(LB03-15-25) Bridging Perception and Reality: The Need for mHealth Tools to Objectively Assess Nutritional Impact of SNAP-Ed Hawaii Among Early Adolescents

Objectives: To examine discrepancies between subjective (SNAP-Ed Youth Questionnaire, YQ) and objective (PortionSize Ed app, PSEd) dietary assessments among early adolescents, and explore whether PSEd can improve the evaluation of SNAP-Ed Hawaii’s nutritional impact.

Methods: One classroom in Hawaii (n=19, mix of grades 6-8) received a 6-week SNAP-Ed nutrition education program + PSEd. At weeks 0 and 7, participants recorded dietary intake via PSEd and completed a 15-item YQ. Participants also completed a demographics questionnaire at baseline. PSEd is a mobile health (mHealth) app for dietary assessment, which includes a nutrient database tailored for Hawaii. Once participants completed their food record using PSEd, diet quality was objectively assessed using Healthy Eating Index-2020 (HEI-2020) component scores including Total Fruits (/5), Total Vegetables (/5), Whole Grains (/10), and Added Sugars (/10), where a higher score is optimal. The YQ provides subjective self-evaluations of fruit, vegetable, whole grain, and sugary drink intake (scale 1-5 for all). For example, the YQ asks, “How often do you eat fruits?”, with responses ranging from 1=not very often to 5=very often. HEI components were compared to these four corresponding YQ food groups. Behavior change was analyzed using mixed effect models for both PSEd and YQ data, controlling key confounders. Cohen’s d indicated small, medium, and large effect sizes (≥0.2, ≥0.5, ≥0.8, respectively).

Results: Overall, 52.6% of participants were female and 73.7% identified as at least part Native Hawaiian/Pacific Islander. SNAP-Ed had a medium negative effect on fruit intake as per YQ responses (3.98→3.52, d=-0.70, p=0.13), whereas PSEd showed no effect (1.58→1.59, d=0.00, p=0.99). For sugary drinks, the YQ indicated a large negative effect (3.3→2.67, d=-0.81, p=0.09), while according to PSEd for “Added Sugar” there was a small negative effect (9.57→8.87, d=-0.45, p=0.33). The effect of SNAP-Ed on vegetable and whole grain intake showed consistency between the YQ and PSEd, which all had negligible to small effects.

Conclusions: The greatest discrepancies between the YQ and PSEd were observed for fruit and sugary drinks/added sugar intake. This highlights the need for integrating objective mHealth tools, like PSEd, into SNAP-Ed for accurately assessing nutritional impact.

Funding Sources: USDA, NIH, LACaTS, SNAP