Optimizing portion-size estimation aids: a formative evaluation in Malawi. Issue 17 (22nd July 2019)

• Record Type: Journal Article
• Authors: Schnefke, Courtney H; Thakwalakwa, Chrissie; Muth, Mary K; Phuka, John; Coates, Jennifer; Rogers, Beatrice; Colaiezzi, Brooke; Bell, Winnie; Flax, Valerie L
• Is Part Of: Public health nutrition. Volume 22:Issue 17(2019)
• Page Start: 3127
• Page End: 3139
• Publication Date: 2019-07-22
• Subjects: Portion-size estimation, -- Dietary intake, -- Low-resource setting, -- Dietary assessment tool, -- Dietary recall; Nutrition -- Periodicals; Nutrition policy -- Periodicals; Public health -- Periodicals; 613.2
• DOI: 10.1017/S1368980019001733
• Languages: English
• ISSNs: 1368-9800

Abstract

Abstract: Objective: To investigate preferences for and ease-of-use perceptions of different aspects of printed and digitally displayed photographic portion-size estimation aids (PSEA) in a low-resource setting and to document accuracy of portion-size selections using PSEA with different visual characteristics. Design: A convergent mixed-methods design and stepwise approach were used to assess characteristics of interest in isolation. Participants served themselves food and water, which were weighed before and after consumption to measure leftovers and quantity consumed. Thirty minutes later, data collectors administered a meal recall using a PSEA and then a semi-structured interview. Setting: Blantyre and Chikwawa Districts in the southern region of Malawi. Participants: Ninety-six women, aged 18–45 years. Results: Preferences and ease-of-use perceptions favoured photographs rather than drawings of shapes, three and five portion-size options rather than three with four virtual portion-size options, a 45° rather than a 90° photograph angle, and simultaneous rather than sequential presentation of portion-size options. Approximately half to three-quarters of participants found the portion-size options represented appropriate amounts of foods or water consumed. Photographs with three portion sizes resulted in more accurate portion-size selections (closest to measured consumption) than other format and number of portion-size option combinations. A 45° angle and simultaneous presentation were more accurate than a 90° angle and sequential presentation of images. Conclusions: Results from testing PSEA visual characteristics separately can be used to generate optimal PSEA, which can improve participants' experiences during meal recalls.