For most Americans, understanding and planning a healthy daily menu can be a confusing and multi- faceted process. The cognitive challenges faced by people with intellectual disabilities (ID) create even greater barriers in understanding the complexity of nutritional concepts such as the food groups, caloric values, saturated fats, cholesterol, daily recommended allowances, special diets, etc. Despite these barriers, various state and federal regulations require agencies to provide evidence of client participation in menu planning and other nutritional processes. This has resulted in a high level of dependency on staff for nutrition planning, and ultimately results in significant health disparities related to excess weight issues in students and adults with ID-and particularly those with Down syndrome. The proposed research will evaluate the utility of an intelligent system multimedia software approach for supporting self-directed menu planning, grocery list development, nutritional education, and meal preparation. The long term goals of the project are to use live audio, video, digital images, animated graphics, and nutrition-based algorithms to: 1) guide users with ID through the process of independently planning and preparing nutritionally healthy menus;2) generate a more independently usable multimedia shopping list based upon those menus, and;3) provide an interactive, game-like format for engaging in nutritional education. Specific objectives for Phase I include development and evaluation of a prototype Menu Planning Module. The prototype system will be tested for usability and efficacy in comparison to a highly rated mainstream menu planning software system that is noted for its ease of use. The Phase I hypothesis is that the prototype system will allow individuals with Down syndrome to complete menu planning tasks with significantly less assistance than when using the mainstream system, and will result in menus that are at least as nutritious as those generated when using the mainstream system. AbleLink Technologies will build upon several previously conducted research projects to guide prototype development. There are three primary project tasks: 1) development and documentation of system requirements;2) to conduct software development of the Phase I system prototype, and;3) to use that prototype in a usability study to determine the efficacy of the approach to improve independence and engagement in the menu planning process. Phase II plans include finalizing and implementing a comprehensive set of menu planning options and features to support different dietary needs;development of the system's nutritional algorithms that will track and compare nutritional values during menu planning to individual nutritional goals to provide an intelligent system approach toward promoting healthier menus;to design and develop the nutrition education module;to complete user login and data tracking/reporting/customization features;and to conduct a real-world field evaluation to determine the efficacy of the system over time in terms of weight loss/gain and other health related outcome measures.
This project will result in MyNutritionPlanner, a cognitively accessible software application that will operate on a wide variety of existing Android and iOS (e.g., iPad, iPhone) devices to enable greater independence, self-direction, and knowledge in nutritional planning and execution. The potential benefit to public health includes a reduction in weight-related health disparities for individuals with intellectual disabilities and a correspondin reduction in remedial health costs for this population.