Prevalence and determinants of misreporting among European children in proxy-reported 24 h dietary recalls.
C Börnhorst, I Huybrechts, W Ahrens...
https://pubmed.ncbi.nlm.nih.gov/22863030/Actively Recruiting
Led by The University of Tennessee, Knoxville · Updated on 2026-06-08
40
Participants Needed
1
Research Sites
30 weeks
Total Duration
Researchers are conducting a randomized crossover trial to develop and compare two proxy-reporting methods for assessing dietary intake in young children aged 2 to 5 years. The study aims to evaluate how usable and feasible a traditional 24-hour dietary recall and an ecological momentary assessment EMA-assisted 24-hour recall are when reported by caregivers. It also seeks to identify dietary misreporting differences between the two methods and examine their accuracy against objectively measured food intake. Caregivers with children in the specified age range will be randomly assigned to start with either the traditional 24-hour recall or the EMA-assisted method. Both groups will provide study foodsone meal and two snacks daily for three consecutive daysto their child. In the EMA condition, caregivers and any second identified caregivers will upload pre- and post-meal photos of the childs eating occasions using an online platform. Following each food provision period, caregivers will complete a telephone-based 24-hour dietary recall with a trained research assistant who will use the photographs to help verify reported intake. After a two-week break, caregivers will switch to the other method. Participants will be involved for two separate three-day food provision periods with a washout in between. Caregivers complete surveys assessing the usability and acceptability of each reporting protocol and the EMA platform interface. Researchers will weigh leftover food for objective intake measurement and analyze misreporting and energy intake accuracy. The study includes safety and feasibility monitoring and will continue until December 2026.
CONDITIONS
Early Childhood Dietary Assessment Study
E
Emilie Holloway, MS, RDN
H
Hollie Raynor, PhD, RD, LDN
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The University of Tennessee, Knoxville
Lead Sponsor
This table compares participation in this trial with other options available for this condition. The information is drawn from published research and the trial’s study details and is provided for educational purposes only.
| Factors | EMA-Assisted 24HR (Photo Uploads) | Traditional 24HR (Telephone, USDA Multi-Pass) |
|---|---|---|
| What it is | A dietary recall process using an Ecological Momentary Assessment (EMA) platform that prompts caregivers to capture pre- and post-meal photos of all eating occasions and upload them via smartphone. Research assistants use these photos to aid caregivers during the dietary recall session. | A standard 24-hour dietary recall by telephone, conducted according to the USDA five-step multi-pass protocol. Caregivers report all foods and beverages consumed by the child, using a supplied booklet to estimate portion sizes. |
| Role in trial | Assigned as one of two dietary assessment methods in a crossover design; all enrolled caregivers complete both methods for their child. | Serves as the active comparator to the EMA-assisted method; all caregivers complete this traditional recall as the other condition in the crossover. |
| Primary use | To facilitate more accurate proxy-reported dietary information in preschool children by supporting caregiver recall with real-time photo documentation of all eating events. | To collect proxy-reported dietary intake information for preschool children based on caregivers' memory and estimation, following accepted national dietary recall procedures. |
| How it is given or performed | Caregivers use a compatible smartphone to photograph all food and beverage items before and after each eating event. Photos are uploaded through an EMA platform, and during the recall interview, research assistants reference these images to help clarify reporting. | A research assistant conducts a telephone interview with the caregiver, who recalls and reports everything the child ate and drank in the previous 24 hours. The caregiver uses a standardized booklet to aid in estimating portion sizes. |
| Evidence status | EMA-assisted recalls have shown promise in increasing accuracy and reducing misreporting in dietary assessment; however, published evidence is limited and further research is needed, particularly in young children using proxy reporting. | Traditional multi-pass 24-hour recall is widely used in pediatric nutrition research but is prone to recall bias and underreporting. Validation studies indicate moderate to low accuracy in reporting true energy intake by caregivers for preschool children. |
| Important limitations | Requires access to a compatible smartphone, repeated photo uploads, and caregiver adherence at every eating occasion. Ease of use and acceptability depend on caregiver comfort with technology, and little is known about proxy report reliability in very young children. | Dependent on caregiver memory and honesty, limited by recall bias, memory errors, social desirability, and known to underreport true intake in young children. No real-time data capture. |
Disclaimer: This comparison is created with the help of artificial intelligence(AI) and may contain errors or missing information. It is not medical advice and does not mean one option is better or safer than another. Clinical trials are still being studied, and joining a trial is your choice. Please consult your healthcare professional before making any decisions.
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Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 screening and enrollment visit
Duration - Approximately 1 week including dietary assessment days
Participants provide study foods to their child for one meal and two snacks over three consecutive days. The primary caregiver completes a traditional 24-hour dietary recall via telephone the following day using the USDA five-step multiple-pass method.
1 telephone dietary recall visit after 3 days of feeding
Duration - 2 weeks
Participants have a two-week break between dietary assessment conditions to avoid carryover effects.
No visits during this period
Duration - Approximately 1 week including dietary assessment days
Participants provide study foods to their child for one meal and two snacks over three consecutive days. Caregivers and a second adult caregiver upload pre- and post-meal photographs of the child’s eating occasions using an online EMA platform. The primary caregiver completes a 24-hour dietary recall via telephone using the USDA five-step multiple-pass method the day after food consumption, aided by the photographs.
Daily photo uploads over 3 days and 1 telephone dietary recall visit
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
RANDOMIZED
Model
CROSSOVER
Primary Purpose
OTHER
Number of Arms
2
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https://pubmed.ncbi.nlm.nih.gov/30060605/The University of Tennessee, Knoxville
Lead Sponsor