Improving Dietary Self-Monitoring and Adherence with Hand-Held Computers: A Pilot Study
Abstract
Purpose.: Innovations in information technology offer new opportunities for creative application of personalized, tailored feedback strategies for improving dietary adherence. We developed and tested a real-time diet-monitoring and feedback system using hand-held computers. The goals were to increase diet self-monitoring, reduce the burden of monitoring food intake, and increase adherence to dietary goals within a clinical trial. Methods.: Participants were 33 women in the Diet Modification arm of the Women's Health Initiative (WHI). After using focus groups to determine system features, women used the Personal Digital Assistant (PDA)–based system for 1 month and received immediate and weekly tailored feedback. The process and outcomes were evaluated using real-time food records collected through the PDAs; surveys; and self-reported food frequency questionnaires. Results.: Participants significantly increased self-monitoring, improved their attitudes toward self-monitoring, and met their dietary goals more often. Reported total fat intake and percent energy from fat decreased significantly. There was a modest decrease in mean caloric intake. Discussion.: The pilot study findings support the largely untapped potential of handheld computers for improving diet monitoring and diet adherence, particularly within a clinical trial.
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In a pilot study, women in a diet modification trial given PDAs for self-monitoring with feedback significantly increased self-monitoring and more often achieved dietary goals.
“In a pilot study where women in a diet modification trial were given personal digital assistants (PDAs) for self-monitoring with feedback, participants significantly increased their self-monitoring and more often achieved dietary goals (14).”
From The Effect of Electronic Self‐Monitoring on Weight Loss and Dietary Intake: A Randomized Behavioral Weight Loss Trial (2011) · cites this paper as [14]
Glanz et al. found that participants in a one-month pilot using hand-held computers significantly increased self-monitoring and met dietary goals more often compared to previous paper diary use.
“Glanz et al. conducted a one-month pilot study using hand-held computers in the Diet Modification arm of the Women’s Health Initiative and found that participants (N=33) significantly increased self-monitoring and met their dietary goals more often compared to previous use of PR for self-monitoring [48].”
From SMART trial: A randomized clinical trial of self-monitoring in behavioral weight management-design and baseline findings (2009) · cites this paper as [48]
Findings from prior studies are equivocal regarding whether PDA use reduces subject burden for self-monitoring and improves long-term adherence and weight loss compared with paper diaries.
“Taken together, findings from these studies are equivocal regarding the use of a PDA to reduce subject burden for self-monitoring and improved long-term adherence and better weight loss compared with using a paper diary.”
From SMART trial: A randomized clinical trial of self-monitoring in behavioral weight management-design and baseline findings (2009) · cites this paper as [48]
The Glanz et al. study was short in duration and not focused on weight loss.
“While the latter study had positive results, it was short in duration and not focused on weight loss.”
From SMART trial: A randomized clinical trial of self-monitoring in behavioral weight management-design and baseline findings (2009) · cites this paper as [48]
Two studies have shown enhanced adherence with PDA use; however, the observation period was limited to 1 month.
“Two studies have shown enhanced adherence with PDA use; however, the observation period was limited to 1 month.27, 28”
From Using mHealth Technology to Enhance Self-Monitoring for Weight Loss (2012) · cites this paper as [28]
Smartphones and photography can be used to make self-monitoring easy and convenient.
“Smartphones and photography can be used to make self-monitoring easy and convenient [6-9].”
From Factors related to sustained use of a free mobile app for dietary self-monitoring with photography and peer feedback: retrospective cohort study (2014) · cites this paper as [7]
Traditional dietary self-monitoring methods can be burdensome to people.
“These methods can be burdensome to people [6,7,15-17] and suffer from underreporting and recall issues [15-19].”
From Factors related to sustained use of a free mobile app for dietary self-monitoring with photography and peer feedback: retrospective cohort study (2014) · cites this paper as [7]
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- Authors
- Glanz, K., Murphy, S., Moylan, J., Evensen, D., & Curb, J. D.
- Affiliations
- University of Hawaiʻi at Mānoa (US)
- Corresponding author
- Glanz, Karen
- Venue
- American Journal of Health Promotion
- Publisher
- SAGE Publications
- Published
- 2006-01
- Volume
- 20
- Issue
- 3
- Pages
- 165-170
- ISSN
- 0890-1171 (ISSN-L)
- 2168-6602
- OpenAlex
- W2177996867
- Cited by
- 93
- References
- 11
- Citations by year
- 2026: 1 · 2023: 2 · 2022: 1 · 2021: 2 · 2020: 2 · 2019: 1 · 2018: 3 · 2017: 5 · 2016: 9 · 2015: 8 · 2014: 7 · 2013: 4 · 2012: 10
- FWCI
- 12.81
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Health Promotion (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Keywords
- dietary self-monitoring, dietary adherence, personal digital assistants, personalized feedback, dietary fat intake, energy intake, women's health, dietary change, Women's Health Initiative
- MeSH terms
- Aged, Aged, 80 and over, Feeding Behavior, Female, Humans, Middle Aged, Patient Compliance, Pilot Projects, Computers, Handheld
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