# Evaluation of the Accuracy, Usability, and User Perspectives of the Ecological Momentary Dietary Assessment App Traqq Among Dutch Adolescents: Protocol for a Mixed Methods Study

## TL;DR

This study evaluates a smartphone app called Traqq for tracking dietary intake among Dutch adolescents, focusing on accuracy, usability, and user experience.

## Contribution

The study introduces a mixed-methods evaluation of Traqq's suitability for adolescents, a population with unique dietary tracking challenges.

## Key findings

- Traqq was used by 98 out of 102 adolescents, with high completion rates for dietary data collection.
- Usability and user perspectives were assessed through questionnaires and interviews to inform app customization.
- The study combines quantitative and qualitative methods to improve dietary assessment accuracy in adolescents.

## Abstract

Self-reported dietary intake data are crucial in nutrition and health research; however, their accuracy is compromised by challenges such as portion size estimations, food identification, memory-related bias, social desirability bias, and reactivity bias. Dietary assessment in adolescents is particularly challenging due to irregular eating habits, meal skipping, and parent or peer influences, potentially resulting in misreporting. Leveraging adolescents’ receptiveness to technology, we investigated the use of an innovative smartphone app (Traqq) that facilitates dietary assessment using repeated short recalls instead of traditional 24-hour recalls. Evaluation studies of the Traqq app in Dutch adults have shown successful results, but its suitability for other target populations, such as adolescents, requires further investigation.

We designed a comprehensive, 3-phase study to evaluate the Traqq app’s accuracy using repeated short recalls, usability, and user perspectives among Dutch adolescents aged 12 to 18 years. This manuscript details the study setup, research methods, and basic characteristics in phases 1 and 2.

In phase 1, adolescents (aged 12-18 years) downloaded the Traqq app and completed a demographic questionnaire. It was used on 4 random school days over 4 weeks, using 2-hour recalls on 2 days and 4-hour recalls on 2 days. A food frequency questionnaire and 2 interviewer-administered 24-hour recalls served as dietary reference methods to assess the Traqq app’s accuracy. In addition, usability was evaluated using the System Usability Scale and an experience questionnaire. In phase 2, user experiences were further explored through semistructured interviews within a subsample of 24 adolescents. These first 2 phases of this mixed methods study are now finalized for data collection. Phase 3 will focus on collecting user insights to inform app customization through cocreation sessions.

Recruitment concluded in September 2022 with 102 adolescents; 98 (96%) provided dietary data via the Traqq app, and 79 (78%) completed the evaluation questionnaire. Adolescents had a mean age of 15 (SD 2) years. The mean BMI was 19.9 (SD 3) kg/m2. A total of 64 (63%) participants were girls, 81 (84%) attended high school, and 88 (92%) were born in the Netherlands. Interviews were held with 6 (25%) boys and 18 (75%) girls. Cocreation sessions will be planned after all data have been analyzed.

In this holistic study, we combine quantitative and qualitative methods to evaluate the dietary assessment performance among adolescents of the Traqq app, which was initially designed for adults. Specifically, next to quantitative comparisons of the Traqq app’s dietary assessment methods, we conducted semistructured interviews, and we will carry out cocreation sessions. With this user-centered, synergistic approach, we aim to establish a list of requirements for a dietary assessment app for adolescents, resulting in more efficient assessments, improved compliance, and enhanced overall accuracy in this population.

ISRCTN Registry ISRCTN46230386; https://www.isrctn.com/ISRCTN46230386

DERR1-10.2196/70194