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Novel Methodological Approaches to Address Social Drivers of Nutrition & Health (Poster Theater Flash Session 5)

(PTFS05-03-25) The PortionSize Ed Mobile App Demonstrated Feasibility, Acceptability, and Preliminary Efficacy for Improving Diet Quality Among Early Adolescents in SNAP-Ed Hawaii

Sunday, June 1, 2025
12:08 PM – 12:12 PM ET
Location: South Hall B (The Hub) - Poster Theater / Poster Board Number PT-3
Objectives: PortionSize Ed is a dietary assessment and nutrition education app that provides feedback on adherence to MyPlate recommendations. Objectives were to assess feasibility, acceptability, and preliminary efficacy of integrating PortionSize Ed into SNAP-Ed to improve diet quality (HEI-2020 scores) among early adolescents in Hawaii.

Methods: Two classrooms (n=25 students each, mix of grades 6 to 8) in Hawaii were randomized to receive the standard 6-week SNAP-Ed nutrition curriculum (SNAP-Ed) or SNAP-Ed with PortionSize Ed (PSEd). Among those who consented, baseline (n=41) demographics and anthropometric measures (ht, wt) were collected, and participants were trained to complete a written (SNAP-Ed) or mobile (PSEd) food record. Food records were completed pre and post intervention to assess change in HEI-2020 scores (scores range from 0-100, with 100 representing highest diet quality). Participants in PSEd were encouraged to record their intake with the app weekly to support behavior change. Participants completed a satisfaction survey (1–6-point Likert scale, with 6 being the best score). Change in HEI-2020 scores were assessed with mixed effect models, controlling for key covariates. Cohen d assessed effect size ( < 0.2, 0.2 ≤ to < 0.5, 0.5 ≤ to < 0.8, ≥ 0.8, >representing a negligible, small, medium, and large effects, respectively).

Results: 19 participants (57.9% females) were randomized to PSEd and 22 (45.5% female) to SNAP-Ed. Attrition was low (2.4%). Participants were in grades 6 (41.5%), 7 (31.7%), and 8 (26.8%), majority identified as Native Hawaiian or other Pacific Islander (70.8%), and 31.8% had overweight or obesity. Mean (±SD) scores for “was it easy to record what you ate?” were 4.4 (±1.3) for the written and 4.4 (±1.6) for the mobile food record. For females, there was a small positive effect on HEI-2020 scores for PSEd (44.2 to 46.0, p = 0.69, d = 0.2), medium negative effect for SNAP-Ed (44.8 to 40.6, p = 0.31, d = -0.6), and medium effect for change between study groups (p = 0.34, d = -0.6). For males, there was a large positive effect for PSEd (37.2 to 42.3, p = 0.34, d = 0.8), and SNAP-Ed (34.5 to 44.2, p = 0.02, d = 2.7), and medium effect for change between study groups (p=0.45, d= 0.5).

Conclusions: Incorporating PortionSize Ed into SNAP-Ed Hawaii is feasible and acceptable. A future study can be powered to determine efficacy.

Funding Sources: USDA, NIH, LACaTS, SNAP