Patterns of Engagement With an Application-Based Dietary Self-Monitoring Tool Within a Randomized Controlled Feasibility Trial.
The Dietary Approaches to Stop Hypertension dietary pattern is a proven way to manage hypertension, but adherence remains low. Dietary tracking applications offer a highly disseminable way to self-monitor intake on the pathway to reaching dietary goals but require consistent engagement to support behavior change. Few studies use longitudinal dietary self-monitoring data to assess trajectories and predictors of engagement. We used dietary self-monitoring data from participants in Dietary Approaches to Stop Hypertension Cloud (N=59), a feasibility trial to improve diet quality among women with hypertension, to identify trajectories of engagement and explore associations between participant characteristics.We used latent class growth modeling to identify trajectories of engagement with a publicly available diet tracking application and used bivariate and regression analyses to assess the associations of classifications of engagement with participant characteristics.We identified 2 latent classes of engagement: consistent engagers and disengagers. Consistent engagers were more likely to be older, more educated, and married or living with a partner. Although consistent engagers exhibited slightly greater changes in Dietary Approaches to Stop Hypertension score, the difference was not significant.This study highlights an important yet underutilized methodologic approach for uncovering dietary self-monitoring engagement patterns. Understanding how certain individuals engage with digital technologies is an important step toward designing cost-effective behavior change interventions.This study is registered at www.clinicaltrials.gov NCT03215472.
