RESUMO
BACKGROUND: The prevalence of childhood obesity and comorbidities is rising alarmingly, and diet is an important modifiable determinant. Numerous dietary interventions in children have been developed to reduce childhood obesity and overweight rates, but their long-term effects are unsatisfactory. Stakeholders call for more personalized approaches, which require detailed dietary intake data. In the case of primary school children, caregivers are key to providing such dietary information. However, as school-aged children are not under the full supervision of one specific caregiver anymore, data are likely to be biased. Recent technological advancements provide opportunities for the role of children themselves, which would serve the overall quality of the obtained dietary data. OBJECTIVE: This study aims to conduct a child-centered exploratory sequential mixed methods study to identify user requirements for a dietary assessment tool for children aged 5 to 6 years. METHODS: Formative, nonsystematic narrative literature research was undertaken to delineate initial user requirements and inform prototype ideation in an expert panel workshop (n=11). This yielded 3 prototype dietary assessment tools: FoodBear (tangible piggy bank), myBear (smartphone or tablet app), and FoodCam (physical camera). All 3 prototypes were tested for usability by means of a usability task (video analyses) and user experience (This or That method) among 14 Dutch children aged 5 to 6 years (n=8, 57% boys and n=6, 43% girls). RESULTS: Most children were able to complete FoodBear's (11/14, 79%), myBear's (10/14, 71%), and FoodCam's (9/14, 64%) usability tasks, but all children required assistance (14/14, 100%) and most of the children encountered usability problems (13/14, 93%). Usability issues were related to food group categorization and recognition, frustrations owing to unsatisfactory functioning of (parts) of the prototypes, recall of food products, and the distinction between eating moments. No short-term differences in product preference between the 3 prototypes were observed, but autonomy, challenge, gaming elements, being tablet based, appearance, social elements, and time frame were identified as determinants of liking the product. CONCLUSIONS: Our results suggest that children can play a complementary role in dietary data collection to enhance the data collected by their parents. Incorporation of a training program, auditory or visual prompts, reminders and feedback, a user-friendly and intuitive interaction design, child-friendly food groups or icons, and room for children's autonomy were identified as requirements for the future development of a novel and usable dietary assessment tool for children aged 5 to 6 years. Our findings can serve as valuable guidance for ongoing innovations in the field of children's dietary assessment and the provision of personalized dietary support.
RESUMO
Background: Assessing dietary intake and eating behavior in children is challenging, owing to children's undeveloped food knowledge and perception of portion sizes. Additionally, caregivers cannot always provide complete surrogate information. Consequently, validated dietary behavior assessment methods for children are limited, but technological innovations offer opportunities for the development of new tools. One of the first steps in the developmental process of a newly developed pediatric dietary assessment tool includes an alignment of the needs and preferences of pediatric dieticians (PDs) as potential users. Objectives: To explore opinions of Dutch PDs about traditional dietary behavior assessment methods for children and potential technological innovations to replace or support traditional methods. Methods: Ten PDs participated in semistructured interviews (total of 7.5 h) based on 2 theoretical frameworks, and data saturation was reached after the seventh interview. Interview transcripts were inductively coded in an iterative process, and overarching themes and domains were identified. Interview data were then used as input for an extensive online survey completed by 31 PDs who were not involved in the initial interview rounds. Results: PDs discussed their perspective on dietary behavior assessments in 4 domains: traditional methods, technological methods, future methods, and external influences on these methods. Generally, PDs felt that traditional methods supported them in reaching their desired goals. However, the time needed to obtain a comprehensive overview of dietary intake behavior and the reliability of conventional methods were mentioned as limitations. For future technologies, PDs mention the ease of use and engaging in children as opportunities. Conclusions: PDs have a positive attitude toward the use of technology for dietary behavior assessments. Further development of assessment technologies should be tailored to the needs of children in different care situations and age categories to increase its usability among children, their caregivers, and dietician. Curr Dev Nutr 2023;xx:xx.
