0.95, respectively; P < .05). The ICC was moderate for percentage of fruits consumed (0.67; P = .06). In-school estimates for ICCs were all significant for amounts served at school 1 and percentage of FV consumed at both schools.
  
  
  
  The protocol resulted in reliable estimation of combined FV served and consumed using digital photography. The ability to estimate FV intake accurately will benefit intervention development and evaluation.
authors.affiliation: Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL. Electronic address: masis2@illinois.edu.
authors.forename: Natalie
authors.initials: N
authors.lastname: Masis
authors.affiliation: Office of Extension and Outreach, University of Illinois Extension, Urbana, IL.
authors.forename: Jennifer
authors.initials: J
authors.lastname: McCaffrey
authors.affiliation: Children's Eating Laboratory, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO.
authors.forename: Susan L
authors.initials: SL
authors.lastname: Johnson
authors.affiliation: Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL.
authors.forename: Karen
authors.initials: K
authors.lastname: Chapman-Novakofski
mesh_terms: D035843:Biomedical Research / Q000193:education / Q000295:instrumentation / Q000379:methods; D002648:Child; D002652:Child Behavior; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D000072001:Diet, Healthy; D005522:Food Services; D005638:Fruit; D006801:Humans; D062409:Lunch; D063731:Mobile Applications; D015596:Nutrition Assessment; D010349:Patient Compliance; D010781:Photography / Q000193:education / Q000295:instrumentation; D064787:Portion Size; D015203:Reproducibility of Results; D012107:Research Design; D012108:Research Personnel / Q000193:education; D012574:Schools; D064788:Serving Size; D014675:Vegetables; D059015:Wireless Technology; D000078329:Workforce
keywords: dietary assessment; digital photography; food intake; fruits and vegetables; reliability; school nutrition