Adapting ASA24 for Use with Children
Working in collaboration with the National Cancer Institute and Westat (the
social science research firm that developed and maintains ASA24), Dr. Tom
Baranowski of the Baylor College of Medicine led the effort to adapt the ASA24
Respondent Web site for use with children aged 10 years and older. Dr.
Baranowski built upon his earlier experience collecting intake data from
children using the Food Intake Recording Software System (FIRSSt), a
self-administered 24-hour recall system primarily designed to assess fruit and
vegetable intake among children. Compared to FIRSSt, ASA24-Kids collects data on
all foods and drinks consumed the previous day using the interface developed for
ASA24-Kids maintains the look and feel as well as the methodology and features
of ASA24-2011 (formerly referred to as Version 1; intended for use with adults),
including the administration of multiple passes, the use of images to aid in
portion size estimation, and the inclusion of optional modules to query location
of meals, whether meals were eaten alone or with others, television and computer
use during meals, and supplement intakes. The potential for ASA24 to be used
with a broad range of respondents, including children, was considered throughout
the development of the software. Features that make the tool amenable to use
with children include an animated avatar to guide and maintain respondents'
interest and the inclusion of common misspellings in the database to minimize
problems with finding foods. A number of modifications have been incorporated to
make ASA24-Kids more appropriate for use with children:
- removal of food and drink terms that are not reported by children aged
8-15 years in national dietary surveillance (45% of food and drink terms were
- removal of drink terms referring to alcoholic beverages and removal of
alcoholic beverages from the list of foods and drinks probed in the Forgotten
Foods pass of the recall (alcoholic beverages were removed due to potential
sensitivities related to the reporting of underage drinking; a future version
of ASA24-Kids may allow researchers to choose whether or not to include
- simplified wording of food and beverage items (e.g., 'carbonated water'
changed to 'bubbly water');
- removal of detailed probe questions based on experience indicating that
most children will be unable to respond (e.g., for french fries: Were they
from fresh potatoes or from frozen?; What kind of fat or oil was used?; Were
they baked or fried?) (46% of probes were deleted); and
- the addition of school to the response options for meal location.
An examination of the impact of modifications of this nature using the Beta
version of ASA24 suggested that the alterations did not lead to significantly
different mean estimates of selected nutrients or food groups among children.
Refer to the publications
section for a list of articles with a more detailed description of the
adaptation of ASA24 for use with children.
Pending funding, future development to enhance the use of the tool with
children could include the introduction of more child-friendly language
throughout the interface, the introduction of additional avatar characters, and
increased interactivity with the avatar throughout the recall.
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- uses version 4.1 of USDA's Food and Nutrient
Database for Dietary Surveys (FNDDS) to estimate nutrient intakes;
- uses version 2.0 of the USDA's MyPyramid
Equivalents Database (MPED) and the USDA's Center for Nutrition Policy and
Addendum to estimate intakes of dietary guidance-based food groups;
nutritionists on the ASA24 team imputed values for nine food codes for which
MyPyramid Equivalents have not yet been assigned by USDA;
- includes optional modules to query the location of meals, with whom meals
were eaten, and television and computer use during meals;
- includes an optional module to query supplement intakes based on
supplements reported in the 2007-08 National Health and Nutrition Examination
Survey (NHANES); and
- is available in English and Spanish.
Refer to methodology and features for additional information on the ASA24 Respondent Web site. A demonstration site is also available.
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Use of ASA24-Kids-2012 with Different Age Groups
- ASA24-Kids is currently recommended for use with children 10 years of age
- It is possible to use ASA24-Kids to collect dietary intake for younger
children using a proxy reporter, such as a parent or guardian. The National
Health and Nutrition Examination Survey (NHANES), which conducts
interviewer-administered dietary recalls, uses a proxy respondent for children
5 years of age and younger and has a parent or guardian assist with recalls
for children 6 to 11 years of age. If relying on proxy reporting, researchers
may consider using the full version of ASA24 (ASA24-2011) rather than
ASA24-Kids. ASA24-2011 includes more detailed questions that are excluded from
ASA24-Kids because of the expectation that children will not be able to
respond accurately (refer to Adapting ASA24 for Use with
- Formative research conducted in the early stages of the adaptation of
ASA24 for children used the Beta version of ASA24. This work suggested that 8-
and 9- year-olds lack the cognitive abilities necessary to complete a
self-administered web-based recall. However, given the modifications made to
adapt the tool for children and the fact that a significant number of
usability issues that affected the Beta version have since been addressed,
further evaluation is needed to determine whether children younger than 10
years of age can complete a recall using ASA24-Kids.
- The age at which older teens have the ability to complete recalls using
ASA24 as opposed to ASA24-Kids has not yet been evaluated. NHANES conducts
unassisted recalls on those aged 12 years and above. ASA24-Kids does not
include alcohol, which may be a consideration in determining which version of
ASA24 to use with studies including older children and adolescents.
Note: ASA24-Kids-2012 does not include infant formula or baby foods. These
will be added to the next version of ASA24-Kids.
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Use of the ASA24-Kids-2012 Respondent Web site requires:
- a high-speed internet connection, such as cable, DSL or FIOS;
- a monitor size of at least 10" (greater than 13" is recommended); and
- version 4.0 of Microsoft Silverlight.
The use of computers with screen resolution set to 1024 x 768 and audio
capability is recommended.
When a respondent opens the ASA24 Respondent Web site home page, the site
will detect the respondent's Silverlight version and screen resolution. If the
above standards are not met, instructions will be provided on how to adjust the
The ASA24-Kids-2012 Respondent Web site has been tested on:
- Microsoft Internet Explorer for Windows, version 6 and higher;
- Mozilla Firefox for Windows and OSX, version 3 and higher;
- Apple Safari for Windows and OSX, version 4; and
- Google Chrome for Windows, version 2.
ASA24 is designed for larger monitors (greater than 10"), and while the application will scale, we do not currently recommend its use on a smart phone or tablet.
Please note that ASA24 is not currently designed to run on Apple's iPhones, iPads, or Mac PowerPCs. ASA24 will also not run in a Linux environment.
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The National Cancer Institute is committed to providing access to ASA24 to
all potential respondents. As such, the ASA24 Respondent Web site has been
designed to comply with Section 508 of the Rehabilitation Act (as amended).
Section 508 requires that all individuals with disabilities have access to and
use of information and data comparable to that provided to individuals without
disabilities, unless an undue burden would be imposed.
Researchers should report any difficulties experienced by a respondent using
assistive technology (such as a screen reader, Braille reader, etc.) in an email
addressed to ASA24Admin@westat.com.
Please describe the nature of the accessibility problem and include the study
name and researcher contact information.
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Registering to Use ASA24-Kids-2012
Studies using ASA24-Kids-2012 will be configured and managed using the
Researcher Web site as with any ASA24 study. If you are interested in using
ASA24-Kids-2012 in your study, clinic, or class, please visit the Researcher Web
site to access the researcher instructions and register to use ASA24 free of
charge. When you receive the acknowledgement email noting your study request,
you will be prompted to email the ASA24 Support Team if you wish to use
If your study includes both adults and children and you wish to use multiple
versions of the ASA24 Respondent Web sites (e.g., ASA24-2011 and
ASA24-Kids-2012), please register a study for each version.
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ASA24™ is a trademark of DHHS.