(P24-108-23) Automated Self-Administered 24-Hour Dietary Assessment Tool (ASA24) for Equitable Diet Data Collection in Primary Care

Objectives: As precision nutrition becomes important in chronic disease management, scalable strategies for collecting diet data in primary care clinics are needed. As tech-based solutions, such as ASA24, are increasingly used in clinical settings, we must investigate if these tools contribute to intervention-generated inequalities that exacerbate health disparities. We assessed differences between patients who were and were not able to complete ASA24 as part of a precision nutrition intervention in federally qualified healthcare center (FQHC) clinics.

Methods: FQHC staff texted English-/Spanish-speaking patients aged 18-64 with BMI ≥25kg/m² and upcoming appointments. Patients were screened for inclusion (smartphone, internet access) and exclusion (pregnancy, eating disorder) criteria. Consented patients reported age, sex, and completed a questionnaire. Patients viewed an instructional video and were then automatically directed to ASA24. A bilingual research assistant was available via phone to provide assistance. We used unpaired t-tests (continuous) and chi-square tests (categorical) to assess differences in age, sex, ethnicity, race, language, income, computer use, and health literacy (HL) between those who completed ASA24 independently and those who did not.

Results: Sixty-six patients consented to the study (mean age=48±10.9; 73% female; 58% Hispanic/Latinx; 15% Black, 5% American Indian/Alaska Native, 64% White, 9% self-described; 77% English-speaking; 56% had at least “enough to get by”; 64% used a computer; mean HL=4±1.4 of 3-9 with higher scores=worse HL). Those who did not complete ASA24 independently, including non-completers (n=27), were significantly older than those who completed ASA24 independently (n=39) (51.7±9.2 vs. 45.9±11.5, t=2.26, p=0.03). There were no other significant sociodemographic differences between groups. In the subset who did not complete ASA24 independently, mean age was not significantly different between non-completers and those who completed with assistance (p=0.64).

Conclusions: We found no evidence of racial/ethnic or socioeconomic disparities in independent ASA24 completion, and age-based disparities were mitigated by providing assistance. ASA24 presents a scalable, equitable option for diet data collection in FHQC clinic settings.

Funding Sources: Agency for Healthcare Research & Quality