Henriksen Hege Berg, Knudsen Markus Dines, Carlsen Monica Hauger, Hjartåker Anette, Blomhoff Rune
Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
Section for Colorectal Cancer Screening, Cancer Registry of Norway, Oslo, Norway.
JMIR Form Res. 2022 Nov 8;6(11):e35933. doi: 10.2196/35933.
In-person dietary counseling and interventions have shown promising results in changing habits toward healthier lifestyles, but they are costly to implement in large populations. Developing digital tools to assess individual dietary intake and lifestyle with integrated personalized feedback systems may help overcome this challenge. We developed a short digital food frequency questionnaire, known as the DIGIKOST-FFQ, to assess diet and other lifestyle factors based on the Norwegian Food-Based Dietary Guidelines. The DIGIKOST-FFQ includes a personalized feedback system, the DIGIKOST report, that benchmarks diet and lifestyle habits. We used qualitative focus group interviews and usability tests to test the feasibility and usability of the DIGIKOST application.
We aimed to explore attitudes, perceptions, and challenges in completing the DIGIKOST-FFQ. We also investigated perceptions and understanding of the personalized feedback in the DIGIKOST report and the technical flow and usability of the DIGIKOST-FFQ and the DIGIKOST report.
Healthy individuals and cancer survivors were invited to participate in the focus group interviews. The transcripts were analyzed using thematic analysis. Another group of healthy individuals completed the usability testing, which was administered individually by a moderator and 2 observers. The results were analyzed based on predefined assignments and discussion with the participants about the interpretation of the DIGIKOST report and technical flow of the DIGIKOST-FFQ.
A total of 20 individuals participated in the focus group interviews, divided into 3 groups of healthy individuals and 3 groups of cancer survivors. Each group consisted of 3 to 4 individuals. Five main themes were investigated: (1) completion time (on average 19.1, SD 8.3, minutes, an acceptable duration), (2) layout (participants reported the DIGIKOST-FFQ was easy to navigate and had clear questions but presented challenges in reporting dietary intake, sedentary time, and physical activity in the last year), (3) questions (the introductory questions on habitual intake worked well), (4) pictures (the pictures were very helpful, but some portion sizes were difficult to differentiate and adding weight in grams would have been helpful), and (5) motivation (users were motivated to obtain personalized feedback). Four individuals participated in the usability testing. The results showed that the users could seamlessly log in, give consent, fill in the DIGIKOST-FFQ, and receive, print, and read the DIGIKOST report. However, parts of the report were perceived as difficult to interpret.
The DIGIKOST-FFQ was overall well received by participants, who found it feasible to use; however, some adjustments with regard to reporting dietary intake and lifestyle habits were suggested. The DIGIKOST report with personalized feedback was the main motivation to complete the questionnaire. The results from the usability testing revealed a need for adjustments and updates to make the report easier to read.
面对面的饮食咨询和干预在促使人们养成更健康的生活方式方面已显示出有前景的结果，但在大量人群中实施成本高昂。开发数字工具来评估个人饮食摄入量和生活方式并配备集成的个性化反馈系统可能有助于克服这一挑战。我们开发了一种简短的数字食物频率问卷，即DIGIKOST-FFQ，以根据挪威基于食物的饮食指南评估饮食和其他生活方式因素。DIGIKOST-FFQ包括一个个性化反馈系统，即DIGIKOST报告，该报告可对饮食和生活方式习惯进行基准评估。我们使用定性焦点小组访谈和可用性测试来检验DIGIKOST应用程序的可行性和可用性。
我们旨在探讨完成DIGIKOST-FFQ时的态度、看法和挑战。我们还调查了对DIGIKOST报告中个性化反馈的看法和理解，以及DIGIKOST-FFQ和DIGIKOST报告的技术流程和可用性。
邀请健康个体和癌症幸存者参加焦点小组访谈。使用主题分析法对访谈记录进行分析。另一组健康个体完成了可用性测试，测试由一名主持人和两名观察员单独进行。根据预先定义的任务以及与参与者就DIGIKOST报告的解读和DIGIKOST-FFQ的技术流程进行的讨论来分析结果。
共有20人参加了焦点小组访谈，分为3组健康个体和3组癌症幸存者。每组由3至4人组成。调查了五个主要主题：（1）完成时间（平均19.1分钟，标准差8.3分钟，这是一个可接受的时长），（2）布局（参与者报告DIGIKOST-FFQ易于浏览且问题清晰，但在报告过去一年的饮食摄入量、久坐时间和身体活动方面存在挑战），（3）问题（关于习惯性摄入量的介绍性问题效果良好），（4）图片（图片非常有帮助，但一些份量大小难以区分，添加克数的重量会很有帮助），以及（5）动机（用户有动力获得个性化反馈）。四人参加了可用性测试。结果表明，用户可以无缝登录、给予同意、填写DIGIKOST-FFQ并接收、打印和阅读DIGIKOST报告。然而，报告的部分内容被认为难以解读。
参与者总体上对DIGIKOST-FFQ评价良好，认为其使用可行；然而，建议在报告饮食摄入量和生活方式习惯方面进行一些调整。带有个性化反馈的DIGIKOST报告是完成问卷的主要动力。可用性测试结果表明需要进行调整和更新，以使报告更易于阅读。
