User Testing of the NCI's ASA24 Respondent Nutrition Report for Total Nutrient Intake From Foods, Beverages, and Dietary Supplements: A Qualitative Study.

BackgroundApproximately 75% of the US population uses dietary supplements to boost their nutrient intake beyond what they obtain from foods and drinks. Therefore, it is crucial to clearly communicate how dietary supplements contribute to overall nutrient intake, enabling consumers to make informed health decisions.ObjectiveThe objective of this study was to test user comprehension of 4 aspects of nutrient intake displayed in the ASA24 Respondent Nutrition Report (Total, Target, Limit, and Warning) among adults with diverse numeracy levels.DesignTwo-phase qualitative study using semi-structured interviews with dietary supplement users (Phase I conducted March 1-April 31, 2021; Phase II conducted June 1-July 31, 2021).Participants/settingA total of 50 dietary supplement users ≥19 years of age were recruited via a nationwide opt-in research panel for phases I (30 participants) and II (20 participants). Participant interviews were conducted virtually.Analyses performedA deductive-to-inductive coding method was used for creation of the codebook; 20% of transcripts were double-coded with inter-rater reliability >90%. Summative content analysis assessed comprehension of reviewed concepts.ResultsIn Phase I, participants found the graphic format easier to understand than a table. Additionally, most participants believed the graphic would be easier for the general public to understand. Using participant feedback from Phase I, the graphic was revised, which led to a better understanding of key features of the graphic for participants in Phase II, especially for nutrients that fell below the target. These updates improved understandability among both higher and lower numeracy participants.ConclusionsContent for Total Nutrient Intake from Foods, Drinks, and Supplements for the ASA24's Respondent Nutrition Report was developed, underwent usability testing, and demonstrated sufficient user comprehension. Future research can evaluate the effectiveness of the final graphic for behavior change with different populations or conduct future testing of the Respondent Nutrition Report (RNR), with a focus on individuals with lower numeracy scores.