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Pilot study: feasibility and evaluation
A-K. Illner1, U. Harttig1, G. Tognon2, S. Salvini2, P. Amiano3, E. Bower3, D. Engeset4, T. Kaasik5, H. Ward6
1 German Institute of Human Nutrition Potsdam-Rehbrücke, Germany2 Cancer Research and Prevention Institute Florence, Italy3 Public Health Division of Gipuzkoa, San Sebastian, Spain4 University of Tromsoe, Norway5 University of Tartu, Estonia6 University of Cambridge, UK
IDAMES Workshop, ICDAM7 06.04.2009 2
foster scientific knowledge of the design and feasibility of approaches that use multiple dietary assessment instruments, including internet-technologies
objective
IDAMES Workshop, ICDAM7 06.04.2009 3
completion of a web- or paper-based self-administered European Food Propensity Questionnaire (EFPQ) and three telephone-administered 24 hour dietary recalls (24HDR) in 400 participants from five ongoing cohort studies in Estonia, Italy, Spain, Norway, Germany
analysis of feasibility & comparison to the Calibration of Methods (COM) study conducted in EPIC-Norfolk (UK) with one 24HDR, three 7-day diaries and two FFQs
Design
IDAMES Workshop, ICDAM7 06.04.2009 4
developed on the basis of a validated German- specific 102-item FFQ applied in the EPIC-Potsdam cohort for the second dietary assessment that was palced on the web
by a web-based working procedure European experts reviewed and modified an English version of the FFQ appropriately to the dietary habits in their countries; the common European version then was translated & placed on the web
final EFPQ asks about the frequency of consumption of 116 foods during the preceding year, demonstrated with graphically displayed portion sizes
Development of web-based EFPQ
reference: https://nugo.dife.de/efbo/portal/en
IDAMES Workshop, ICDAM7 06.04.2009 5
Hanning, R. M., Woodruff, S. J., Lambraki, I., Jessup, L., Driezen, P., and Murphy, C. C. Nutrient intakes and food consumption patterns among Ontario students in grades six, seven, and eight. Can J Public Health, 98: 12-6, 2007;
Bälter, K., Bälter, O., Fondell, E. and Lagerros, Y. Web-based and mailed questionnaires: a comparison of response rates and compliance. Epidemiology, 16:4 S577-590, 2005.
common 6-languages Food Propensity Questionnaire:English, Italian, Norwegian, Spanish, Basque, Estonian, German
EFPQ: https://nugo.dife.de/efbo/portal/en
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source: https://nugo.dife.de/efbo/portal/en
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Response & participation rates
Table 1: Total response, participation and % distributions for the European Food Propensity Questionnaire (EFPQ) by IDAMES Center
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Reasons for non-participation
*non-participants with indication of reason
21,0
35,5
24,2
19,4
0,0
5,0
10,0
15,0
20,0
25,0
30,0
35,0
40,0
45,0
1
rea
so
n o
f n
on
-pa
rtic
ipa
tio
n (
%)
no interest no time, not availabe health constraints other
n = 62*/138 non-participants
Other: e.g. no internet, no computer
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General characteristics
Table 2: general characteristics of web-based EFPQ-users and Paper-EFPQ-users
IDAMES Workshop, ICDAM7 06.04.2009 15
Participation in 24HDRs
Table 3: participation rates in 24HDRs by IDAMES center
IDAMES Workshop, ICDAM7 06.04.2009 16
Completion time for web-based EFPQ
0,0
10,0
20,0
30,0
40,0
50,0
60,0
70,0
80,0
< 20 min 20 - <40 min 40 - <60 min 60 - <180 min >180 min
pro
po
rtio
n o
f su
bje
cts
(%)
Florence (I) Potsdam (D) San Sebastian (EE) Tartu (E) Tromsoe (NOR)
N = 26 N = 19 N = 11 N = 65 N = 21
Median completion time: 33.8 min
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Subjective completion time of web-based EFPQ
0,0
10,0
20,0
30,0
40,0
50,0
60,0
70,0
80,0
90,0
<20 min 20-<40 min 40-<60 min >=60 min
per
cen
tag
e o
f su
bje
cts
(%)
Florence (I) Potsdam (D) San Sebastian (EE) Tartu (E) Tromsoe (NOR)
N = 26 N = 19 N = 11 N = 65 N = 21
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Login counts for web-based EFPQ
0,0
10,0
20,0
30,0
40,0
50,0
60,0
70,0
1 login 2-3 logins 4-5 logins 6-8 logins
Florence (I) Potsdam (D) San Sebastian (EE) Tartu (E) Tromsoe (NOR)
N = 26 N = 19 N = 11 N = 65 N = 21
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Missing & implausible data
80-90% of the paper-based EFPQs contained missing or implausible data recontact was needed
30.9% of subjects reported to have diffilculties in estimating their food intake
questions about frequency of consumption about alcohol, mixed dishes
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summary
participation rate for the overall approach was moderate and differed between the centres
participation in the 24HDRs decreased accross the data collection rounds
the web-based EFPQ was feasible & flexible in terms of time & completion and well accepted among its users
this study supports the feasibility of using multiple dietary assessment methods within culturally different study populations, including internet- based instruments.
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Future perspectives
further development of the EFPQ is needed to refine its methodology for an enlarged application in other countries
generating a better understanding of the desgin and feasibility of approaches with several instruments
which and how many short-term instruments are needed?
IDAMES Workshop, ICDAM7 06.04.2009 22
Thank you for your attention!
European Food Propensity Questionnaire/EFPQ : https://nugo.dife.de/efbo/portal/de
All WP5partners:
Heiner Boeing
Ulrich Harttig
Heather Ward
Gianluca Tognon
Simonetta Salvini
Pilar Amiano
Dagrun Engeset
Taie Kaasik