Transcript Presentation Title

Clinical Nutrition
King Saud University
Done by:
Mona Al-Dubayan
24-Hour Dietary
Recall
Mona Aldubayan
Noha Barnawi
Sara Al-Rashid
Outline
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What is 24-hour Dietary Recall?
24-Hour Food Recall Kit
Purpose & Goal
The Interview (Opening – Ending)
Multi-Pass Method
Types of Questions
Summary
What is it?
• Twenty-four hour diet recall interview is a quantitative
research method used in nutritional assessment, and
asks individuals to recall foods and beverage they
consumed in the twenty-four hours prior to the
interview.
• It can self-administered or administered by a trained
professional.
• Specifically:
- What food/drink was consumed?
- How much was consumed?
- Time it was consumed?
- How was it prepared?
- How was it served?
- Specifics of food (low fat, 1%, whole)
Self-administered Form
• Twenty-four hour recalls are easy to use, but do require
the use of context specific props for accuracy.
• Use of props is important in order to obtain accurate
information on the amounts of foods and beverages
consumed.
• Researchers should use items that the individuals are
comfortable with and make sure that they reflect
accurate amounts. EX: 24-Hour Food Recall Kit
24-Hour Food Recall Kit
• Purpose: To assist paraprofessional/interviewer in
taking the food recall and estimating the amounts
more accurately.
Kit contains:
o Measuring cups and spoons (Liquid and Dry)
- 1 tablespoon,1 teaspoon, 1/2 teaspoon, 1/4
teaspoon
- 4 oz. cup, 8 oz. cup, 12 oz, 16 oz, cup
o CD- 1 slice of bread
o Deck of cards or the palm of your hand = 3oz
o Food Models
24-Hour Food Recall Kit.
Cont,
o Red Dinner Plate, to use as a visual to measure out
portions or determine how large a pizza slice or a
portion of dessert might be.
o Ask questions such as, “Did it take up the whole
plate? Was it half a plate a fourth of the plate?”
o Plastic container of 2 to 3 cups of rice.
o Rice will be used as an example of measuring more
dense foods such as mashed potatoes and
oatmeal.
o Plastic container of 2 to 3 cups dried beans or dry
cereal.
o Beans or cereal may be used as an example of
measuring foods that are more loosely packed,
such as dry cereal or vegetables
Purpose & Goal
• Purpose: To gain information regarding the
participant’s diet. This information will be used to
determine the nutritional and educational needs of the
participant.
• Food recalls are also used to evaluate the effectiveness
of the nutrition program.
• Goal: To get accurate and complete listing of all food
and drink consumed in the last 24 hours.
Preparation for Interview
• Review medical record & info
• Make the environment comfortable
- Keep desk neat
- Choose private & quiet location, away from
distractions
• Set up the food models to help client recall
amounts/portions
Opening the Interview
• Build Rapport (sympathetic, trusting, & friendly
relationship)
- Greet client, use their name & appropriate title
(Mr./Ms), ask them what they’d like to be called
- Children, use first name
- Introduce yourself and title
- Small talk
- Express your interest to help
- Encourage client to express themselves/ask
burning questions
Opening the Interview,
Cont
- Let client know you will do a 24 hr recall, explain:
 What it is
 Discuss purpose of what you will do with client
info.
 How long it will take
- Privacy
 Only staff will see client info., on a need to know
basis to perform assessment
Start the Interview
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Explain to the participant that you need to know only
what she (he) actually ate. She (he) should not feel
embarrassed about any food, as there are no “good” or
“bad” foods. No one eats just the right foods all the time.
Do not express in words or facial expressions either
approval or disapproval of foods mentioned by the
participant.
Begin by asking open ended questions. Save close ended
questions for later
Do not ask leading questions that would lead the
participant to feel she (he) “should” have had a certain
item and, thus say that they did. Use your Food Recall Kit
to determine the amounts of foods consumed. Begin by
asking open ended questions. Example: (“You don’t drink
whole milk, do you?”)
Avoid labeling meals, breakfast/lunch/dinner
6.
Use your Food Recall Kit to determine the amounts of
foods consumed. If a home recipe was used, obtain a
copy. If food was eaten in a restaurant, record the name
or type of restaurant.
6.
Start with the most recent meal or snack that the
participant consumed.
– Work backwards to cover all foods and beverage
consumed in the last 24 hours or in a “typical day”.
Weekends and holidays are not typical days and
recalls from these days may provide an inaccurate
view of the participant’s diet.
Multi-Pass Method
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Step #1 Quick List
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Step #2 Detailed Description
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Step #3 Review
1.Quick List
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Get a list of all foods eaten without trying to
determine amounts
– The client should tell you everything eaten or drunk,
including snacks, coffee breaks, even carbonated
water – either eaten at home or away from home.
– To obtain this list of foods from the participant use
the following types of probes to find what foods
were eaten:
A. The first type of probing is related to time.
 Examples:
– “At what time was this? Did you eat or drink anything
before or after that?”
– “What did you have at that time?”
– “At what time did you go to bed?”
Quick List, Cont.
B. The second type of probe is related to the participant’s
activities.
o Examples:
• “What did you do this morning?”
• “While you were working around the house, did you take
a break to have something to eat or drink?”
• “Did you watch TV last night? When you watched TV, did
you eat anything?”
• “Did you have anything to drink with this?”
Quick List, Cont.
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The third type of probe tries to get more complete
information about foods already reported.
Examples:
“Do you remember anything else that you ate or drank
with this food?”
“What else did you have at this meal?”
“Was the (bread, vegetable) eaten plain or did you put
something on it?
“Did you have anything in your coffee?”
“Did you have a second helping?”
2.Detailed Description
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This will include recording preparation method, brand
name, portion size, and the time the food or beverage
was consumed.
– Determine if all of the food was eaten or if some
food was left on the plate.
– Encourage the participant to describe foods as
clearly as possible.
– interviewer may have to restate questions to get
more information.
– Describe combination dishes carefully. Mixtures such
as sandwiches, soups, stew, pizza, casseroles, etc. can
be prepared in many ways.
– Ask to see packages, if available, on prepackaged
foods, and record brand name and other pertinent
information.
3.Review
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Once the 24 hour food recall is complete read the list
back to the participant. Ask the participant if the recall is
correct or if they forgot to mention any food that was
consumed.
Closing The Interview
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End when objective has been achieved or when client is
tiring
Discuss questions/comments client might have
Thank client for his/her patience & cooperation
Types of Questions
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Open or neutral questions: explanatory response; allows
the client to talk about information that he/she feels is
important.
– Start with what, how or when or an open statement.
– “Tell me about your favorite foods.”
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Closed Ended question: require only a yes or no answer
and provide no additional information. Can be used to
ask for specific information but fail to reveal anything
else about a client’s attitude.
– “Do you salt your food at the table?”
– “Have you tried to lose weight before?”
Types of Questions. Cont,
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Leading questions: interviewer makes suggestions about
the desired or expected answer
– “You don’t drink whole milk, do you?”
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Behavioral questions: For the client to change
undesirable eating habits, it is important to find out what
he/she eats, not what he/she knows about choosing
foods.
– “What methods have you tried to lose weight?”
Reluctant/uncomfortable
clients
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Question-framing
This strategy is needed for clients who are reluctant or
uncomfortable to reveal their true habits/behaviors.
Ask a series of “framed” questions, which allows the client
to Hypothesize about an imaginary situation and therefore
remove himself from a negative disclosure. For example:
CLIENT (overweight): I never eat sweets. In fact, I seldom
eat any Dessert.
INTERVIEWER: Let us for a moment imagine that you were
at a friend’s party and the only desserts being served were
cheese cake, chocolate mousse, and pecan pie. Which
would you choose?
CLIENT (a reluctant child): I don’t have favorite foods.
INTERVIEWER: Let us pretend you were invited to spend a
day at the beach with some friends. When asked to bring
your own food, which foods would you bring?
Summarized Tips for
better recalls
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Be Patient
Be non-judgmental
Allow client to talk without interruptions
Allow for questions and comments.
Don’t approve or disapprove with body language or
words
Use Food Models– ask the participant to point to serving
sizes.
Use open ended questions
Ask about added ingredients or condiments
Avoid Leading Questions