T. Ayodele1, S. Thom1, B. Sivakumar1, J. Arcand1
1Faculty of Health Sciences, Ontario Tech University, Oshawa, ON

Mobile Health (mHealth) interventions are capable of supporting dietary modification among patients with cardiovascular diseases (CVDs), a population with high rates of nonadherence. However, the ambiguous quality of dietary assessment methods used in mHealth intervention effectiveness studies limits the quality of their findings.

This secondary analysis of a systematic review assessed the overall quality and appropriateness of dietary assessment measures used in studies examining the impact of mHealth interventions on dietary adherence for the secondary prevention of CVD in adults.

The Ovid-Medline, Ovid Cochrane, CENTRAL, CINAHL, EMBASE, Scopus, Web of Science, ProQuest Dissertations/Theses and PsycINFO databases were searched. Studies were included if they involved adults with CVD, used mHealth interventions, measured dietary adherence, and were quasi-experimental or randomized controlled trials. Systematic reviews were excluded. After screening and review, thirteen studies and fourteen dietary assessment tools (one study used two tools) were evaluated for quality. Assessment criteria were developed to evaluate the quality of the primary dietary outcome measures in each study, informed by existing risk of bias assessment tools.

The majority (n=12) of dietary assessment tools relied on participant self-reports and two included objective urinary measures. Six tools were validated for measuring the nutrients/foods of interest, out of which, only three were validated for the intended populations. Only one tool was capable of assessing usual intake, with none of the remaining thirteen tools including adjustments to account for variation in day-to-day intake. Only two studies conducted assessments of over or under-reporting of nutrient/food intake.

The identified mHealth intervention studies used dietary assessment measures that had a high risk of bias from subjectivity, systematic error and lack of validation, sensitivity, and day-to-day variation assessments.

These findings highlight the need for using higher quality dietary assessment measures in mHealth nutrition intervention research for CVD management.

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