Abstract
Background: Accurately measuring dietary intake can be challenging, especially with children. For this reason, wearable cameras are starting to be used in research as an alternative and complementary method for assessing diet. They have the potential for reducing participant burden and recall bias that can occur with traditional dietary assessment methods, such as diet recalls. However, little is known about children’s experiences with cameras and whether they alter their eating habits while wearing them.
Objective: To explore child and parent experiences of having wearable and stationary cameras in their home and perceived changes (if any) to their eating habits.
Design: Fifteen children (aged 11-15 years) and their parents took part in a qualitative study using semi-structured interviews to explore their experiences with cameras at home. This was part of a larger and ongoing study called BED (Bedtime Electronic Device) which is investigating the effects of evening and nighttime screen use on sleep, diet, and wellbeing using wearable and stationary cameras. Participants wear a camera for three hours before bedtime and are filmed overnight with a stationary camera on four evenings to measure their screen use. They also wear a Fitbit and accelerometer for eight days and nights, and complete daily surveys on sleep quality and wellbeing, as well as 24-hour diet recalls on three non-consecutive days in the study period. Qualitative interviews were completed on the final day of the study. Transcripts were coded and themes identified.
Results:
The mean age of the children was 12 years and 80% identified as NZ European only. Four themes were identified and described, based on the parents’ and/or children’s responses. One was ‘awareness’, where 33% participants and 53% parents reported becoming more aware of the wearable cameras, respectively. However, this was followed by an adjustment to the cameras during the other evenings. ‘Practicality and ease of use’ of the cameras was a second theme, referring to the physical discomfort and hindrance on evening activities (eating and leisure) that participants found while wearing them. A third theme denoted ‘social embarrassment’ included 80% of children expressing anticipated discomfort when asked about their willingness to wear the cameras in public places. Finally, 93% of participants reported making no changes to their regular eating habits and evening activities while wearing the cameras, referring to the theme ‘behaviour changes’. However, some children (33%) believed that the cameras were ineffective at capturing their food intake due to the position on their chest. Suggestions to improve the comfort and effectiveness of the cameras for capturing food intake included using smaller cameras located higher up on the chest or worn on the shoulder or head.
Conclusion:
This study has highlighted the potential for using wearable cameras as an alternative method for dietary assessment in children. Most of the children perceived no changes were made to their usual eating habits while wearing the cameras. Future research could implement these suggestions in addition to a longer period for wearing the cameras to capture total food intake across an entire day. This would allow for the data collected to be more representative of usual diets, as well as being in a more comfortable and discreet position to potentially mitigate participants’ social embarrassment.