Development of the Intake24 New Zealand dietary feedback function: review of existing 24-hour recall tools and expert input

Abstract

National nutrition surveys are essential to inform public health policies and programmes by providing detailed information on the dietary intake and nutritional wellbeing of a population. In New Zealand (NZ), updated, high-quality population-level dietary data is urgently needed, as the last Adult Nutrition Survey was conducted in 2008/09. Researchers from the University of Auckland and Massey University developed tools and methods to support a future National Nutrition Survey, including Intake24-NZ, a web-based 24-hour dietary recall system(1). Beyond capturing dietary intake data, Intake24-NZ provides an opportunity to deliver tailored, evidence-based dietary feedback directly to participants and users, raising awareness of national dietary guidelines, directing users to reliable online resources, and improving nutrition literacy. This research describes the development of a tailored dietary feedback function within Intake24-NZ and its pilot testing with NZ registered nutrition professionals to identify improvements in accuracy, cultural safety and relevance for Māori and other ethnic groups, and appropriateness for public use. Key feedback features of three existing international 24-hour dietary recall tools (ASA24-United States, Intake24-United Kingdom, myfood24-Australia) were reviewed to guide the development of the Intake24-NZ dietary feedback function. Relevant nutrients were selected based on the reviews, alongside other relevant dietary data sources and expert consultation. Nutrient recommendations were based on the NZ Eating and Activity Guidelines for Adults, Australia/NZ Nutrient Reference Values, and World Health Organization guidelines. A sample of NZ registered dietitians and nutritionists reviewed a prototype dietary feedback report and completed an 18-item acceptability questionnaire. Quantitative data was summarised descriptively and qualitative feedback thematically analysed to identify suggestions for improvement. The review of feedback features of existing tools collated information on layout, content, tailoring, and use of disclaimers. Preliminary development of the Intake24-NZ feedback function resulted in an interactive design featuring ‘nutrient tiles’ with expandable ‘tell me more’ sections. These display intakes for 11 key nutrients, along with disclaimers, practical dietary tips, population-level recommendations, and culturally relevant food examples. Māori health concepts and links to evidence-based nutrition and behaviour-change resources are embedded, with guidance on how to access further support. Full findings from the review, development process, and acceptability testing will be presented at the conference. This study provides a reproducible process for developing tailored dietary feedback for use in online 24-hour recall dietary assessment tools. Expert feedback is a vital step in the development process, providing a foundation for iterative refinement toward future implementation.