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

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foster scientific knowledge of the design and feasibility of approaches that use multiple dietary assessment instruments, including internet-technologies

objective

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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

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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

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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

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Participation in 24HDRs

Table 3: participation rates in 24HDRs by IDAMES center

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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?

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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