Evidence-based development of a mobile telephone food record.

Mobile telephones with an integrated camera can provide a unique mechanism for collecting dietary information that reduces burden on record-keepers. Objectives for this study were to test whether participant's proficiency with the mobile telephone food record improved after training and repeated use and to measure changes in perceptions regarding use of the mobile telephone food record after training and repeated use. Seventy-eight adolescents (26 males, 52 females) ages 11 to 18 years were recruited to use the mobile telephone food record for one or two meals. Proficiency with the mobile telephone food record was defined as capturing a useful image for image analysis and self-reported ease of use. Positive changes in perceptions regarding use of the mobile telephone food record were assumed to equate to potentially improved proficiency with the mobile telephone food record. Participants received instruction for using the mobile telephone food record prior to their first meal, and captured an image of their meals before and after eating. Following the first meal, participants took part in an interactive session where they received additional training on capturing images in various snacking situations and responded to questions about user preferences. Changes in the participants' abilities to capture useful images and perceptions about the usability of the mobile telephone food record were examined using McNemar, Wilcoxon rank-sum test, and paired t test. After using the mobile telephone food record, the majority of participants (79%) agreed that the software was easy to use. Eleven percent of participants agreed taking images before snacking would be easy. After additional training, the percent increased significantly to 32% (P<0.0001). For taking images after snacking, there was also improvement (21% before training and 43% after; P<0.0001). Adolescents readily adopt new technologies; however, the mobile telephone food record design needs to accommodate the lifestyles of its users to ensure useful images and continuous use. Further, these results suggest that additional training in using a new technology may improve the accuracy among users.