Children's Dietary Recalls: Prompts, Retention Interval, and Accuracy

描述(申请人提供)：饮食和疾病之间的关系在公共卫生中是一个关键的关系。许多研究依赖于高年级的小学生自我报告饮食摄入量。我们2009年的验证研究结果表明，四年级儿童的饮食回忆准确性受到保留间隔(从报告的膳食到采访之间的时间)的影响。24小时饮食回忆中校餐部分的准确性(24hDR)在回忆之前24小时(紧接访谈前的24小时)比回忆前一天(面试前一天的午夜至午夜)更好。然而，即使在保留间隔最短和准确性最好的情况下，召回也有重大错误：40%的观察到的食物被遗漏(没有报告)，25%的报告的食物被侵入(没有观察到)。需要更多的研究来提高儿童饮食回忆的准确性。两个突出的24hDR协议是用于研究的营养数据系统(NDSR)和自动多通道方法(AMPM)；一个新的协议是自动自我管理24hDR(ASA24)。这些协议中的每一个协议的软件都是针对前一天的。回忆的准确性也可能受到提示的影响，这些提示被用来要求受试者对目标时期的事件进行初步回忆。这些提示可以是向前(最近到最近)、反向(最近到最远)、开放(免费[无说明])或餐名(早餐、午餐等)。NDSR软件使用向前提示，AMPM软件使用开放提示，而ASA24软件使用餐名提示。任何24hDR都有保留间隔和提示；因此，有必要确定保留间隔和提示的组合，以最大限度地提高回忆准确性，但经验证据仅限于小型先导性研究。这个为期4年的项目有3个目标，以四年级儿童为对象进行数据收集。目标1是比较8种情况下饮食回忆的准确性，这些条件是通过跨越2个保持间隔(下午获得之前的24小时回忆；早上获得前一天的回忆)和4个提示(前进；倒退；开放；用餐)来定义的。将观察480名儿童每人吃学校早餐和学校午餐，然后进行访谈，以获得24hDR，使用8种条件中的一种，每种条件60名儿童(每种性别30名)。每个孩子报告的24hDR学校膳食部分的数据将与两次学校膳食的观察数据进行比较，并将评估孩子在食物项目、数量、能量和大量营养素方面的准确性。目标二是评估社会期望、体重指数、社会经济地位和成就测试分数与饮食回忆准确性的关系。目标三是通过课堂管理对大约210名儿童进行为期1个月的重测信度，该量表包含14个条目。这个R01项目将比较24hDR方案的关键但未经测试的方面，并为完善软件提供经验证据，以便从儿童那里获得更准确的24hDR，用于流行病学研究、干预和临床实践，从而提高我们对饮食和疾病之间关系的理解。 公共卫生相关性：饮食和疾病之间的关系是公共卫生中的一个关键问题，但饮食评估是具有挑战性的，特别是在学龄儿童中。饮食调查中的错误报告是一个广为人知的问题，它威胁到我们查明饮食和疾病之间真实关系的能力。该项目将为完善软件提供经验证据，以便为全国性调查、流行病学研究、干预和临床实践获得更准确的24小时儿童饮食召回，从而提高我们对饮食和疾病之间关系的理解。

DESCRIPTION (provided by applicant): The relationship between diet and disease is a critical one in public health. Many studies rely on elementary school children in upper-grade levels to self-report dietary intake. Results from our 2009 validation study showed that 4th-grade children's dietary recall accuracy was affected by retention interval (elapsed time between to-be-reported meals and the interview). Accuracy for the school-meal parts of 24-hour dietary recalls (24hDRs) was better for recalls about the prior 24 hours (the 24 hours immediately preceding the interview) than for recalls about the previous day (midnight to midnight of the day before the interview). However, even when the retention interval was shortest and accuracy was best, recalls had substantial errors: 40% of items observed eaten were omitted (not reported), and 25% of items reported eaten were intruded (not observed). More research is needed to improve children's dietary recall accuracy. Two prominent 24hDR protocols are the Nutrition Data System for Research (NDSR) and the Automated Multiple-Pass Method (AMPM); a new protocol is the Automated Self-Administered 24hDR (ASA24). Software for each of these protocols targets the previous day. Recall accuracy may also be influenced by prompts used to ask subjects for their initial recall of the target period's events. These prompts can be forward (most distant to most recent), reverse (most recent to most distant), open (free [no instructions]), or meal name (breakfast, lunch, etc). NDSR software uses forward prompts, AMPM software uses open prompts, and ASA24 software uses meal name prompts. Any 24hDR has a retention interval and prompts; thus, it is necessary to identify the combination of retention interval and prompts that maximizes recall accuracy, but empirical evidence is limited to a small pilot study. This 4-year project has 3 aims and data collection with 4th-grade children. Aim 1 is to compare dietary recall accuracy for 8 conditions defined by crossing 2 retention intervals (prior-24-hour recall obtained in the afternoon; previous-day recall obtained in the morning) with 4 prompts (forward; reverse; open; meal). Each of 480 children will be observed eating school breakfast and school lunch, and then interviewed to obtain a 24hDR using 1 of the 8 conditions, with 60 children (30 per sex) per condition. Each child's reported data for the school-meal parts of the 24hDR will be compared to observed data for the 2 school meals, and the child's accuracy will be assessed for food items, amounts, energy, and macronutrients. Aim 2 is to assess relationships of social desirability, body mass index, socioeconomic status, and achievement test scores with dietary recall accuracy of 480 children in Aim 1. Aim 3 is to conduct 1-month test-retest reliability (in Year 1) for a 14-item social desirability scale via classroom administration to approximately 210 children. This R01 project will compare crucial yet untested aspects of 24hDR protocols and provide empirical evidence for refining software to obtain more accurate 24hDRs from children for epidemiologic studies, interventions, and clinical practice, and thereby improve our understanding of relationships between diet and disease. PUBLIC HEALTH RELEVANCE: The relationship between diet and disease is a critical one in public health, but dietary assessment is challenging, especially among school children. Misreporting in dietary surveys is a widely recognized problem that threatens our ability to pinpoint true relationships between diet and disease. This project will provide empirical evidence for refining software to obtain more accurate 24-hour dietary recalls from children for national surveys, epidemiologic studies, interventions, and clinical practice, and thereby improve our understanding of relationships between diet and disease.