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.