A Qualitative Analysis of the Remote Food Photography Method and the Automated Self-Administered 24-hour Dietary Assessment Tool for Assessing Children's Food Intake Reported by Parent Proxy.

Background: Accuracy and participant burden are two key considerations in the selection of a dietary assessment tool for assessing children's full-day dietary intake.
Objective: The aim of this study was to identify barriers experienced by parents and burden when using two technology-based measures of dietary intake to report their child's intake: the Remote Food Photography Method (RFPM) and the Automated Self-Administered 24-hour Dietary Assessment Tool (ASA24).
Design: Qualitative, semistructured, focus groups were conducted with parents who served as proxy reporters of their child's dietary intake using the two different dietary assessment methods (ie, RFPM and ASA24) 1 week apart.
Participants/setting: This study was conducted in 2019 and included 32 parents of children aged 7 to 8 years in Colorado and Louisiana.
Main Outcome Measures: Barriers adhering to the protocol and burden with the RFPM and ASA24.
Qualitative Analyses: Qualitative content analysis and Atlas.ti software were used to analyze and interpret focus group data.
Results: For the RFPM, parents described missing photos due to unobserved intake, forgetting to capture images, disruption of mealtimes, and child embarrassment when meals were photographed at school. For the ASA24, parents described the time commitment as the main source of burden and the need to expand the food database to include additional ethnic foods and restaurant items. The main strengths were ease of use for the RFPM and the consolidated workload for the ASA24.
Conclusions: The barriers experienced by parents and burden differed by method, highlighting the importance of considering the unique characteristics of each assessment tool when designing a pediatric dietary assessment study and interpreting findings.
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