Validation of the INDDEX24 mobile app vs. a pen-and-paper 24-hour dietary recall using the weighed food record as a benchmark in Burkina Faso

Abstract

Abstract Effective nutrition policies require timely, accurate individual dietary consumption data; collection of such information has been hampered by cost and complexity of dietary surveys and lag in producing results. The objective of this work was to assess accuracy and cost-effectiveness of a streamlined, tablet-based dietary data collection platform for 24-hour individual dietary recalls (24HR) administered using INDDEX24 platform vs. a pen-and-paper (PAPI) questionnaire, with weighed food record (WFR) as a benchmark. This cross-sectional comparative study included women 18-49 years old from rural Burkina Faso (n=116 INDDEX24; n=115 PAPI). A weighed food record was conducted; the following day, a 24HR was administered by different interviewers. Food consumption data were converted into nutrient intakes. Validity of 24HR estimates of nutrient and food group consumption was based on comparison with WFR using equivalence tests (group level) and percentages of participants within ranges of percent error (individual level). Both modalities performed comparably estimating consumption of macro- and micronutrients, food groups, and quantities (modalities’ divergence from WFR not significantly different). Accuracy of both modalities was acceptable (equivalence to WFR significant at p <.05) at group level for macronutrients, less so for micronutrients and individual-level consumption (percent within +/-20% of WFR 17%-45% for macronutrients; 5%-17% for micronutrients). INDDEX24 was more cost-effective than PAPI based on superior accuracy of a composite nutrient intake measure (but not gram amount or item count) due to lower time and personnel costs. INDDEX24 for 24HR dietary surveys linked to dietary reference data shows comparable accuracy to PAPI at lower cost.