Evaluation of a PDA-based dietary assessment and intervention program: a randomized controlled trial

Research design/methodology

TYPE: randomized controlled trial

VALIDITY: Bias and controls were addressed; however, administrators were aware of the randomization process.

ENVIRONMENT: Private corporate environment for study design and control.  Measurements and data collection appear to have been managed in the field.

Research question

To compare the use of a PDA-based dietary assessment program, DietMatePro, to a paper-based diary system for monitoring dietary intake and improving adherence to a dietary regimen.

The primary measured outcome was diet adherence.

Patient/Problem/Population definition

PATIENT: PDA tools to facilitate diet diaries
PROBLEM:  poor adherence to diet and diaries
POPULATION: subjects with BMI between 24 and 30
TYPE: health services research

Intervention

PDAs as monitoring device for diet compliance and as an alternative to paper-based diaries

Comparison

PDA tool versus paper-based system

Outcome

Adherence to diet in the intervention group (DietMatePro) was 43% compared to the control group (paper diary) at 28% (p ≤ 0.039).

Application of results to patient care

It is important to mitigate participants' recording burden on the PDA.  It is also important to isolate whether or not apparent improvements in paper-based diary recall are attributable to incomplete retrospective recall (remembering what was eaten insufficiently) rather than real improvements in diary keeping.

Diary recording with DietMatePro was approximated at 8 minutes per entry.  This was not identified as an undue burden, but should be considered an unacceptable hurdle for participants.

Further areas for research  

This study contributes to the evidence base on usage of mobile devices for diary keeping in general.  There needs to be further research looking at long-term use and impact on clinical outcomes, such as self-monitoring.