Clare E Collins*, The University of Newcastle, AUSTRALIA, Callaghan, Australia Track: Practice Presentation Topic: Health information on the web: Supply and Demand Presentation Type: Oral presentation Submission Type: Single Presentation Building: Sheraton Maui Resort Room: B - Kapalua Date: 2014-11-14 09:45 AM – 10:30 AM Last modified: 2014-10-24

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Background: The Australian Dietary Guidelines (ADGs) recommend consuming a wide variety of nutritious food from core groups (breads and cereals, fruits, vegetables, dairy foods, lean meat, poultry, fish and vegetarian alternatives), while limiting foods which are nutrient poor. Adherence to ADGs and relationships with health outcomes have been evaluated for epidemiological purposes by diet quality indices or scores and shown to predict nutritional adequacy of dietary intake, risk factors for chronic conditions and total morbidity and mortality.
Objective: 1. To describe the adaptation of a validated brief diet quality index, the Australian Recommended Food Score (ARFS) into a free online format, the Healthy Eating Quiz (HEQ) and 2. To report data on HEQ use and scores obtained over the first two years.
Methods: The ARFS was developed to reflect adherence to the ADGs and modelled on the US Recommended Food Score. ARFS was derived from a 120-question semi-quantitative food frequency questionnaire (FFQ) and contains 70-questions in eight food group sub-scales (vegetables, fruit, meat/flesh foods, non-meat/flesh protein foods, breads/cereals, dairy foods, water and spreads/sauces). The total score ranges from 0 to 73. Validity of the relationship between ARFS and FFQ nutrients has been established in adults, adolescents, children and pre-schoolers.
Results: The ARFS was adapted into the online HEQ (www.healthyeatingquiz.com.au) using an iterative process between the programmer and research team. Individuals register a profile that includes basic demographics and indicate consent for data inclusion in research. In response to Version 1 user feedback, the second version was released 12 months later. The final format presents questions across eight screens and takes 5-minutes to complete, with system-generated real-time feedback, including suggestions for improving score components. Version 2 provides extended feedback information on why subscale food are important for health and nutrition, with drop-down menus added to reveal two additional categories of information (How to improve your score and Did you know?). Invitations to complete the HEQ were made via links embedded in program websites (e.g. Channel 10’s Biggest Loser TV, Back to Basics, Healthy Dads Healthy Kids) and media articles on nutrition. Since February 2012 >45000 people (82.2% female, 7.1% vegetarians, 29% aged 16-24year, 20.5% 25-34 years, 13% 35-44years, 12% 45-54 years) have completed the HEQ, with 2.6% return users, indicating that diet quality is commonly low (38% scored ≤32) to moderate (27% scored 33 to≤38) with only 10% achieving a high score (≥47). When examining sub-scales score distributions the proportion of people in the lowest category varied and in descending order were lean animal protein (55%), whole grains (46%), vegetables (38%), reduced fat dairy (37%) and fruit (35%). Spontaneous feedback indicates that HEQ users include individuals seeking feedback, school teachers using it within class, health promotion/researchers seeking fast ways to assess dietary patterns.
Conclusions: Current use of the HEQ as a novel tool to evaluate diet quality demonstrates that people are interested in online feedback on their dietary intake and that it has broad reach and appeal. Evaluation of use within an intervention to improve adherence to dietary guidelines is warranted.