TY  - JOUR
AU  - Henriksen, Hege Berg
AU  - Knudsen, Markus Dines
AU  - Carlsen, Monica Hauger
AU  - Hjartåker, Anette
AU  - Blomhoff, Rune
PY  - 2022
DA  - 2022/11/8
TI  - A Short Digital Food Frequency Questionnaire (DIGIKOST-FFQ) Assessing Dietary Intake and Other Lifestyle Factors Among Norwegians: Qualitative Evaluation With Focus Group Interviews and Usability Testing
JO  - JMIR Form Res
SP  - e35933
VL  - 6
IS  - 11
KW  - digital assessment tool
KW  - assessment tool
KW  - food frequency questionnaire
KW  - food
KW  - diet
KW  - nutrition
KW  - questionnaire
KW  - focus group
KW  - interview
KW  - usability
KW  - physical activity
KW  - lifestyle factor
KW  - dietary intake
KW  - digital health
KW  - chronic disease
KW  - chronic condition
KW  - health promotion
KW  - cancer
KW  - survivor
KW  - thematic analysis
KW  - research tool
KW  - measurement tool
AB  - Background: In-person dietary counseling and interventions have shown promising results in changing habits toward healthier lifestyles, but they are costly to implement in large populations. Developing digital tools to assess individual dietary intake and lifestyle with integrated personalized feedback systems may help overcome this challenge. We developed a short digital food frequency questionnaire, known as the DIGIKOST-FFQ, to assess diet and other lifestyle factors based on the Norwegian Food-Based Dietary Guidelines. The DIGIKOST-FFQ includes a personalized feedback system, the DIGIKOST report, that benchmarks diet and lifestyle habits. We used qualitative focus group interviews and usability tests to test the feasibility and usability of the DIGIKOST application. Objective: We aimed to explore attitudes, perceptions, and challenges in completing the DIGIKOST-FFQ. We also investigated perceptions and understanding of the personalized feedback in the DIGIKOST report and the technical flow and usability of the DIGIKOST-FFQ and the DIGIKOST report. Methods: Healthy individuals and cancer survivors were invited to participate in the focus group interviews. The transcripts were analyzed using thematic analysis. Another group of healthy individuals completed the usability testing, which was administered individually by a moderator and 2 observers. The results were analyzed based on predefined assignments and discussion with the participants about the interpretation of the DIGIKOST report and technical flow of the DIGIKOST-FFQ. Results: A total of 20 individuals participated in the focus group interviews, divided into 3 groups of healthy individuals and 3 groups of cancer survivors. Each group consisted of 3 to 4 individuals. Five main themes were investigated: (1) completion time (on average 19.1, SD 8.3, minutes, an acceptable duration), (2) layout (participants reported the DIGIKOST-FFQ was easy to navigate and had clear questions but presented challenges in reporting dietary intake, sedentary time, and physical activity in the last year), (3) questions (the introductory questions on habitual intake worked well), (4) pictures (the pictures were very helpful, but some portion sizes were difficult to differentiate and adding weight in grams would have been helpful), and (5) motivation (users were motivated to obtain personalized feedback). Four individuals participated in the usability testing. The results showed that the users could seamlessly log in, give consent, fill in the DIGIKOST-FFQ, and receive, print, and read the DIGIKOST report. However, parts of the report were perceived as difficult to interpret. Conclusions: The DIGIKOST-FFQ was overall well received by participants, who found it feasible to use; however, some adjustments with regard to reporting dietary intake and lifestyle habits were suggested. The DIGIKOST report with personalized feedback was the main motivation to complete the questionnaire. The results from the usability testing revealed a need for adjustments and updates to make the report easier to read. 
SN  - 2561-326X
UR  - https://formative.jmir.org/2022/11/e35933
UR  - https://doi.org/10.2196/35933
UR  - http://www.ncbi.nlm.nih.gov/pubmed/36346647
DO  - 10.2196/35933
ID  - info:doi/10.2196/35933
ER  -