Relative validity of multiple telephone versus face-to-face 24-hour dietary recalls

Design of the CHARGE study: A randomized control trial evaluating a novel treatment for Veterans with binge eating disorder and overweight and obesity

A large number of Veterans experience binge eating and overweight or obesity, which are associated with significant health and psychological consequences. The gold-standard program for the treatment of binge eating, Cognitive Behavioral Therapy (CBT), results in decreases in binge eating frequency but does not result in significant weight loss. We developed the Regulation of Cues (ROC) program to reduce overeating and binge eating through improvement in sensitivity to appetitive cues and decreased responsivity to external cues, an approach that has never been tested among Veterans. In this study, we combined ROC with energy restriction recommendations from behavioral weight loss (ROC+). This study is a 2-arm randomized controlled trial designed to evaluate the feasibility and acceptability of ROC+, and to compare the efficacy of ROC+ and CBT on reduction of binge eating, weight, and energy intake over 5-months of treatment and 6-month follow-up. Study recruitment completed in March 2022. One hundred and twenty-nine Veterans were randomized (mean age = 47.10 (sd = 11.3) years; 41% female, mean BMI = 34.8 (sd = 4.7); 33% Hispanic) and assessments were conducted at baseline, during treatment and at post-treatment. The final 6-month follow-ups will be completed in April 2023. Targeting novel mechanisms including sensitivity to internal cures and responsivity to external cues is critically important to improve binge eating and weight-loss programs among Veterans. Clinicaltrials.govNCT03678766.

Bone mineral density and normal-weight obesity syndrome: beyond body weight and body mass index

INTRODUCTION

This study aimed to evaluate, for the first time, the bone profile of adult women and men with and without normal-weight obesity (NWO) syndrome and its association with bone health-related nutrient intake, anthropometry, and body composition.

MATERIALS AND METHODS

This was a cross-sectional study of adults aged between 20 and 59 years with normal body weight, separated according to body fat (BF) percentage into NWO and non-NWO syndrome groups. BF > 30% and > 19% were considered high for women and men, respectively. Socioeconomic, physical activity, food consumption, anthropometric, and body composition data were evaluated. Student's t-test or Mann-Whitney test and Pearson's χ² or Fisher's exact tests were applied for comparisons. Multiple linear regression models were developed, with bone parameters as the dependent variables and anthropometric, body composition, and food consumption data as the main independent variables.

RESULTS

The sample consisted of 224 adults (69.2% women) with a median (interquartile range) age of 23 (21-25) years, 71% of whom had NWO syndrome. Compared with women, a higher percentage of men had a lower-than-expected spinal bone mineral density (BMD) Z-score for age (10%; p = 0.0214). Bone parameters were similar between groups. Spinal BMD was negatively associated with male sex and positively associated with body weight. The femoral BMD was negatively associated with BF percentage and positively associated with body mass index.

CONCLUSION

The negative association of BMD with BF percentage may suggest a higher risk of bone alterations in individuals with NWO syndrome and should be monitored over time.

Intake Differences between Subsequent 24-h Dietary Recalls Create Significant Reporting Bias in Adults with Obesity

In depth understanding of the dietary patterns of individuals with obesity is needed in practice and research, in order to support dietitians and physicians in the design and implementation of nutritional management. We aimed to analyze the consistency of energy, macro-, and micronutrient reported intakes in four non-consecutive 24-h dietary recalls from 388 adults with obesity using information collected in the NutriGen Study (ClinicalTrials.gov, NCT02837367). Significant decreases were identified for reported energy and several, macro- and micronutrient intakes, between the first and subsequent 24-h recalls. Significant differences of reported intakes were identified in sensitivity analyses, suggesting that the first recall (also the only one performed on site, face-to-face) might be a point of bias. A comparison of the differences in intakes between weekend and weekday, after adjustment for false discovery rate were non-statistically significant either in male, females, or in total. To overcome this potential bias, studies should be carefully conducted, starting from the design phase, through to the analysis and interpretation phases of the study. Prior to averaging specific intakes across all sessions of reporting, a preliminary analysis must be conducted to identify if a certain time point had significant differences from all other time points and overview potential sources of bias: reporting bias, training bias, or behavioral changes could be responsible for such differences.

Comparison of the eating behaviour and dietary consumption in older adults with and without visual impairment

Globally, a high prevalence of obesity and undernutrition has been reported in people with visual impairment (VI) who have reported multi-factorial obstacles that prevent them from achieving a healthy diet, such as having restricted shopping and cooking abilities. The present study is the first to investigate the relationship between VI and dietary consumption using a representative sample size, standardised methods to categorise VI and a detailed analysis of dietary consumption. Ninety-six participants with VI and an age-matched control group of fifty participants were recruited from across the UK. All participants were aged 50 years or over. The participants completed a 24-h food recall for a period of 3 d. The participants also answered questions about their abilities to shop for and cook food as well as their knowledge of healthy eating. The participants with VI in this sample consumed significantly fewer energy content and other nutrients than is recommended for their age group and when compared with an age-matched control group. The participants with VI mainly made food choices irrespective of nutritional value. The results of the present study highlight for the first time that a large proportion of older adults with VI in the UK are undernourished. These results suggest local and government-led initiatives should be implemented to support the diets of older adults in the UK, and these initiatives could include healthy eating workshops, café clubs or skills training and rehabilitation.

The Association between the Mediterranean Dietary Pattern and Cognitive Health: A Systematic Review

The ageing population is accompanied by increased rates of cognitive decline and dementia. Not only does cognitive decline have a profound impact on an individual's health and quality of life, but also on that of their caregivers. The Mediterranean diet (MD) has been known to aid in reducing the risk of cardiovascular diseases, cancer and diabetes. It has been recently linked to better cognitive function in the elderly population. The purpose of this review was to compile evidence based data that examined the effect of adherence to the MD on cognitive function and the risk of developing dementia or Alzheimer's disease. This review followed PRISMA guidelines and was conducted using four databases and resulted in 31 articles of interest. Cross-sectional studies and cohort studies in the non-Mediterranean region showed mixed results. However, cohort studies in the Mediterranean region and randomized controlled trials showed more cohesive outcomes of the beneficial effect of the MD on cognitive function. Although more standardized and in-depth studies are needed to strengthen the existing body of evidence, results from this review indicate that the Mediterranean diet could play a major role in cognitive health and risk of Alzheimer's disease and dementia.

Evaluating the Effectiveness of Home Health as a Disease Management Strategy

Home health (HH) is considered by many to be complementary to existing disease management (DM) programs, or even suitable as a stand-alone DM intervention. The advantage is thought to be with the face-to-face interaction, in contrast to the standard DM telephonic interview. However, much of the literature appears to indicate that telecommunication is as successful as face-to-face contact (typically referred to as “usual care”) for administering health surveys, providing counseling, changing health behaviors, and monitoring physiologic functioning. Given the desire to expand into the area of DM, HH agencies will need to identify and demonstrate areas in which they have a clinical and competitive edge over traditional DM models. This article describes and provides examples of three research designs that may assist the HH industry in evaluating their effectiveness in delivering DM services: the randomized controlled trial, the regression-discontinuity design, and case-control matching on the propensity score.

Dietary assessment methods for intakes of iron, calcium, selenium, zinc and iodine

The EURopean micronutrient RECommendations Aligned (EURRECA) Network of Excellence is working towards developing aligned micronutrient recommendations across Europe. The purpose of the present study was to conduct a review of methods used in validation studies carried out in adults assessing dietary intake of EURRECA priority minerals. A search strategy and inclusion criteria were defined and a scoring system was developed to rate the quality of each validation study that produced a quality index with possible scores obtained ranging from 0.5 to 7. A MEDLINE and EMBASE literature review was conducted. Articles/validation studies meeting the inclusion criteria included: 79/88 for Fe; 95/104 for Ca; 13/15 for Se; 29/30 for Zn; 7/9 for iodine. The most frequently used method to ascertain dietary intake was the Food Frequency Questionnaire (FFQ), whereas dietary records (DR) and 24 h recalls were the most used reference methods. The correlation coefficients (CC) between study mineral intakes estimated by FFQ and the reference method were weighted according to the study's quality index and obtained acceptable to good ratings, ranging from 0.36 to 0.60 when the reference method was DR and from 0.41 to 0.58 when the reference was 24 h recalls. A minority of studies (n 9) used biomarkers for validation and among these, five included iodine obtaining a CC of 0.47. The FFQ was seen as a valid method for assessing mineral intake, particularly for Ca and, to a lower extent, for iodine and Zn. Se and Fe showed only acceptable correlations. The present review provides new insights regarding the characteristics that assessment methods for dietary mineral intakes should fulfil.

Association of low intake of milk and vitamin D during pregnancy with decreased birth weight

BACKGROUND

Some pregnant women may be advised or choose to restrict milk consumption and may not take appropriate supplements. We hypothesized that maternal milk restriction during pregnancy, which can reduce intakes of protein, calcium, riboflavin and vitamin D, might represent a health risk by lowering infant birth weight.

METHODS

We screened women between the ages of 19 and 45 years who were attending prenatal programs in Calgary, Alberta (51 degrees N) for low milk consumption (< or = 250 mL/d). Using repeat dietary recalls, we compared these women and their offspring with women whose daily milk consumption exceeded 250 mL (1 cup). Birth weight, length and head circumference were obtained from birth records.

RESULTS

Women who consumed < or = 250 mL/d of milk (n = 72) gave birth to infants who weighed less than those born to women who consumed more (n = 207; 3410 g v. 3530 g, respectively; p = 0.07). Infant lengths and head circumferences were similar. Women who restricted milk intake had statistically significantly lower intakes of protein and vitamin D as well. In multivariate analyses controlled for previously established predictors of infant birth weight, milk consumption and vitamin D intake were both significant predictors of birth weight. Each additional cup of milk daily was associated with a 41 g increase in birth weight (95% confidence interval [CI] 14.0-75.1 g); each additional microgram of vitamin D, with an 11 g increase (95% CI 1.2-20.7 g). Neither protein, riboflavin nor calcium intake was found to predict birth weight.

INTERPRETATION

Milk and vitamin D intakes during pregnancy are each associated with infant birth weight, independently of other risk factors.

Validation of a brief telephone battery for neurocognitive assessment of patients with pulmonary arterial hypertension

BACKGROUND

The effects of pulmonary arterial hypertension on brain function are not understood, despite patients' frequent complaints of cognitive difficulties. Using clinical instruments normally administered during standard in-person assessment of neurocognitive function in adults, we assembled a battery of tests designed for administration over the telephone. The purpose was to improve patient participation, facilitate repeated test administration, and reduce the cost of research on the neuropsychological consequences of acute and chronic cardiorespiratory diseases. We undertook this study to validate telephone administration of the tests.

METHODS

23 adults with pulmonary arterial hypertension underwent neurocognitive assessment using both standard in-person and telephone test administration, and the results of the two methods compared using interclass correlations.

RESULTS

For most of the tests in the battery, scores from the telephone assessment correlated strongly with those obtained by in-person administration of the same tests. Interclass correlations between 0.5 and 0.8 were observed for tests that assessed attention, memory, concentration/working memory, reasoning, and language/crystallized intelligence (p < or = 0.05 for each). Interclass correlations for the Hayling Sentence Completion test of executive function approached significance (p = 0.09). All telephone tests were completed within one hour.

CONCLUSION

Administration of this neurocognitive test battery by telephone should facilitate assessment of neuropsychological deficits among patients with pulmonary arterial hypertension living across broad geographical areas, and may be useful for monitoring changes in neurocognitive function in response to PAH-specific therapy or disease progression.

Comparación entre encuestas telefónicas y encuestas «cara a cara» domiciliarias en la estimación de hábitos de salud y prácticas preventivas

OBJECTIVE

This study examines the influence of the interview method (telephone or face-to-face in households) on the assessment of health behaviors and preventive practices.

MATERIAL AND METHOD

The same questionnaire was completed by two independent samples of the population aged 18-64 years living in the municipality of Madrid. One sample (n = 1,391 subjects) completed the questionnaire by telephone interview and the other (n = 739) by face-to-face interview in households. The results of the two samples for 28 variables related to anthropometry, physical activity, food consumption, tobacco and alcohol use, preventive practices and injuries were compared.

RESULTS

The telephone sample had a higher rate of failed contact (31.8% vs. 22.2%) but a greater degree of cooperation than the sample for the face-to-face interview (83.0% vs. 74.0%). In total, 19 of the 28 variables showed a relative variation of less than 10% between the two surveys; the differences found were between 10 and 20% for eight variables and were higher than 20% for one variable. Differences were statistically significant for only four variables (sedentary leisure time, consumption of vegetables, giving up smoking and cholesterol measurement), with a relative variation of 6.1% (p < 0.01), 10% (p < 0.001), 36.7% (p < 0.01) and 8.6% (p < 0.01), respectively. The total cost of the telephone interview was half that of the face-to-face household interview.

CONCLUSIONS

The results of both surveys were very similar. Because of its lower cost, the telephone interview is a good option in public health research when data collection by interview is required.

Accuracy of fourth-graders' dietary recalls of school breakfast and school lunch validated with observations: in-person versus telephone interviews

OBJECTIVE

To investigate the accuracy of children's dietary recalls of school breakfast and school lunch validated with observations and obtained during in-person versus telephone interviews.

DESIGN

Each child was observed eating school breakfast and school lunch and was interviewed that evening about that day's intake.

SETTING

Ten elementary schools.

PARTICIPANTS

A sample of fourth-graders was randomly selected within race (black, white) and gender strata, observed, and interviewed in person (n = 33) or by telephone (n = 36).

MAIN OUTCOMES MEASURED

Rates for omissions (items observed but not reported) and intrusions (items reported but not observed) were calculated to determine accuracy for reporting items. A measure of total inaccuracy was calculated to determine inaccuracy for reporting items and amounts combined.

ANALYSIS

Analysis of variance; chi-square.

RESULTS

Interview type (in person, telephone) did not significantly affect recall accuracy. For omission rate, intrusion rate, and total inaccuracy, means were 34%, 19%, and 4.6 servings for in-person recalls and 32%, 16%, and 4.3 servings for telephone recalls of school breakfast and school lunch.

CONCLUSIONS AND IMPLICATIONS

The accuracy of children's recalls of school breakfast and school lunch is not significantly different whether obtained in person or by telephone. Whether interviewed in person or by telephone, children reported only 67% of items observed; furthermore, 17% of items reported were not observed.

Comparison of telephone vs face-to-face interviews in the assessment of dietary intake by the 24 h recall EPIC SOFT program--the Norwegian calibration study

OBJECTIVE

To compare food group intakes in grams, total energy and energy contribution from macronutrients between two random samples of women, using a standardized computer program (EPIC SOFT) with either a face-to-face or a telephone 24 h recall interview design.

METHODS

Two groups of Norwegian women living in Tromsø were drawn at random from the Norwegian Women and Cancer Study (NOWAC) cohort. The EPIC SOFT computer program was used to conduct single 24 h dietary recalls either by telephone or face to face. For the latter, 160 women were invited, of whom 111 responded positively (crude response rate=69.4%) and 102 were interviewed. For the telephone option, 180 were invited to participate, 109 responded positively (crude response rate=60.6%) and 103 were interviewed.

RESULTS

The two groups of women were similar with respect to age, body mass index, basal metabolic rate, smoking, education, physical activity and special diet status. No statistically significant difference in dietary intake was found between interviews conducted by telephone and face-to-face, except for 'egg and egg products' (P<0.01), for which intake was higher in the telephone group. Total energy intake differed, but the difference was attributable to one interviewer. The distribution of energy-contributing nutrients was not significantly different between groups, except for reported energy percentage from protein (P=0.02), which was significantly higher in the face-to-face group.

CONCLUSION

The telephone vs face-to-face interview design did not influence recalled diet when using the EPIC SOFT program.

Comparison of self-assessment of solvent exposure with measurement and professional assessment for female petrochemical workers in China

OBJECTIVE

The primary objective of this paper is to examine the validity of self-assessment of solvent exposure by comparing it with professional assessment and actual measurements.

METHODS

Self-assessment of exposures to benzene, toluene, styrene, and xylene was obtained from 132 female workers. The exposures were also estimated by an occupational hygienist and by actual measurement. Self-assessment, professional assessment, and measurement were then compared with each other.

RESULTS

Fair to good agreement was found between self-assessment, professional assessment, and measurement for benzene, styrene, and xylene. The agreement between self-assessment and measurement was poor for toluene, whereas the agreement between self-assessment and professional assessment was good. The latter was caused by a biased professional assessment.

CONCLUSIONS

Workers' self-assessment and professional assessment provided useful information for benzene, styrene, and xylene exposure, but not for toluene exposure. False agreement can be obtained when professional assessment was used as reference in validity study.

Validity of a telephone-administered 24-hour dietary recall in telephone and non-telephone households in the rural Lower Mississippi Delta region

OBJECTIVE

To determine if 24-hour dietary recall data are influenced by whether data are collected by telephone or face-to-face interviews in telephone and non-telephone households.

DESIGN

Dual sampling frame of telephone and non-telephone households. In telephone households, participants completed a 24-hour dietary recall either by face-to-face interview or telephone interview. In non-telephone households, participants completed a 24-hour dietary recall either by face-to-face interview or by using a cellular telephone provided by a field interviewer.

SUBJECTS/SETTING

Four hundred nine participants from the rural Delta region of Arkansas, Louisiana, and Mississippi.

MAIN OUTCOME MEASURES

Mean energy and protein intakes.

STATISTICAL ANALYSES PERFORMED

Comparison of telephone and non-telephone households, controlling for type of interview, and comparison of telephone and face-to-face interviews in each household type using unpaired t tests and linear regression, adjusting for gender, age, and body mass index.

RESULTS

Mean differences between telephone and face-to-face interviews for telephone households were -171 kcal (P = 0.1) and -6.9 g protein (P = 0.2), and for non-telephone households -143 kcal (P = 0.6) and 0.4 g protein (P = 1.0). Mean differences between telephone and non-telephone households for telephone interviews were 0 kcal (P = 1.0) and -0.9 g protein (P = 0.9), and for face-to-face interviews 28 kcal (P = 0.9) and 6.4 g protein (P = 0.5). Findings persisted when adjusted for gender, age, and body mass index. No statistically significant differences were detected for mean energy or protein intake between telephone and face-to-face interviews or between telephone and non-telephone households.

APPLICATIONS/CONCLUSIONS

These data provide support that telephone surveys adequately describe energy and protein intakes for a rural, low-income population.

Comparison of the effectiveness of a telephone 24-hour dietary recall method vs an in-person method among urban African-American women

OBJECTIVE

To examine the comparative accuracy of telephone and in-person 24-hour dietary recall methods.

SUBJECTS

One hundred eighty-five African-American females, aged 40 years and older, recruited from Sunday church services in Baltimore City, Md.

METHODS

Participants were trained to estimate portion size with plastic food models and a 2-dimensional food recall booklet. Dietary intake was then assessed with 2 in-person 24-hour dietary recalls and 1 telephone 24-hour dietary recall, all using a computer-assisted, multiple pass approach. Results from the 2 in-person recalls were averaged and compared with the results from the telephone recall.

STATISTICAL ANALYSES

Cross-tabulation, paired t test, Pearson's correlation, chance-corrected agreement, and stepwise linear regression analyses were performed.

RESULTS

There were no significant differences between the telephone and in-person methods for any nutrient. Agreement between methods was moderate for all major dietary components, with corrected correlations between methods ranging from 0.26 to 0.97 (P<.001), and kappas ranging from 0.155 to 0.372 (P<.01). Levels of low-energy reporting were high (88% telephone, 91% in-person), though there were no significant differences between methods.

CONCLUSIONS

The telephone 24-hour dietary recall method appears to be comparable to the standard in-person method among older African-American women. Portion-size training in person may make subsequent telephone dietary recalls acceptable in this population.

In-person vs telephone-administered multiple-pass 24-hour recalls in women: validation with doubly labeled water

OBJECTIVE

To determine the accuracy of energy intakes estimated with the multiple-pass 24-hour recall method in women by conducting in-person and telephone interviews. Doubly labeled water measurements of total energy expenditure were used for validation.

SUBJECTS

Thirty-five weight-stable women (mean age = 30 years, range = 19 to 46 years) participated.

DESIGN

Total energy expenditure was measured over a 14-day period using the doubly labeled water method. During this time, 4 multiple-pass 24-hour recalls were obtained from the women (2 in-person, 2 by telephone) who were provided 2-dimensional food models to estimate portion sizes. The Food Intake Analysis System was used to analyze recall data.

STATISTICAL ANALYSES

Paired t tests were conducted to examine differences between energy intake estimated from the telephone and in-person interviews. Agreement between the energy intake estimates from the telephone recalls and the in-person recalls was assessed using the technique of Bland and Altman. Paired t tests were used to compare energy intake estimated from the telephone and in-person recalls to total energy expenditure.

RESULTS

No significant difference in mean daily energy intake was found between the telephone (2,253 +/- 688 kcal) and in-person (2,173 +/- 656 kcal) interviews (P = .36). However, the mean energy intake from each interview method was significantly lower than total energy expenditure (2,644 +/- 503 kcal) (P = .006 and .001, respectively).

APPLICATIONS/CONCLUSIONS

Underreporting of energy intake was widespread in the sample. Although the multiple-pass 24-hour recall method did not generate a group measure of energy intake that was accurate or unbiased, the telephone-administered multiple-pass 24-hour recall was just as effective in estimating energy intake as the recall administered in-person. Dietetics professionals should be aware of the pervasive and serious problem of under-reporting of self-reported food intakes.

The use of telephone interview methodology to obtain 24-hour dietary recalls

OBJECTIVE

To compare 24-hour dietary recalls collected over the telephone to in-person recalls collected in the 1994-1996 Continuing Survey of Food Intakes by Individuals (CSFII).

DESIGN

Trained interviewers collected 24-hour dietary recalls over the telephone using the multiple-pass approach. These results were compared to in-person interviews from a pooled subsample of CSFII respondents.

SUBJECTS/SETTING

List-assisted random-digit dialing was used to identify 700 women between the ages of 20 and 49 years. One eligible woman per household was selected to participate.

STATISTICAL ANALYSES

Approximate t tests to examine differences in average nutrient and energy intakes were conducted on weighted data.

RESULTS

The reported intakes of most nutrients in the current 24-hour dietary recalls collected over the telephone were significantly higher than those reported in the 1994 and 1995 CSFII, but there were no significant differences between the telephone survey and 1996 CSFII results. The 24-hour dietary recalls collected over the telephone yielded consistently greater mean nutrient intake per respondent compared with a comparable pooled subsample from the 1994, 1995, and 1996 CSFII. Generally, no significant differences were found in the food group data between the telephone survey and the CSFII survey. Mean dietary intakes reported by the comparable CSFII subsample increased from 1994 to 1996.

APPLICATIONS

Collecting 24-hour dietary recalls over the telephone is a practical and valid data collection tool for use in national food consumption surveys.

Time-tradeoff values and standard-gamble utilities assessed during telephone interviews versus face-to-face interviews

The purpose of this study was to compare time-tradeoff values and standard-gamble utilities obtained during telephone interviews with those obtained through face-to-face interviews. Sixty-five patients with peripheral arterial occlusive disease completed both interviews. One week prior to the telephone interview, the patients received by mail a questionnaire in which the value and utility measures were presented in writing. The face-to-face interviews used the same questions, but the interviewer used visual aids. The mean time-tradeoff values were 0.84 (SD 0.20) vs 0.86 (SD 0.17) for the telephone and face-to-face interviews, respectively (p = 0.31). The mean standard-gamble utilities were 0.93 (SD 0.16) vs 0.92 (SD 0.17) for the telephone and face-to-face interviews, respectively (p = 0.26). In conclusion, telephone interviews yield similar time-tradeoff values and standard-gamble utilities compared with face-to-face interviews, suggesting that telephone interviews can replace face-to-face interviews.

Nutritional factors in cancer prevention

Current epidemiologic and laboratory evidence suggests that nutritional factors may play an important role in chemoprevention, although the relative importance of that role for the various micronutrients and dietary constituents is still unclear. The complexity of this area of investigation and practice clearly requires knowledge of the relevant measurement tools, chemistry, biology, and food science, and also the limitations that must be considered in the interpretation of nutritional data. Despite the challenges encountered in translation to clinical research and practice, nutrition remains a promising area of chemoprevention, likely to yield important information and strategies with a large public health impact.

Telephone vs face-to-face interviews for quantitative food frequency assessment

OBJECTIVE

To develop and test a quantitative food frequency method for administration by telephone.

DESIGN

A comparison study of telephone and face-to-face interviews was conducted among a representative sample of the five major ethnic groups in Oahu, Hawaii. Two interviews were administered 4 to 6 months apart by trained interviewers using identical questionnaires and color photographs of food items showing three different portion sizes. The order of the interviewing methods was randomly assigned. The questionnaire included 115 food items selected to estimate 80% or more of usual dietary intakes. Frequencies and quantities of each item consumed during the past year were obtained.

SUBJECTS/SETTING

Subjects were recruited from the Health Surveillance Program of the Hawaii State Department of Health and consisted of 167 men and 158 women, aged 45 to 74 years, who provided a telephone number. Eighty percent of the face-to-face interviews were conducted in the subjects' homes and 20% were conducted at the workplace or the University of Hawaii Cancer Research Center, if requested.

STATISTICAL ANALYSES

The paired t test was used to compare the mean daily intakes obtained by the telephone and face-to-face methods. Agreement was measured by the intraclass correlation coefficient (ICC), Pearson correlation coefficient and weighted kappa statistic.

RESULTS

The means of energy and each nutrient were slightly higher in the first interview than the second, regardless of the interviewing method. Because of close correspondence among all 3 statistical measures of agreement, only the ICCs are reported. The ICCs ranged from .61 for protein and vitamin A to .69 for dietary cholesterol among men, and from .61 for vitamin C to .74 for saturated fat among women. Agreement was not significantly affected by age, gender, ethnicity, order of interview, or educational level.

APPLICATIONS

Telephone interviews to obtain quantitative food frequencies are cost-efficient methods for estimating usual dietary intakes among persons in widely scattered geographic areas. Photographs of the foods in 3 portion sizes mailed in advance help the respondents estimate amounts eaten.