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Background: Qualitative methods were used to better understand how to obtain interviewer-administered recalls of physical activity from children., Methods: Subjects were 24 third- and fifth-grade children from 1 school in Columbia, South Carolina. Cognitive interviews targeted different retention intervals (about the same or previous school day). Round 1's protocols used an open format and had 4 phases (obtain free recall, review free recall, obtain details, review details). Round 2's protocols used a chronological format and had 3 phases (obtain free recall, obtain details, review details). Trained coders identified discrepancies across interview phases in children's recalls of physical activity at physical education (PE) and recess. Based on the school's schedule, children's reports of PE and recess were classified as omissions (scheduled but unreported) or intrusions (unscheduled but reported)., Results: Across interview phases, there were numerous discrepancies for Round 1 (regardless of grade, sex, or retention interval) but few discrepancies for Round 2. For Rounds 1 and 2, respectively, 0% and 0% of children omitted PE, while 33% and 0% intruded PE; 44% and 56% of children omitted recess, while 33% and 0% intruded recess., Conclusions: Results provide important information for facilitating interviewer-administered recalls of physical activity with elementary-age children.

Background: Accurate information about children's intake is crucial for national nutrition policy and for research and clinical activities. To analyze accuracy for reporting energy and nutrients, most validation studies utilize the "conventional approach," which was not designed to capture errors of reported foods and amounts. The "reporting-error-sensitive approach" captures errors of reported foods and amounts., Objective: To extend results to energy and macronutrients for a validation study concerning retention interval (elapsed time between to-be-reported meals and the interview) and accuracy for reporting school-meal intake, the conventional and reporting-error-sensitive approaches were compared. DESIGN AND PARTICIPANTS/SETTING: Fourth-grade children (n=374) were observed eating two school meals, and interviewed to obtain a 24-hour recall using one of six interview conditions from crossing two target periods (prior 24 hours and previous day) with three interview times (morning, afternoon, and evening). Data were collected in one district during three school years (2004-2005, 2005-2006, and 2006-2007)., Main Outcome Measures: Report rates (reported/observed), correspondence rates (correctly reported/observed), and inflation ratios (intruded/observed) were calculated for energy and macronutrients., Statistical Analyses Performed: For each outcome measure, mixed-model analysis of variance was conducted with target period, interview time, their interaction, and sex in the model; results were adjusted for school year and interviewer., Results: With the conventional approach, report rates for energy and macronutrients did not differ by target period, interview time, their interaction, or sex. With the reporting-error-sensitive approach, correspondence rates for energy and macronutrients differed by target period (four P values <0.0001) and the target period by interview-time interaction (four P values <0.0001); inflation ratios for energy and macronutrients differed by target period (four P values <0.0001), and inflation ratios for energy and carbohydrate differed by the target period by interview-time interaction (both P values <0.005)., Conclusions: Shortening the retention interval of dietary recalls increases accuracy for reporting energy and macronutrients. For validation studies, it is best to obtain reference information from a method that provides details about foods and amounts consumed and to use an analytic approach that captures errors of reported foods and amounts., (2010 American Dietetic Association. Published by Elsevier Inc. All rights reserved.)

Objective: To use data from a published validation study concerning retention interval and school food-service production records to examine intrusions (uneaten items reported eaten) in the school-meal parts of 24 h recalls., Design: For that study, children were observed eating two school meals (breakfast, lunch) and interviewed under one of six conditions from two target periods (previous day (PDTP), prior 24 h (24TP)) crossed with three interview times (morning, afternoon (AIT), evening). For the present article, a catalogue was constructed of foods available for that study's school meals. The study's intrusions were classified as stretches (on children's meal trays but uneaten), internal confabulations (in children's school food-service environments for that meal but not on children's trays) or external confabulations (not in children's school food-service environments for that meal). Occurrence, types and amounts of intrusions were investigated., Setting/subjects: Six schools; sixty fourth-grade children (ten per condition)., Results: For breakfast, for the 24TP v. PDTP, reported items were less likely to be intrusions, internal confabulations and external confabulations; and intrusions were more likely to be stretches. For lunch, for the 24TP-AIT condition v. the other five conditions, reported items were less likely to be intrusions and external confabulations. Mean amounts reported eaten were smaller for stretches than for internal confabulations or external confabulations at breakfast, and for stretches than for internal confabulations at lunch., Conclusions: Accuracy was better for the 24TP (with fewer intrusions of which proportionally more were stretches which had smaller amounts reported eaten) than for the PDTP. Studies with 24 h recalls should minimize retention interval to improve accuracy.

Objective: To investigate whether school-meal observations influenced children's 24-hour dietary recalls., Study Design and Setting: Over three school years, 555 randomly selected fourth-grade children were interviewed to obtain a 24-hour dietary recall; before being interviewed, 374 children were observed eating two school meals (breakfast, lunch), and 181 children were not observed. Within observation-status groups (observed, unobserved), children were randomized within sex to one of six combinations from two target periods (prior 24 hours, previous day) crossed with three interview times (morning, afternoon, evening)., Results: For each of the five variables (interview length, meals/snacks, meal components, items, kilocalories), naïve and adjusted equivalence tests rejected that observation-status groups were different, indicating that school-meal observations did not influence children's 24-hour dietary recalls. There was a target-period effect on length (P<0.0001) (longer for prior-24-hour recalls), a school year effect on length (P=0.0002) (longer for third year), and a target period-interview time interaction on items (P=0.0110) and kilocalories (P=0.0047) (both smaller for previous-day recalls in the afternoon than prior-24-hour recalls in the afternoon and previous-day recalls in the evening), indicating that variables were sufficiently sensitive and psychometrically reliable., Conclusion: Conclusions about 24-hour dietary recalls by fourth-grade children observed eating school meals in validation studies are generalizable to 24-hour dietary recalls by comparable but unobserved children in nonvalidation studies.

Background: For a 24-hour dietary recall, two possible target periods are the prior 24 hours (24 hours immediately preceding the interview time) and previous day (midnight to midnight of the day before the interview), and three possible interview times are morning, afternoon, and evening. Target period and interview time determine the retention interval (elapsed time between to-be-reported meals and the interview), which, along with intervening meals, can influence reporting accuracy., Objective: The effects of target period and interview time on children's accuracy for reporting school meals during 24-hour dietary recalls were investigated. DESIGN AND SUBJECTS/SETTING: During the 2004-2005, 2005-2006, and 2006-2007 school years in Columbia, SC, each of 374 randomly selected fourth-grade children (96% African American) was observed eating two consecutive school meals (breakfast and lunch) and interviewed to obtain a 24-hour dietary recall using one of six conditions defined by crossing two target periods with three interview times. Each condition had 62 or 64 children (half boys)., Main Outcome Measures: Accuracy for reporting school meals was quantified by calculating rates for omissions (food items observed eaten but unreported) and intrusions (food items reported eaten but unobserved); a measure of total inaccuracy combined errors for reporting food items and amounts., Statistical Analyses Performed: For each accuracy measure, analysis of variance was conducted with target period, interview time, their interaction, sex, interviewer, and school year in the model., Results: There was a target-period effect and a target-period by interview-time interaction on omission rates, intrusion rates, and total inaccuracy (six P values <0.004). For prior-24-hour recalls compared to previous-day recalls, and for prior-24-hour recalls in the afternoon and evening compared to previous-day recalls in the afternoon and evening, omission rates were better by one third, intrusion rates were better by one half, and total inaccuracy was better by one third., Conclusions: To enhance children's dietary recall accuracy, target periods and interview times that minimize the retention interval should be chosen.

For school breakfast each day, many elementary schools offer a choice between a cold option that includes ready-to-eat (RTE) cereal and a hot option that includes a non-RTE-cereal entrée such as waffles. For breakfast reports, intrusions (reports of uneaten items) in correctly reported and misreported breakfast options were examined using data from five dietary-reporting validation studies. In each study, fourth-grade children were observed eating school breakfast and school lunch and then interviewed to obtain a dietary recall. A breakfast option was correctly reported in 240 breakfast reports for 203 intrusions total, and misreported in 97 breakfast reports for 189 intrusions total. Asymmetry was evident in misreported options; specifically, children observed eating a cold option almost never misreported a hot option, but children observed eating a hot option often misreported a cold option. Proportionately more breakfast reports were intrusion-free when a breakfast option was correctly reported than misreported. Linking of intrusions (i.e., multiple intrusions from the same option in a breakfast report) was especially evident with misreported breakfast options. Methodological aspects of dietary recalls such as target period (prior 24h; previous day), interview time (morning; afternoon; evening), and interview format (meal; open) had implications for intrusions and misreported breakfast options.

Validation-study data and foodservice production records were analyzed to test hypotheses concerning sources of intrusions (reports of uneaten items) in the school-meal parts of children's dietary recalls. Each child was observed eating school meals on two days, and interviewed the morning after each observation day; one interview used forward-order (morning-to-evening) and one used reverse-order (evening-to-morning) prompts. Lunch intrusions were likelier to have been available in the foodservice environment at lunch as day before the interview came closer, and on days before than after the interview. Temporal dating errors are contributing sources of intrusions in the school-lunch parts of children's recalls.

Background: Intrusions in dietary recalls may originate in confusion of episodic memories manifested as temporal dating errors., Objective: Data from a validation study (concerning reporting accuracy over multiple recalls) and school foodservice production records were used to investigate origins of intrusions in school meals in children's 24-hour recalls. DESIGN/SUBJECTS/SETTING: During the 1999-2000 school year, 104 fourth-grade children were observed eating school meals on 1 to 3 nonconsecutive days separated by >or=25 days, and interviewed about the previous day's intake in the morning on the day after each observation day., Statistical Analyses Performed: For breakfast and lunch separately, logistic regression was used to investigate the effect of time (ie, days) before the interview day on the probability that intrusions referred to items available in the school foodservice environment. Exploratory analyses were conducted for breakfast options observed and/or reported eaten., Results: For interviews in which reported meals met criteria to be considered school meals and that contained intrusions, of 634 and 699 items reported eaten at breakfast and lunch, respectively, 394 and 331 were intrusions. Availability in the school foodservice environment of items referred to by intrusions in reports of lunch, but not breakfast, decreased as days increased before the interview day (P=0.031 and P=0.285, respectively). Concerning breakfast, children observed eating a cold option (ie, ready-to-eat cereal, milk, juice, crackers [graham or animal]) almost always reported a cold option, whereas children observed eating a hot option (ie, non-ready-to-eat cereal entrée [eg, sausage biscuit], milk, and fruit or juice) reported a cold option in approximately 50% of interviews., Conclusions: In children's 24-hour recalls, confusion of episodic memories contributes to intrusions in school lunch, and generic dietary information (eg, cold option items available daily) or confusion of episodic memories may contribute to intrusions in school breakfast. Understanding the origins of intrusions may help in developing interview methods to decrease the occurrence of intrusions.

Objective: To compare reporting accuracy for breakfast and lunch in 2 studies., Design: Children were observed eating school meals and interviewed the following morning about the previous day. In Study 1, 104 children were each interviewed 1 to 3 times with >or=25 days separating any 2 interviews. In Study 2, 121 children were each interviewed once in forward (morning-to-evening) and once in reverse (evening-to-morning) order, with these interviews separated by >or=29 days., Setting: 12 schools., Participants: Fourth-grade children., Main Outcome Measures: For each meal, food-item variables (observed number, reported number, omission rate, intrusion rate, total inaccuracy) and kcal variables (observed, reported, correspondence rate, inflation ratio)., Analysis: General linear mixed models., Results: For each study, observed and reported numbers of items and kcal, and correspondence rate (reporting accuracy), were greater for lunch than for breakfast; omission rate, intrusion rate, and inflation ratio (measures of reporting error) were greater for breakfast than for lunch. In Study 1, for each meal over interviews, total inaccuracy decreased and correspondence rate increased. In Study 2, for each meal for boys for reverse and for girls for forward order, omission rate was lower and correspondence rate was higher., Conclusions and Implications: Breakfast was reported less accurately than lunch. Despite improvement over interviews (Study 1) and differences for order x sex (Study 2), reporting accuracy was low for breakfast and lunch.

Objective: Validation-study data are used to illustrate that conventional energy and macronutrient (protein, carbohydrate, fat) variables, which disregard accuracy of reported items and amounts, misrepresent reporting accuracy. Reporting-error-sensitive variables are proposed which classify reported items as matches or intrusions, and reported amounts as corresponding or overreported., Methods: 58 girls and 63 boys were each observed eating school meals on 2 days separated by > or =4 weeks, and interviewed the morning after each observation day. One interview per child had forward-order (morning-to-evening) prompts; one had reverse-order prompts. Original food-item-level analyses found a sex-x-order prompt interaction for omission rates. Current analyses compared reference (observed) and reported information transformed to energy and macronutrients., Results: Using conventional variables, reported amounts were less than reference amounts (ps<0.001; paired t-tests); report rates were higher for the first than second interview for energy, protein, and carbohydrate (ps< or =0.049; mixed models). Using reporting-error-sensitive variables, correspondence rates were higher for girls with forward- but boys with reverse-order prompts (ps< or =0.041; mixed models); inflation ratios were lower with reverse- than forward-order prompts for energy, carbohydrate, and fat (ps< or =0.045; mixed models)., Conclusions: Conventional variables overestimated reporting accuracy and masked order prompt and sex effects. Reporting-error-sensitive variables are recommended when assessing accuracy for energy and macronutrients in validation studies.

Quality control is an important aspect of a study because the quality of data collected provides a foundation for the conclusions drawn from the study. For studies that include interviews, establishing quality control for interviews is critical in ascertaining whether interviews are conducted according to protocol. Despite the importance of quality control for interviews, few studies adequately document the quality control procedures used during data collection. This article reviews quality control for interviews and describes methods and results of quality control for interviews from two of our studies regarding the accuracy of children's dietary recalls; the focus is on quality control regarding interviewer performance during the interview, and examples are provided from studies with children. For our two studies, every interview was audio recorded and transcribed. The audio recording and typed transcript from one interview conducted by each research dietitian either weekly or daily were randomly selected and reviewed by another research dietitian, who completed a standardized quality control for interviews checklist.Major strengths of the methods of quality control for interviews in our two studies include: (a) interviews obtained for data collection were randomly selected for quality control for interviews, and (b) quality control for interviews was assessed on a regular basis throughout data collection. The methods of quality control for interviews described may help researchers design appropriate methods of quality control for interviews for future studies.

This article (a) provides a general review of interobserver reliability (IOR) and (b) describes our method for assessing IOR for items and amounts consumed during school meals for a series of studies regarding the accuracy of fourth-grade children's dietary recalls validated with direct observation of school meals. A widely used validation method for dietary assessment is direct observation of meals. Although many studies utilize several people to conduct direct observations, few published studies indicate whether IOR was assessed. Assessment of IOR is necessary to determine that the information collected does not depend on who conducted the observation. Two strengths of our method for assessing IOR are that IOR was assessed regularly throughout the data collection period and that IOR was assessed for foods at the item and amount level instead of at the nutrient level. Adequate agreement among observers is essential to the reasoning behind using observation as a validation tool. Readers are encouraged to question the results of studies that fail to mention and/or to include the results for assessment of IOR when multiple people have conducted observations.

Purpose: This study evaluated the effect of recency on accuracy of fourth-graders' dietary reports., Methods: Each of 60 randomly selected children was observed eating school meals (breakfast, lunch) and interviewed to obtain a 24-hour dietary recall using one of six conditions generated by crossing two target periods (previous day, prior 24 hours) with three interview times (morning, afternoon, evening), with 10 children (5 males) per condition. Accuracy of the school meal portions of each recall was assessed by comparing reports to observations. 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 combined errors for reporting items and amounts., Results: Using the prior 24 hours as the target period yielded better performance than did using the previous day: Omission rates were lower by about one-third, intrusion rates by about one-half, and total inaccuracy by about one-third (all p's<0.01). A marginally significant interaction of target period by interview time was found for omission rate (p=0.08), but not for intrusion rate (p=0.15) or for total inaccuracy (p=0.47)., Conclusions: This provides evidence that recency influences children's recall accuracy and demonstrates the importance of an awareness of principles of memory when designing what are essentially memory tests for epidemiologic studies.

Background: Do children recall school breakfast and school lunch intake during 24-h recalls more accurately when prompted to report meals and snacks in reverse versus forward order?, Methods: One hundred twenty-one fourth-graders stratified by race (Black, White) and gender were each observed and interviewed twice (once per order) regarding the previous day's intake. Omission and intrusion rates determined accuracy for reporting items. Total inaccuracy determined accuracy for reporting items and amounts., Results: Results failed to indicate significant effects of interviewer, weekday, sequence (first or second recall), or race on omission rates, intrusion rates, or total inaccuracy. A significant order by gender interaction was found for omission rates, which were lower (i.e., better) for males for reverse (53%) versus forward recalls (62%), but not females (61 versus 53%) (P < 0.008). Intrusion rates were acceptable for males for 54% of reverse recalls and 40% of forward recalls (P = 0.095). Means were 57 and 32%, and 6.4 servings for omission rate, intrusion rate, and total inaccuracy for reverse recalls, and 56 and 39%, and 6.9 servings for forward recalls., Conclusions: Prompting children to report in reverse versus forward order improved omission and intrusion rates for males more so than females. Regardless of reverse or forward order, children reported <50% of items observed; furthermore, >30% of items reported were not observed. Research is needed to enhance accuracy of children's dietary recalls.

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.

Objective: To determine the accuracy and consistency of fourth-graders' school breakfast and school lunch recalls obtained during 24-hour recalls and compared with observed intake., Design: Children were interviewed using a multiple-pass protocol at school the morning after being observed eating school breakfast and school lunch., Subjects: 104 children stratified by ethnicity (African-American, white) and gender were randomly selected and interviewed up to 3 times each with 4 to 14 weeks between each interview., Statistical Analysis: Match, omission, and intrusion rates to determine accuracy of reporting items; arithmetic and/or absolute differences to determine accuracy for reporting amounts; total inaccuracy to determine inaccuracy for reporting items and amounts combined; intraclass correlation coefficients (ICC) to determine consistency., Results: Means were 51% for omission rate, 39% for intrusion rate, and 7.1 servings for total inaccuracy. Total inaccuracy decreased significantly from the first to the third recall (P=0.006). The ICC was 0.29 for total inaccuracy and 0.15 for omission rate. For all meal components except bread/grain and beverage, there were more omissions than intrusions. Mean arithmetic and absolute differences per serving in amount reported for matches were -0.08 and 0.24, respectively. Mean amounts per serving of omissions and intrusions were 0.86 and 0.80, respectively., Applications/conclusions: The low accuracy and low consistency of children's recalls from this study raise concerns regarding the current uses of dietary recalls obtained from children. To improve the accuracy and consistency of children's dietary recalls, validation studies are needed to determine the best way(s) to interview children.

A validation study of children's dietary reporting provided an opportunity to investigate whether cognitive ability is a source of systematic error in dietary recalls. From the fall of 2004 through the spring of 2007, fourth-grade children (n = 374) in Columbia, South Carolina, were observed eating school meals and interviewed to obtain 24-hour dietary recalls; subsequently, measures of dietary reporting error were calculated. The common factor extracted from 4 subject-area achievement tests (scores on which were provided by the school district for 362 children) was used as a measure of cognitive ability. For the 325 children who reported school meals that met the criteria to be reports about school meals, as cognitive ability increased, dietary reporting error decreased; the relation between cognitive ability and dietary reporting performance was stronger among girls than among boys. The mean cognitive ability for 37 children who reported no meals that satisfied the criteria for being reports about school meals was significantly lower than that for the 325 children who reported meals that satisfied these criteria. These findings indicate that cognitive ability is a source of systematic error in children's dietary recalls. More generally, the quality of epidemiologic survey data may depend systematically on the cognitive ability of respondents. [ABSTRACT FROM PUBLISHER]

Abstract: In dietary recall for a specified target period, an intrusion denotes an item reported eaten that was not consumed during that period. Intrusions may denote items available during the specified period, items consumed during other periods, or items from general knowledge of dietary intake. To investigate a cognitive basis of intrusions, we analyzed data from a dietary-reporting validation study in which 69 fourth-grade children were observed eating 2 school meals (breakfast and lunch) and interviewed that evening about that day''s intake in person or by telephone. Of 450 items reported eaten for school meals, 82 were intrusions. Observations and school food service production records were used to determine whether items denoted by intrusions were available in school food service environments on the interview day, as many as 3 school days prior to the interview day, and the day following the interview. Availability of items denoted by intrusions decreased backward over days from the interview day, and decreased from the interview day to the following day. Among 40 children who reported at least 1 intrusion, mean number of intrusions (controlling for number of items reported) increased as interviews occurred later in the week. These results are consistent with the idea that some intrusions are based on specific memories of items encountered but not eaten during the target period, or encountered before the target period. Other intrusions are likely based on general dietary knowledge. It may be possible to design interview techniques to reduce the occurrence of intrusions that are incorrectly based on specific memories. [Copyright &y& Elsevier]