Nutrients, Vol. 17, Pages 3145: Integration of the PortionSize Ed App into SNAP-Ed for Improving Diet Quality Among Adolescents in Hawaiʻi: A Randomized Pilot Study
Nutrients doi: 10.3390/nu17193145
Authors:
Emerald S. Proctor
Kiari H. L. Aveiro
Ian Pagano
Lynne R. Wilkens
Leihua Park
Leilani Spencer
Jeannie Butel
Corby K. Martin
John W. Apolzan
Rachel Novotny
John Kearney
Chloe P. Lozano
Background/Objectives: Coupling mobile health (mHealth) technology with community-based nutrition programs may enhance diet quality in adolescents. This pilot study evaluated the feasibility, acceptability, and preliminary efficacy of integrating PortionSize Ed (PSEd), an image-assisted dietary assessment and education app, into the six-week Hawaiʻi Food and Lifeskills for Youth (HI-FLY) curriculum delivered via Supplemental Nutrition Assistance Program Education (SNAP-Ed). Methods: Adolescents (grades 6–8) from two classrooms were cluster-randomized into HI-FLY or HI-FLY + PSEd. Both groups received HI-FLY and completed Youth Questionnaires (YQ) and food records (written or app-based) at Weeks 0 and 7. Feasibility and acceptability were assessed via enrollment, attrition, and User Satisfaction Surveys (USS). Diet quality was measured using Healthy Eating Index-2020 (HEI-2020) scores and analyzed via mixed-effects models. Results: Of 50 students, 42 (84%) enrolled and attrition was minimal (2.4%). The sample was 49% female and 85% at least part Native Hawaiian or Pacific Islander (NHPI). PSEd was acceptable, with average USS scores above the scale midpoint. No significant HEI-2020 changes were observed, though YQ responses indicated improvements in sugary drink intake (p = 0.03) and use of nutrition labels in HI-FLY + PSEd (p = 0.0007). Conclusions: Integrating PSEd into SNAP-Ed was feasible, acceptable, and demonstrated potential healthy behavior change among predominantly NHPI youth in Hawaiʻi.
Background/Objectives: Coupling mobile health (mHealth) technology with community-based nutrition programs may enhance diet quality in adolescents. This pilot study evaluated the feasibility, acceptability, and preliminary efficacy of integrating PortionSize Ed (PSEd), an image-assisted dietary assessment and education app, into the six-week Hawaiʻi Food and Lifeskills for Youth (HI-FLY) curriculum delivered via Supplemental Nutrition Assistance Program Education (SNAP-Ed). Methods: Adolescents (grades 6–8) from two classrooms were cluster-randomized into HI-FLY or HI-FLY + PSEd. Both groups received HI-FLY and completed Youth Questionnaires (YQ) and food records (written or app-based) at Weeks 0 and 7. Feasibility and acceptability were assessed via enrollment, attrition, and User Satisfaction Surveys (USS). Diet quality was measured using Healthy Eating Index-2020 (HEI-2020) scores and analyzed via mixed-effects models. Results: Of 50 students, 42 (84%) enrolled and attrition was minimal (2.4%). The sample was 49% female and 85% at least part Native Hawaiian or Pacific Islander (NHPI). PSEd was acceptable, with average USS scores above the scale midpoint. No significant HEI-2020 changes were observed, though YQ responses indicated improvements in sugary drink intake (p = 0.03) and use of nutrition labels in HI-FLY + PSEd (p = 0.0007). Conclusions: Integrating PSEd into SNAP-Ed was feasible, acceptable, and demonstrated potential healthy behavior change among predominantly NHPI youth in Hawaiʻi. Read More