Evaluation of the Automated Self‐Administered 24‐hour Dietary Assessment Tool (ASA24) for use with children: An observational feeding study
Authors: Kirkpatrick Sharon , Raffoul Amanda , Sacco Jocelyn , Lee Kirsten , Chen Emily , Pasha Saamir , Marcinow Michelle , Orr Sarah , Hobin Erin 
Published: November 2023

With technological innovation, it is now possible to collect 24‐hour dietary recalls in a broader range of studies than previously possible. The Automated Self‐Administered 24‐hour Dietary Assessment Tool (ASA24), a web‐based tool that enables self‐administered 24‐hour recalls (24HRs), has been shown to be feasible and perform well in terms of capturing true intake in samples of adults. However, data to inform use with children are limited. This observational feeding study was conducted to evaluate children's ability to accurately report a lunch time meal using ASA24. The study was conducted among children in grades 5–8 (ages 10–13 years) within a school setting and involved consuming a study‐provided lunch, with consumption unobtrusively documented, during a regular lunch period. Students were served an individual cheese pizza, baby carrots, ranch dip, yogurt, a cookie, and a choice of water, juice, or milk. Plate waste was collected and weighed. The following day, participants were asked to complete ASA24, along with a demographic and health questionnaire, within a 50–60 minute class period. A total of 98 children participated in both days of the study. The majority (n=82) were asked to complete ASA24‐2016; in one grade 5 class, 16 students completed ASA24‐Kids for comparison purposes. Several children did not fully complete ASA24 and true intake data were missing for a small number due to logistical challenges in collecting plate waste within classroom settings. This left 61 recalls that included sufficient detail for food codes to be assigned within the ASA24 system and for which true intake was known. Among these, 7 recalled lunches did not match what was served and were excluded from further analysis, leaving 54 recalls. This subsample of 54 children reported matches for 73% of the foods and beverages actually consumed. When stricter criteria were applied (e.g., only cheese pizza and not other varieties of pizza considered an exact match), 60.1% of matches were considered exact, 30.3% were close, and 9.6% were far. Median completion time decreased from 51 minutes among 10 year olds to 33 minutes among 13 year olds. Observation of children during ASA24 completion suggested they were enthusiastic about completing it but many had difficulty navigating the steps independently; this was particularly true for children in grades 5 and 6 compared to those in grades 7 and 8. Overall, this study suggests that supports may be required to help children complete ASA24; this may include the use of the demonstration version to familiarize them with the steps.Support or Funding InformationThis study was supported by the Public Health Ontario Project Initiation Fund and a Canadian Cancer Society Research Institute Capacity Development Award (grant 702855 held by S. Kirkpatrick). The authors are grateful to collaborators Jess Haines, Paula Robson, Amy Subar, and Michelle Vine, as well as Fei Zuo for assistance with data collection.