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Tarro S, Lahdenperä M, Junttila N, Lampimäki A, Lagström H. Parental Self-Efficacy and Child Diet Quality between Ages 2 and 5: The STEPS Study. Nutrients 2022; 14:nu14224891. [PMID: 36432577 PMCID: PMC9698359 DOI: 10.3390/nu14224891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/07/2022] [Accepted: 11/13/2022] [Indexed: 11/22/2022] Open
Abstract
Parental self-efficacy (PSE), a measure of the subjective competence in the parental role, has been linked with child well-being and health. Research on the influence of PSE on child eating habits is scarce, and the few studies have concentrated on certain food groups, such as vegetables or fruits, and have mostly included only maternal PSE. Thus, the aim of this study was to explore the associations between PSE (separately for mothers and fathers and as a total family-level score) and child diet quality in a cross-sectional and longitudinal study setting. PSE was measured at child ages of 1.5 and 5 years, and diet quality was measured at ages 2 and 5. Participants are from the Steps to Healthy Development (STEPS) Study (n = 270-883). We found that maternal PSE and family level PSE score were associated with child diet quality. Paternal PSE was not, but the dimension Routines was associated with child diet quality. PSE was similarly associated with child diet quality at both age points. Our results suggest that PSE is an important construct in the development of healthy dietary habits in children, and supporting parenting programs aimed at higher PSE could promote healthy diet quality in children.
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Affiliation(s)
- Saija Tarro
- Department of Public Health, University of Turku and Turku University Hospital, FI-20014 Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, FI-20014 Turku, Finland
- Correspondence:
| | | | - Niina Junttila
- Department of Teacher Education, University of Turku, FI-20014 Turku, Finland
- Department of Teacher Education, University of Jyväskylä, FI-40014 Jyväskylä, Finland
| | - Antti Lampimäki
- Department of Public Health, University of Turku and Turku University Hospital, FI-20014 Turku, Finland
| | - Hanna Lagström
- Department of Public Health, University of Turku and Turku University Hospital, FI-20014 Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, FI-20014 Turku, Finland
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2
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Mennella JA, Smethers AD, Decker JE, Delahanty MT, Stallings VA, Trabulsi JC. Effects of Early Weight Gain Velocity, Diet Quality, and Snack Food Access on Toddler Weight Status at 1.5 Years: Follow-Up of a Randomized Controlled Infant Formula Trial. Nutrients 2021; 13:nu13113946. [PMID: 34836199 PMCID: PMC8625308 DOI: 10.3390/nu13113946] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/25/2021] [Accepted: 10/26/2021] [Indexed: 12/22/2022] Open
Abstract
This study followed children who participated in a feeding trial in which the type of randomized infant formula fed from 2 weeks significantly affected weight gain velocity during the first 4 months and weight-for-length Z (WLZ) scores up to 11.5 months. We focused on measures of anthropometry, dietary intakes, and parenting related to the provision of snack foods that were collected at the end of the trial (1 year) and the 1.5 years follow-up visit. We not only describe what toddlers are eating, but we also determined the independent and/or interactive effects of randomized formula group, early weight gain velocity, the nutrient content of the post-formula diet, and maternal snack food practices, on toddlers’ weight status. Diet quality underwent drastic changes during this 6-month period. As infant formula disappeared from the diet, fruit and 100% fruit juice intake increased slightly, while intake of “What We Eat in America” food categories sweetened beverages and snacks and sweets more than doubled. Added sugars accounted for 5% of energy needs at 1 year and 9% at 1.5 years. Generalized linear mixed models revealed that, independent of the randomized formula group, greater velocities of weight gain during early infancy and lower access to snacks as toddlers predicted higher WLZ and a greater proportion of toddlers with overweight at 1.5 years. Energy and added sugar intake had no significant effects. These findings add to the growing body of evidence that unhealthy dietary habits are formed even before formula weaning and that, along with improving early diet, transient rapid weight gain and parental feeding practices are modifiable determinants that may reduce risks for obesity.
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Affiliation(s)
- Julie A. Mennella
- Monell Chemical Senses Center, Philadelphia, PA 19104, USA;
- Correspondence:
| | | | - Jessica E. Decker
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE 19173, USA; (J.E.D.); (M.T.D.); (J.C.T.)
| | - Michelle T. Delahanty
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE 19173, USA; (J.E.D.); (M.T.D.); (J.C.T.)
| | | | - Jillian C. Trabulsi
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE 19173, USA; (J.E.D.); (M.T.D.); (J.C.T.)
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Chen B, Kattelmann K, Comstock C, McCormack L, Wey H, Meendering J. Parenting Styles, Food Parenting Practices and Dietary Intakes of Preschoolers. Nutrients 2021; 13:nu13103630. [PMID: 34684630 PMCID: PMC8537258 DOI: 10.3390/nu13103630] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/14/2021] [Accepted: 10/14/2021] [Indexed: 11/16/2022] Open
Abstract
Previous evidence suggests that children’s eating behaviors were largely influenced by the parent and home eating structure. This study examined the relationship between parenting styles (including authoritative, authoritarian, indulgent, and uninvolved), food parenting practices (within Structure, Coercive Control, and Autonomy Support constructs) and dietary intakes of preschoolers. Children aged 3–5 years and their parents were recruited from preschools/daycare centers and parents completed the surveys (n = 166). Dietary intakes were collected using the Harvard Service Food Frequency Questionnaire (HSFFQ), parenting style was assessed using the Parenting Dimensions Inventory-Short Version (PDI-S), and food parenting practices were measured using Comprehensive Home Environment Survey (CHES). The results showed that food parenting practices had a higher number of specific significant findings on children’s nutrient and food group intakes than parenting styles. Correlation analyses showed positive parenting practices within Structure were significantly related to healthier children’s intakes (e.g., vegetables, iron, and folate) and less unhealthy dietary intakes (e.g., sweets and total fats). Regression models show that children with authoritative parents consumed more fruits compared to children with authoritarian parents and indulgent parents. The results addressed the importance of parental influences for preschoolers’ healthy dietary intakes, which suggested that future interventions and educational programs could enhance parenting practices to impact child diet.
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Affiliation(s)
- Biyi Chen
- School of Health and Consumer Sciences, South Dakota State University, Brookings, SD 57006, USA; (B.C.); (C.C.); (L.M.); (J.M.)
| | - Kendra Kattelmann
- School of Health and Consumer Sciences, South Dakota State University, Brookings, SD 57006, USA; (B.C.); (C.C.); (L.M.); (J.M.)
- Correspondence: ; Tel.: +1-605-688-4045
| | - Christopher Comstock
- School of Health and Consumer Sciences, South Dakota State University, Brookings, SD 57006, USA; (B.C.); (C.C.); (L.M.); (J.M.)
| | - Lacey McCormack
- School of Health and Consumer Sciences, South Dakota State University, Brookings, SD 57006, USA; (B.C.); (C.C.); (L.M.); (J.M.)
| | - Howard Wey
- Ethel Austin Martin Program, South Dakota State University, Brookings, SD 57006, USA;
| | - Jessica Meendering
- School of Health and Consumer Sciences, South Dakota State University, Brookings, SD 57006, USA; (B.C.); (C.C.); (L.M.); (J.M.)
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Jansen E, Thapaliya G, Aghababian A, Sadler J, Smith K, Carnell S. Parental stress, food parenting practices and child snack intake during the COVID-19 pandemic. Appetite 2021; 161:105119. [PMID: 33450298 PMCID: PMC7987761 DOI: 10.1016/j.appet.2021.105119] [Citation(s) in RCA: 90] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 11/28/2020] [Accepted: 01/09/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has caused unprecedented disruptions to the lives of families. This study aimed to investigate the impact of pandemic-associated stress on food parenting practices including interactions surrounding snacks, and child diet. METHODS Parents (N = 318) of 2-12-year old children completed a cross-sectional online survey assessing current COVID-19-specific stress, pre-COVID-19 stress, financial stress (e.g. food insecurity), food parenting practices, and child snack intake frequency. Structural Equation Modeling was used to model simultaneous paths of relationships and test direct and indirect effects. RESULTS Stress, including financial hardship, was higher compared with before the crisis. The majority of children had regular mealtimes and irregular snack times. Higher COVID-19-specific stress was associated with more non-nutritive use of food and snacks (e.g. emotional and instrumental feeding), but also more structure and positive interactions (e.g. eating with or engaging with child around mealtimes). Higher COVID-19-specific stress was also associated with greater child intake frequency of sweet and savory snacks, with some evidence for mediation by snack parenting practices. CONCLUSION Our findings indicate that stress associated with the COVID-19 pandemic may be linked to child snack intake with potential impacts on child obesity risk, and suggest several modifiable points of intervention within the family context.
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Affiliation(s)
- E Jansen
- Division of Child & Adolescent Psychiatry, Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - G Thapaliya
- Division of Child & Adolescent Psychiatry, Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - A Aghababian
- Division of Child & Adolescent Psychiatry, Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - J Sadler
- Division of Child & Adolescent Psychiatry, Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - K Smith
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - S Carnell
- Division of Child & Adolescent Psychiatry, Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Gibson EL, Androutsos O, Moreno L, Flores-Barrantes P, Socha P, Iotova V, Cardon G, De Bourdeaudhuij I, Koletzko B, Skripkauskaite S, Manios Y. Influences of Parental Snacking-Related Attitudes, Behaviours and Nutritional Knowledge on Young Children's Healthy and Unhealthy Snacking: The ToyBox Study. Nutrients 2020; 12:nu12020432. [PMID: 32046193 PMCID: PMC7071198 DOI: 10.3390/nu12020432] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 01/23/2020] [Accepted: 02/04/2020] [Indexed: 12/25/2022] Open
Abstract
This study investigated parental influences on preschool children's healthy and unhealthy snacking in relation to child obesity in a large cross-sectional multinational sample. Parents and 3-5 year-old child dyads (n = 5185) in a kindergarten-based study provided extensive sociodemographic, dietary practice and food intake data. Parental feeding practices that were derived from questionnaires were examined for associations with child healthy and unhealthy snacking in adjusted multilevel models, including child estimated energy expenditure, parental education, and nutritional knowledge. Parental healthy and unhealthy snacking was respectively associated with their children's snacking (both p < 0.0001). Making healthy snacks available to their children was specifically associated with greater child healthy snack intake (p < 0.0001). Conversely, practices that were related to unhealthy snacking, i.e., being permissive about unhealthy snacking and acceding to child demands for unhealthy snacks, were associated with greater consumption of unhealthy snacks by children, but also less intake of healthy snacks (all p < 0.0001). Parents having more education and greater nutritional knowledge of snack food recommendations had children who ate more healthy snacks (all p < 0.0001) and fewer unhealthy snacks (p = 0.002, p < 0.0001, respectively). In the adjusted models, child obesity was not related to healthy or unhealthy snack intake in these young children. The findings support interventions that address parental practices and distinguish between healthy and unhealthy snacking to influence young children's dietary patterns.
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Affiliation(s)
- Edward Leigh Gibson
- Department of Psychology, University of Roehampton, London SW15 4JD, UK;
- Correspondence:
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42132 Trikala, Greece
| | - Luis Moreno
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Edificio del SAI, C/Pedro Cerbuna s/n, 50009 Saragossa, Spain; (L.M.); (P.F.-B.)
- Instituto Agroalimentario de Aragón (IA2), 50013 Saragossa, Spain
- Fundación Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Saragossa, Spain
| | - Paloma Flores-Barrantes
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Edificio del SAI, C/Pedro Cerbuna s/n, 50009 Saragossa, Spain; (L.M.); (P.F.-B.)
- Instituto Agroalimentario de Aragón (IA2), 50013 Saragossa, Spain
- Fundación Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Saragossa, Spain
| | - Piotr Socha
- The Children’s Memorial Health Institute, 04-730 Warsaw, Poland;
| | - Violeta Iotova
- Department of Pediatrics, Medical University of Varna, 9002 Varna, Bulgaria;
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, 9000 Ghent, Belgium; (G.C.); (I.D.B.)
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sports Sciences, Ghent University, 9000 Ghent, Belgium; (G.C.); (I.D.B.)
| | - Berthold Koletzko
- Dr von Hauner Children’s Hospital, LMU-Ludwig-Maximilians-University at Munich, D-80337 Munich, Germany;
| | | | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece;
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Bahorski JS, Schneider-Worthington CR, Chandler-Laney PC. Modified eating in the absence of hunger test is associated with appetitive traits in infants. Eat Behav 2020; 36:101342. [PMID: 31759281 PMCID: PMC9327243 DOI: 10.1016/j.eatbeh.2019.101342] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 10/29/2019] [Accepted: 11/06/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Appetite traits and feeding practices have been linked to children's weight status. For example, eating in response to food cues (high food responsiveness (FR)), and poor regulation of intake (low satiety responsiveness (SR)), increase risk for obesity. Appetitive traits of infants, and feeding practices, are typically measured by parent-report. The purpose of this study was to use a modified eating in the absence of hunger (EAH) paradigm, measuring infants' intake 30 min after a typical meal, to test whether infant acceptance of a second meal is associated with parent-reported appetitive traits or feeding practices. METHODS Healthy infants aged 3-5 months (N = 54) were fed a typical meal and then offered a second meal by bottle 30 min later. Appetitive traits and feeding practices were assessed with surveys. Analyses of covariance were used to assess whether appetitive traits differed by acceptance of the second meal after adjusting for covariates. RESULTS Fifty-nine percent of infants accepted the second meal and these infants had greater parent-reported FR (M = 3.06 ± 0.58 vs M = 2.43 ± 0.80, p < 0.01) and lower SR (M = 1.87 ± 0.62 vs M = 2.67 ± 0.87, p = 0.01), compared to infants who rejected it. Group differences remained after adjusting for infant age, feeding mode, weight-for-length, and maternal body mass index. No other appetitive traits or feeding practices differed by group. CONCLUSIONS Results expand research in older children by showing that infant response to a modified EAH protocol is associated with parent-reported FR and SR. Future research with this protocol in infants should investigate the consistency of this behavior across time and examine whether response to this protocol predicts subsequent growth.
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Affiliation(s)
- Jessica S. Bahorski
- University of Alabama at Birmingham, School of Nursing, 1701 University Blvd, Birmingham, AL 35294, USA,Corresponding author: Florida State University, College of Nursing, 98 Varsity Way, Tallahassee, FL 32306, USA. (J.S. Bahorski)
| | | | - Paula C. Chandler-Laney
- University of Alabama at Birmingham, Department of Nutrition Sciences, 1675 University Blvd, Birmingham, AL 35233, USA
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Avecilla-Benítez MA, Sospedra I, Cano-Climent A, Richart-Martínez M, Oliver-Roig A. Development and Validation of a New Questionnaire Assessing Feeding Styles in Toddlers: Toddler Feeding Style Questionnaire (TFSQ). J Pediatr Nurs 2019; 47:e65-e74. [PMID: 31130342 DOI: 10.1016/j.pedn.2019.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 05/01/2019] [Accepted: 05/04/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE To develop and validate a new questionnaire assessing feeding styles in toddlers, the Toddler Feeding Style Questionnaire (TFSQ). DESIGN AND METHODS An instrumental design was used in this study. A convenience sample of 546 Spanish mothers of a toddler (12-24 months-old) completed the TFSQ and a web-based survey to obtain data on feeding styles, sociodemographic and anthropometric characteristics, weaning and attachment style. Items were developed and classified into two content domains: responsiveness and demandingness. For the construct validity analysis, the sample was randomly divided into two halves used to the exploratory and confirmatory factor analysis, respectively. Validation hypotheses about the differences in the TFSQ scores were suggested. RESULTS The factorial analysis revealed a responsiveness scale and a demandingness scale. The McDonald's Omega and Cronbach's alpha values coincided in both scales, being 0.84 and 0.75, respectively. A high responsiveness and demandingness feeding styles degree of agreement showed a statistically significant association with the correspondent scale (p < .01). The 33.3% of children who are overweight or obese have mothers who classify themselves as neglectful. Both scales were related to the mothers' attachment styles, toddler's age and the time of weaning at 6 and 12 months. CONCLUSIONS The TFSQ provides a valid and reliable Responsiveness and Demandingness scale to evaluate feeding styles in toddlers. PRACTICE IMPLICATIONS Parental feeding styles influence future eating behavior and children's weight. There is a lack of validated instruments used to evaluate feeding styles in toddlerhood based on the two theoretical dimensions of responsiveness and demandingness.
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Affiliation(s)
| | - Isabel Sospedra
- Nursing Department, Faculty of Health Science, University of Alicante, Alicante, Spain.
| | - Antonio Cano-Climent
- Hospital General d'Ontinyent, Conselleria de Sanitat Universal i Salut Pública, Ontinyent, Spain
| | | | - Antonio Oliver-Roig
- Nursing Department, Faculty of Health Science, University of Alicante, Alicante, Spain.
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Frankel LA, Powell E, Jansen E. The Relationship between Structure-Related Food Parenting Practices and Children's Heightened Levels of Self-Regulation in Eating. Child Obes 2019; 14:81-88. [PMID: 29193981 DOI: 10.1089/chi.2017.0164] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Food parenting practices influence children's eating behaviors and weight status. Food parenting practices also influence children's self-regulatory abilities around eating, which has important implications for children's eating behaviors. The purpose of the following study is to examine use of structure-related food parenting practices and the potential impact on children's ability to self-regulate energy intake. METHODS Parents (n = 379) of preschool age children (M = 4.10 years, SD = 0.92) were mostly mothers (68.6%), Non-White (54.5%), and overweight/obese (50.1%). Hierarchical Multiple Regression was conducted to predict child self-regulation in eating from structure-related food parenting practices (structured meal setting, structured meal timing, family meal setting), while accounting for child weight status, parent age, gender, BMI, race, and yearly income. RESULTS Hierarchical Multiple Regression results indicated that structure-related feeding practices (structured meal setting and family meal setting, but not structured meal timing) are associated with children's heightened levels of self-regulation in eating. Models examining the relationship within children who were normal weight and overweight/obese indicated the following: a relationship between structured meal setting and heightened self-regulation in eating for normal-weight children and a relationship between family meal setting and heightened self-regulation in eating for overweight/obese children. CONCLUSIONS Researchers should further investigate these potentially modifiable parent feeding behaviors as a protective parenting technique, which possibly contributes to a healthy weight development by enhancing self-regulation in eating.
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Affiliation(s)
- Leslie A Frankel
- 1 Department of Psychological, Health, and Learning Sciences, The University of Houston , Houston, TX
| | - Elisabeth Powell
- 1 Department of Psychological, Health, and Learning Sciences, The University of Houston , Houston, TX
| | - Elena Jansen
- 2 Center for Children's Health Research, School of Exercise and Nutrition Sciences, Queensland University of Technology , South Brisbane, Australia
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Patel C, Karasouli E, Shuttlewood E, Meyer C. Food Parenting Practices among Parents with Overweight and Obesity: A Systematic Review. Nutrients 2018; 10:E1966. [PMID: 30545102 PMCID: PMC6316864 DOI: 10.3390/nu10121966] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 12/06/2018] [Accepted: 12/10/2018] [Indexed: 01/22/2023] Open
Abstract
Given the links between parental obesity and eating psychopathology in their children, it is important to understand the mechanisms via which unhealthy relationships with eating are passed from generation to generation. The aim was to review research focusing on food-related parenting practices (FPPs) used by parents with overweight/obesity. Web of Science, PubMed and PsycINFO were searched. Studies that included a measure of FPPs were considered eligible and were required to have examined FPPs by parental weight status. Twenty studies were included. Single studies suggest differences between parents with healthy-weight vs. overweight/obesity with respect to; food accessibility, food availability and modelling. Multiple studies suggest that several parenting strategies do not differ according to parental weight status (child involvement, praise, use of food to control negative emotions, use of food-based threats and bribes, pressure, restriction, meal and snack routines, monitoring, and rules and limits). There was inconclusive evidence with respect to differences in parental control, encouragement and use of unstructured FPPs among parents with healthy-weight vs. overweight/obesity. The findings of this review imply some differences between parents with overweight/obesity and healthy-weight and the use of some food-related parenting practices, however, they should be interpreted with caution since research remains limited and is generally methodologically weak. The review highlights opportunities for further research, and suggests improvements to current measures of FPPs.
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Affiliation(s)
- Chloe Patel
- Applied Psychology, International Digital Laboratory, Warwick Manufacturing Group, University of Warwick, Coventry CV4 7AL, UK.
| | - Eleni Karasouli
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK.
| | - Emma Shuttlewood
- Weight Management Services, Specialist Surgery, University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK.
| | - Caroline Meyer
- Applied Psychology, International Digital Laboratory, Warwick Manufacturing Group, University of Warwick, Coventry CV4 7AL, UK.
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK.
- Weight Management Services, Specialist Surgery, University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK.
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Davison KK, Blake CE, Kachurak A, Lumeng JC, Coffman DL, Miller AL, Hughes SO, Power TG, Vaughn AF, Blaine RE, Younginer N, Fisher JO. Development and preliminary validation of the Parenting around SNAcking Questionnaire (P-SNAQ). Appetite 2018; 125:323-332. [PMID: 29475073 DOI: 10.1016/j.appet.2018.01.035] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 12/22/2017] [Accepted: 01/28/2018] [Indexed: 01/03/2023]
Abstract
Snacking makes significant contributions to children's dietary intake but is poorly understood from a parenting perspective. This research was designed to develop and evaluate the psychometrics of a theoretically grounded, empirically-informed measure of snack parenting. The Parenting around SNAcking Questionnaire (P-SNAQ) was developed using a conceptual model derived from current theory and mixed-methods research to include 20 hypothesized snack parenting practices along 4 parenting dimensions (autonomy support, structure, coercive control and permissiveness). Expert panel evaluation and cognitive interviews were used to refine items and construct definitions. The initial instrument of 105 items was administered to an ethnically diverse, low-income sample of 305 parents (92% mothers) of children aged 1-6 y participating in three existing cohort studies. The sample was randomly split into two equal samples. Exploratory factor analysis was conducted with the first sample to identify snack parenting practices within each parenting dimension, followed by confirmatory factor analysis with the second sample to test the hypothesized factor structure. Internal consistency of sub-scales and associations with existing measures of food parenting practices and styles and child weight status were evaluated. The final P-SNAQ scale included 51 items reflecting 14 snack parenting practices across four parenting dimensions. The factor structure of the P-SNAQ was consistent with prior theoretical frameworks. Internal consistency coefficients were good to very good for 12 out of 14 scales and subscale scores were moderately correlated with previously validated measures. In conclusion, initial evidence suggests that P-SNAQ is a psychometrically sound measure for evaluating a wide range of snack parenting practices in young children.
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Affiliation(s)
- K K Davison
- Harvard T.H. Chan School of Public Health, Department of Nutrition, 665 Huntington Ave, Boston, MA 02445, USA; Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, 665 Huntington Ave, Boston, MA 02445, USA.
| | - C E Blake
- University of South Carolina, Department of Health Promotion, Education and Behavior, 915 Greene Street, Columbia, SC 29208, USA
| | - A Kachurak
- Temple University, Center for Obesity Research and Education, 3323 N Broad St, Suite 175, Philadelphia, PA 19140, USA
| | - J C Lumeng
- University of Michigan, Department of Pediatrics, Medical School, Department of Nutritional Sciences, School of Public Health, 300 North Ingalls Street, 10th Floor, Ann Arbor, MI, 48109, USA
| | - D L Coffman
- Temple University, Center for Obesity Research and Education, 3323 N Broad St, Suite 175, Philadelphia, PA 19140, USA
| | - A L Miller
- University of Michigan, Department of Health Behavior and Health Education, School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - S O Hughes
- USDA/ARS Children's Nutrition Research Center at Baylor College of Medicine, Department of Pediatrics, 1100 Bates Ave, Houston, TX 77030, USA
| | - T G Power
- Washington State University, Department of Human Development, PO Box 644852, Pullman, WA 99164-4852, USA
| | - A F Vaughn
- University of North Carolina at Chapel Hill, Center for Health Promotion and Disease Prevention, 1700 Martin L. King Jr. Blvd, CB 7426, Chapel Hill, NC 27599-7426, USA
| | - R E Blaine
- California State University, Long Beach, Department of Family and Consumer Sciences, 1250 Bellflower Blvd, Long Beach, CA 90840-0501, USA
| | - N Younginer
- University of South Carolina, Department of Health Promotion, Education and Behavior, 915 Greene Street, Columbia, SC 29208, USA
| | - J O Fisher
- Temple University, Center for Obesity Research and Education, 3323 N Broad St, Suite 175, Philadelphia, PA 19140, USA
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Corsini N, Kettler L, Danthiir V, Wilson C. Parental feeding practices to manage snack food intake: Associations with energy intake regulation in young children. Appetite 2017; 123:233-240. [PMID: 29288678 DOI: 10.1016/j.appet.2017.12.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 11/29/2017] [Accepted: 12/21/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND Little attention has been directed to understanding the relationship between restriction and regulation of snack food intake in toddlers. OBJECTIVE The aim of this study was to examine the effects of parental restriction of toddlers' eating of snacks in the absence of hunger (EAH) and to examine the impact of three contextual factors; snack food access, frequency of snack food consumption, and attraction to snack food. DESIGN 64 parents and toddlers (aged 22-36 months) took part in a protocol to measure EAH (defined as kJ of energy-dense snack foods consumed). Mean EAH was 199 kJ (SD = 299), with 43 children consuming at least some snacks. Restriction was measured with the Child Feeding Questionnaire Restriction subscale. Snack food access was measured with Allow Access from the Toddler Snack Food Feeding Questionnaire (TSFFQ), snack food consumption was measured with a short snack food frequency questionnaire, and attraction to snack foods was measured with Child's Attraction from the TSFFQ. Moderated regression analyses tested interactions between Restriction and contextual factors in predicting EAH. RESULTS EAH was associated with Restriction (r = 0.25, p = .05, 95% CI 0.004 - 0.47). There was an interaction between Restriction and accessibility of snack foods (R2 change = 0.08, p = .025); restriction was associated with EAH only when access to snack foods in the home was, on average, higher. The effect of Restriction on EAH was not moderated by frequency of snack food consumption or Child's Attraction. CONCLUSIONS These finding have practical relevance and reinforce the importance of the home food environment for managing young children's snack food intake.
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Affiliation(s)
- Nadia Corsini
- CSIRO Animal, Food and Health Sciences, PO Box 10041, Adelaide BC, SA, 5000, Australia; School of Psychology, University of Adelaide, Adelaide, SA, 5001, Australia; Rosemary Bryant AO Research Centre, Sansom Institute, University of South Australia, Australia.
| | - Lisa Kettler
- School of Psychology, University of Adelaide, Adelaide, SA, 5001, Australia.
| | - Vanessa Danthiir
- CSIRO Animal, Food and Health Sciences, PO Box 10041, Adelaide BC, SA, 5000, Australia; School of Psychology, University of Adelaide, Adelaide, SA, 5001, Australia.
| | - Carlene Wilson
- Flinders Centre for Innovation in Cancer, Flinders University of South Australia, GPO Box 2100, Adelaide, 5001, Australia; La Trobe University, Melbourne, Australia.
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12
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Food parenting and child snacking: a systematic review. Int J Behav Nutr Phys Act 2017; 14:146. [PMID: 29096640 PMCID: PMC5668962 DOI: 10.1186/s12966-017-0593-9] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 10/03/2017] [Indexed: 01/10/2023] Open
Abstract
Background While the role of parenting in children’s eating behaviors has been studied extensively, less attention has been given to its potential association with children’s snacking habits. To address this gap, we conducted a systematic review to describe associations between food parenting and child snacking, or consuming energy dense foods/foods in between meals. Methods Six electronic databases were searched using standardized language to identify quantitative studies describing associations of general and feeding-specific parenting styles as well as food parenting practices with snacking behaviors of children aged 2–18 years. Eligible peer-reviewed journal articles published between 1980 and 2017 were included. Data were extracted using a standard protocol by three coders; all items were double coded to ensure consistency. Results Forty-seven studies met inclusion criteria. Few studies focused on general feeding (n = 3) or parenting styles (n = 10). Most studies focused on controlling food parenting practices (n = 39) that were not specific to snacking. Parental restriction of food was positively associated with child snack intake in 13/23 studies, while pressure to eat and monitoring yielded inconsistent results. Home availability of unhealthy foods was positively associated with snack intake in 10/11 studies. Findings related to positive parent behaviors (e.g. role modeling) were limited and yielded mixed results (n = 9). Snacking was often assessed using food frequency items and defined post-hoc based on nutritional characteristics (e.g. energy-dense, sugary foods, unhealthy, etc.). Timing was rarely included in the definition of a snack (i.e. chips eaten between meals vs. with lunch). Conclusions Restrictive feeding and home access to unhealthy foods were most consistently associated with snacking among young children. Research is needed to identify positive parenting behaviors around child snacking that may be used as targets for health promotion. Detailed definitions of snacking that address food type, context, and purpose are needed to advance findings within the field. We provide suggested standardized terminology for future research. Electronic supplementary material The online version of this article (10.1186/s12966-017-0593-9) contains supplementary material, which is available to authorized users.
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13
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Lusmilasari L, Chaiyawat W, Rodcumdee B. Psychometric properties of the Parental Feeding Behaviours Questionnaire for Indonesian parents of young children. Int J Nurs Pract 2017; 24. [PMID: 29064139 DOI: 10.1111/ijn.12604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 09/13/2017] [Accepted: 09/18/2017] [Indexed: 12/01/2022]
Abstract
PURPOSE The objective of this study was to test the psychometric properties of the Parental Feeding Behaviours Questionnaire (PFBQ) to measure feeding behaviours of Indonesian parents of toddlers (young children). METHODS A total of 696 parents of toddlers were obtained by convenience sampling during September 2013 to April 2014. To validate the PFBQ, confirmatory factor analysis and the contrasted group technique were conducted. Reliability of this instrument was examined by construct reliability and test-retest reliability. RESULTS Results showed that the regression coefficients of all 56 indicators were statistically significant (P < 0.001). The contrasted group technique showed significantly different parental feeding behaviours between parents of well-nourished and malnourished toddlers (P = 0.047). The test-retest reliability of the PFBQ was acceptable (Pearson correlation = 0.644), and the construct reliability ranged from 0.88 to 0.96. CONCLUSIONS The PFBQ is a valid and reliable instrument; however, more studies are required to identify acceptable tools to measure more culturally diverse range of parental feeding behaviours.
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Affiliation(s)
- Lely Lusmilasari
- School of Nursing, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Mubarik F, Bhaskaran K, Kho S, Vereijken C, Nambiar S, Eussen S, Muhardi L. Development of food lists as a first step to develop a food frequency questionnaire for toddlers in a multi-ethnic population. Nutr Diet 2017; 74:11-17. [PMID: 28731552 DOI: 10.1111/1747-0080.12323] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Revised: 07/04/2016] [Accepted: 08/05/2016] [Indexed: 11/28/2022]
Abstract
AIM Toddlerhood is an important stage of growth, thus understanding the food intake of children in this age group is important. In Singapore, there is currently no simple tool, such as Food Frequency Questionnaire (FFQ), to collect dietary information from this ethnically diverse age group. Generating an appropriate food list is a crucial step in the development of a FFQ and this step is not clearly documented in the literature. The purpose of this study is to generate food lists and portion sizes for toddlers from three major ethnic groups in Singapore and document the processes involved in this first stage. METHODS A total of 30 mothers (equal number of Malays, Indians and Chinese) of 11-24-month-old children completed three-day food records and participated in the focus group discussion. The reported food items were then categorised into food groups. RESULTS The food lists varied by ethnic groups with the longest list obtained from Chinese toddlers. There were also other foods that were then classified as common foods for all ethnicities. Commonly used utensils among the three ethnic groups were small-sized bowls, plates, cups and spoons. For portion sizes, these utensils were typically half-filled for the toddlers. CONCLUSIONS As all Singaporeans have access to the same foods, the ethnic-specific food lists generated in this study could be combined into one list. Together with portion sizes, this information can be used for developing a semi-quantitative FFQ.
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Affiliation(s)
- Farya Mubarik
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Kalpana Bhaskaran
- School of Humanities & Social Science, Centre for Applied Science, Temasek Polytechnic, Singapore
| | - Stephanie Kho
- School of Humanities & Social Science, Centre for Applied Science, Temasek Polytechnic, Singapore
| | - Carel Vereijken
- Early Life Nutrition, Danone Nutricia Research, Utrecht, The Netherlands
| | - Smita Nambiar
- Diet and Nutrition, Danone Nutricia Research, Singapore
| | - Simone Eussen
- Early Life Nutrition, Danone Nutricia Research, Utrecht, The Netherlands
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15
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Holley CE, Farrow C, Haycraft E. Investigating offering of vegetables by caregivers of preschool age children. Child Care Health Dev 2017; 43:240-249. [PMID: 27554997 DOI: 10.1111/cch.12400] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 07/27/2016] [Accepted: 08/01/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Research into the methods which caregivers use to encourage children to eat vegetables is limited, with minimal evidence about what the barriers are to offering these foods. Vegetable consumption in children is typically low, and so gaining information on these factors is vital in order to develop further caregiver-centred interventions to increase children's vegetable consumption. This study aimed to investigate the methods caregivers use to offer vegetables to preschool aged children, as well as the factors which influence whether and how caregivers present vegetables to their children. METHOD Seventeen caregivers with a preschool aged child participated in focus groups to assess these questions. RESULTS Thematic analysis indicated that caregivers use a range of methods to offer their children vegetables, with these methods falling into three broad categories: behavioural/active methods, passive methods and food manipulations. Influences on caregiver offering which emerged from the focus groups formed four categories: information, cost, parent factors and child factors. CONCLUSIONS Together with large-scale quantitative data, this information can be used to shape future interventions aiming to increase children's vegetable intake as well as to tailor advice given to caregivers striving to achieve a healthful diet for their children.
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Affiliation(s)
- C E Holley
- Loughborough University, Leicestershire, UK
| | - C Farrow
- Aston University, Birmingham, UK
| | - E Haycraft
- Loughborough University, Leicestershire, UK
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Vaughn AE, Ward DS, Fisher JO, Faith MS, Hughes SO, Kremers SPJ, Musher-Eizenman DR, O'Connor TM, Patrick H, Power TG. Fundamental constructs in food parenting practices: a content map to guide future research. Nutr Rev 2016; 74:98-117. [PMID: 26724487 DOI: 10.1093/nutrit/nuv061] [Citation(s) in RCA: 387] [Impact Index Per Article: 48.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Although research shows that "food parenting practices" can impact children's diet and eating habits, current understanding of the impact of specific practices has been limited by inconsistencies in terminology and definitions. This article represents a critical appraisal of food parenting practices, including clear terminology and definitions, by a working group of content experts. The result of this effort was the development of a content map for future research that presents 3 overarching, higher-order food parenting constructs--coercive control, structure, and autonomy support--as well as specific practice subconstructs. Coercive control includes restriction, pressure to eat, threats and bribes, and using food to control negative emotions. Structure includes rules and limits, limited/guided choices, monitoring, meal- and snacktime routines, modeling, food availability and accessibility, food preparation, and unstructured practices. Autonomy support includes nutrition education, child involvement, encouragement, praise, reasoning, and negotiation. Literature on each construct is reviewed, and directions for future research are offered. Clear terminology and definitions should facilitate cross-study comparisons and minimize conflicting findings resulting from previous discrepancies in construct operationalization.
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Affiliation(s)
- Amber E Vaughn
- A.E. Vaughn and D.S. Ward are with the Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. D.S. Ward is with the Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. J.O. Fisher is with the Center for Obesity Research and Education, Temple University, Philadelphia, Pennsylvania, USA. M.S. Faith is with the Department of Counseling, School, and Educational Psychology, Graduate School of Education, University of Buffalo, State University of New York, Buffalo, New York, USA. S.O. Hughes and T.M. O'Connor are with the US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA. S.P.J. Kremers is with the Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands. D.R. Musher-Eizenman is with the Department of Psychology, Bowling Green State University, Bowling Green, Ohio, USA. H. Patrick is with LiveHealthier, Inc., Bethesda, Maryland, USA. T.G. Power is with the Department of Human Development, Washington State University, Pullman, Washington, USA.
| | - Dianne S Ward
- A.E. Vaughn and D.S. Ward are with the Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. D.S. Ward is with the Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. J.O. Fisher is with the Center for Obesity Research and Education, Temple University, Philadelphia, Pennsylvania, USA. M.S. Faith is with the Department of Counseling, School, and Educational Psychology, Graduate School of Education, University of Buffalo, State University of New York, Buffalo, New York, USA. S.O. Hughes and T.M. O'Connor are with the US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA. S.P.J. Kremers is with the Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands. D.R. Musher-Eizenman is with the Department of Psychology, Bowling Green State University, Bowling Green, Ohio, USA. H. Patrick is with LiveHealthier, Inc., Bethesda, Maryland, USA. T.G. Power is with the Department of Human Development, Washington State University, Pullman, Washington, USA
| | - Jennifer O Fisher
- A.E. Vaughn and D.S. Ward are with the Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. D.S. Ward is with the Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. J.O. Fisher is with the Center for Obesity Research and Education, Temple University, Philadelphia, Pennsylvania, USA. M.S. Faith is with the Department of Counseling, School, and Educational Psychology, Graduate School of Education, University of Buffalo, State University of New York, Buffalo, New York, USA. S.O. Hughes and T.M. O'Connor are with the US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA. S.P.J. Kremers is with the Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands. D.R. Musher-Eizenman is with the Department of Psychology, Bowling Green State University, Bowling Green, Ohio, USA. H. Patrick is with LiveHealthier, Inc., Bethesda, Maryland, USA. T.G. Power is with the Department of Human Development, Washington State University, Pullman, Washington, USA
| | - Myles S Faith
- A.E. Vaughn and D.S. Ward are with the Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. D.S. Ward is with the Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. J.O. Fisher is with the Center for Obesity Research and Education, Temple University, Philadelphia, Pennsylvania, USA. M.S. Faith is with the Department of Counseling, School, and Educational Psychology, Graduate School of Education, University of Buffalo, State University of New York, Buffalo, New York, USA. S.O. Hughes and T.M. O'Connor are with the US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA. S.P.J. Kremers is with the Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands. D.R. Musher-Eizenman is with the Department of Psychology, Bowling Green State University, Bowling Green, Ohio, USA. H. Patrick is with LiveHealthier, Inc., Bethesda, Maryland, USA. T.G. Power is with the Department of Human Development, Washington State University, Pullman, Washington, USA
| | - Sheryl O Hughes
- A.E. Vaughn and D.S. Ward are with the Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. D.S. Ward is with the Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. J.O. Fisher is with the Center for Obesity Research and Education, Temple University, Philadelphia, Pennsylvania, USA. M.S. Faith is with the Department of Counseling, School, and Educational Psychology, Graduate School of Education, University of Buffalo, State University of New York, Buffalo, New York, USA. S.O. Hughes and T.M. O'Connor are with the US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA. S.P.J. Kremers is with the Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands. D.R. Musher-Eizenman is with the Department of Psychology, Bowling Green State University, Bowling Green, Ohio, USA. H. Patrick is with LiveHealthier, Inc., Bethesda, Maryland, USA. T.G. Power is with the Department of Human Development, Washington State University, Pullman, Washington, USA
| | - Stef P J Kremers
- A.E. Vaughn and D.S. Ward are with the Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. D.S. Ward is with the Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. J.O. Fisher is with the Center for Obesity Research and Education, Temple University, Philadelphia, Pennsylvania, USA. M.S. Faith is with the Department of Counseling, School, and Educational Psychology, Graduate School of Education, University of Buffalo, State University of New York, Buffalo, New York, USA. S.O. Hughes and T.M. O'Connor are with the US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA. S.P.J. Kremers is with the Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands. D.R. Musher-Eizenman is with the Department of Psychology, Bowling Green State University, Bowling Green, Ohio, USA. H. Patrick is with LiveHealthier, Inc., Bethesda, Maryland, USA. T.G. Power is with the Department of Human Development, Washington State University, Pullman, Washington, USA
| | - Dara R Musher-Eizenman
- A.E. Vaughn and D.S. Ward are with the Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. D.S. Ward is with the Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. J.O. Fisher is with the Center for Obesity Research and Education, Temple University, Philadelphia, Pennsylvania, USA. M.S. Faith is with the Department of Counseling, School, and Educational Psychology, Graduate School of Education, University of Buffalo, State University of New York, Buffalo, New York, USA. S.O. Hughes and T.M. O'Connor are with the US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA. S.P.J. Kremers is with the Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands. D.R. Musher-Eizenman is with the Department of Psychology, Bowling Green State University, Bowling Green, Ohio, USA. H. Patrick is with LiveHealthier, Inc., Bethesda, Maryland, USA. T.G. Power is with the Department of Human Development, Washington State University, Pullman, Washington, USA
| | - Teresia M O'Connor
- A.E. Vaughn and D.S. Ward are with the Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. D.S. Ward is with the Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. J.O. Fisher is with the Center for Obesity Research and Education, Temple University, Philadelphia, Pennsylvania, USA. M.S. Faith is with the Department of Counseling, School, and Educational Psychology, Graduate School of Education, University of Buffalo, State University of New York, Buffalo, New York, USA. S.O. Hughes and T.M. O'Connor are with the US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA. S.P.J. Kremers is with the Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands. D.R. Musher-Eizenman is with the Department of Psychology, Bowling Green State University, Bowling Green, Ohio, USA. H. Patrick is with LiveHealthier, Inc., Bethesda, Maryland, USA. T.G. Power is with the Department of Human Development, Washington State University, Pullman, Washington, USA
| | - Heather Patrick
- A.E. Vaughn and D.S. Ward are with the Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. D.S. Ward is with the Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. J.O. Fisher is with the Center for Obesity Research and Education, Temple University, Philadelphia, Pennsylvania, USA. M.S. Faith is with the Department of Counseling, School, and Educational Psychology, Graduate School of Education, University of Buffalo, State University of New York, Buffalo, New York, USA. S.O. Hughes and T.M. O'Connor are with the US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA. S.P.J. Kremers is with the Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands. D.R. Musher-Eizenman is with the Department of Psychology, Bowling Green State University, Bowling Green, Ohio, USA. H. Patrick is with LiveHealthier, Inc., Bethesda, Maryland, USA. T.G. Power is with the Department of Human Development, Washington State University, Pullman, Washington, USA
| | - Thomas G Power
- A.E. Vaughn and D.S. Ward are with the Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. D.S. Ward is with the Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. J.O. Fisher is with the Center for Obesity Research and Education, Temple University, Philadelphia, Pennsylvania, USA. M.S. Faith is with the Department of Counseling, School, and Educational Psychology, Graduate School of Education, University of Buffalo, State University of New York, Buffalo, New York, USA. S.O. Hughes and T.M. O'Connor are with the US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA. S.P.J. Kremers is with the Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands. D.R. Musher-Eizenman is with the Department of Psychology, Bowling Green State University, Bowling Green, Ohio, USA. H. Patrick is with LiveHealthier, Inc., Bethesda, Maryland, USA. T.G. Power is with the Department of Human Development, Washington State University, Pullman, Washington, USA
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Bryant M, Ashton L, Brown J, Jebb S, Wright J, Roberts K, Nixon J. Systematic review to identify and appraise outcome measures used to evaluate childhood obesity treatment interventions (CoOR): evidence of purpose, application, validity, reliability and sensitivity. Health Technol Assess 2015; 18:1-380. [PMID: 25125212 DOI: 10.3310/hta18510] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Lack of uniformity in outcome measures used in evaluations of childhood obesity treatment interventions can impede the ability to assess effectiveness and limits comparisons across trials. OBJECTIVE To identify and appraise outcome measures to produce a framework of recommended measures for use in evaluations of childhood obesity treatment interventions. DATA SOURCES Eleven electronic databases were searched between August and December 2011, including MEDLINE; MEDLINE In-Process and Other Non-Indexed Citations; EMBASE; PsycINFO; Health Management Information Consortium (HMIC); Allied and Complementary Medicine Database (AMED); Global Health, Maternity and Infant Care (all Ovid); Cumulative Index to Nursing and Allied Health Literature (CINAHL) (EBSCOhost); Science Citation Index (SCI) [Web of Science (WoS)]; and The Cochrane Library (Wiley) - from the date of inception, with no language restrictions. This was supported by review of relevant grey literature and trial databases. REVIEW METHODS Two searches were conducted to identify (1) outcome measures and corresponding citations used in published childhood obesity treatment evaluations and (2) manuscripts describing the development and/or evaluation of the outcome measures used in the childhood intervention obesity evaluations. Search 1 search strategy (review of trials) was modelled on elements of a review by Luttikhuis et al. (Oude Luttikhuis H, Baur L, Jansen H, Shrewsbury VA, O'Malley C, Stolk RP, et al. Interventions for treating obesity in children. Cochrane Database Syst Rev 2009;1:CD001872). Search 2 strategy (methodology papers) was built on Terwee et al.'s search filter (Terwee CB, Jansma EP, Riphagen II, de Vet HCW. Development of a methodological PubMed search filter for finding studies on measurement properties of measurement instruments. Qual Life Res 2009;18:1115-23). Eligible papers were appraised for quality initially by the internal project team. This was followed by an external appraisal by expert collaborators in order to agree which outcome measures should be recommended for the Childhood obesity Outcomes Review (CoOR) outcome measures framework. RESULTS Three hundred and seventy-nine manuscripts describing 180 outcome measures met eligibility criteria. Appraisal of these resulted in the recommendation of 36 measures for the CoOR outcome measures framework. Recommended primary outcome measures were body mass index (BMI) and dual-energy X-ray absorptiometry (DXA). Experts did not advocate any self-reported measures where objective measurement was possible (e.g. physical activity). Physiological outcomes hold potential to be primary outcomes, as they are indicators of cardiovascular health, but without evidence of what constitutes a minimally importance difference they have remained as secondary outcomes (although the corresponding lack of evidence for BMI and DXA is acknowledged). No preference-based quality-of-life measures were identified that would enable economic evaluation via calculation of quality-adjusted life-years. Few measures reported evaluating responsiveness. LIMITATIONS Proposed recommended measures are fit for use as outcome measures within studies that evaluate childhood obesity treatment evaluations specifically. These may or may not be suitable for other study designs, and some excluded measures may be more suitable in other study designs. CONCLUSIONS The CoOR outcome measures framework provides clear guidance of recommended primary and secondary outcome measures. This will enhance comparability between treatment evaluations and ensure that appropriate measures are being used. Where possible, future work should focus on modification and evaluation of existing measures rather than development of tools de nova. In addition, it is recommended that a similar outcome measures framework is produced to support evaluation of adult obesity programmes. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
- Maria Bryant
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - Lee Ashton
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - Julia Brown
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - Susan Jebb
- Medical Research Council (MRC) Human Nutrition Research, Cambridge, UK
| | - Judy Wright
- Institute of Health Sciences, University of Leeds, Leeds, UK
| | | | - Jane Nixon
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
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Bryant M, Ashton L, Nixon J, Jebb S, Wright J, Roberts K, Brown J. Framework of outcome measures recommended for use in the evaluation of childhood obesity treatment interventions: the CoOR framework. Pediatr Obes 2014; 9:e116-31. [PMID: 24729517 DOI: 10.1111/j.2047-6310.2014.220.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 12/03/2013] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Consensus is lacking in determining appropriate outcome measures for assessment of childhood obesity treatments. Inconsistency in the use and reporting of such measures impedes comparisons between treatments and limits consideration of effectiveness. This study aimed to produce a framework of recommended outcome measures: the Childhood obesity treatment evaluation Outcomes Review (CoOR) framework. METHODS A systematic review including two searches was conducted to identify (1) existing trial outcome measures and (2) manuscripts describing development/evaluation of outcome measures. Outcomes included anthropometry, diet, eating behaviours, physical activity, sedentary time/behaviour, fitness, physiology, environment, psychological well-being and health-related quality of life. Eligible measures were appraised by the internal team using a system developed from international guidelines, followed by appraisal from national external expert collaborators. RESULTS A total of 25,486 papers were identified through both searches. Eligible search 1 trial papers cited 417 additional papers linked to outcome measures, of which 56 were eligible. A further 297 outcome development/evaluation papers met eligibility criteria from search 2. Combined, these described 191 outcome measures. After internal and external appraisal, 52 measures across 10 outcomes were recommended for inclusion in the CoOR framework. CONCLUSION Application of the CoOR framework will ensure greater consistency in choosing robust outcome measures that are appropriate to population characteristics.
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Affiliation(s)
- M Bryant
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
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Zarnowiecki DM, Dollman J, Parletta N. Associations between predictors of children's dietary intake and socioeconomic position: a systematic review of the literature. Obes Rev 2014; 15:375-91. [PMID: 24433310 DOI: 10.1111/obr.12139] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2013] [Revised: 11/05/2013] [Accepted: 12/02/2013] [Indexed: 12/16/2022]
Abstract
Socioeconomically disadvantaged children are at higher risk of consuming poor diets, in particular less fruits and vegetables and more non-core foods and sweetened beverages. Currently the drivers of socioeconomically related differences in children's dietary intake are not well understood. This systematic review explored whether dietary predictors vary for children of different socioeconomic circumstances. Seven databases and reference lists of included material were searched for studies investigating predictors of 9-13-year-old children's diet in relation to socioeconomic position. Individual- and population-based cross-sectional, cohort and epidemiological studies published in English and conducted in developed countries were included. Twenty-eight studies were included in this review; most were conducted in Europe (n = 12) or North America (n = 10). The most frequently used indicators of socioeconomic position were parent education and occupation. Predictors of children's dietary intake varied among children of different socioeconomic circumstances. Socioeconomic position was consistently associated with children's nutrition knowledge, parent modelling, home food availability and accessibility. Indeterminate associations with socioeconomic position were observed for parent feeding practices and food environment near school. Differences in the determinants of eating between socioeconomic groups provide a better understanding of the drivers of socioeconomic disparities in dietary intake, and how to develop targeted intervention strategies.
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Affiliation(s)
- D M Zarnowiecki
- Exercise for Health and Human Performance Group, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
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Vaughn AE, Tabak RG, Bryant MJ, Ward DS. Measuring parent food practices: a systematic review of existing measures and examination of instruments. Int J Behav Nutr Phys Act 2013; 10:61. [PMID: 23688157 PMCID: PMC3681578 DOI: 10.1186/1479-5868-10-61] [Citation(s) in RCA: 134] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Accepted: 05/08/2013] [Indexed: 11/10/2022] Open
Abstract
During the last decade, there has been a rapid increase in development of instruments to measure parent food practices. Because these instruments often measure different constructs, or define common constructs differently, an evaluation of these instruments is needed. A systematic review of the literature was conducted to identify existing measures of parent food practices and to assess the quality of their development. The initial search used terms capturing home environment, parenting behaviors, feeding practices and eating behaviors, and was performed in October of 2009 using PubMed/Medline, PsychInfo, Web of knowledge (ISI), and ERIC, and updated in July of 2012. A review of titles and abstracts was used to narrow results, after which full articles were retrieved and reviewed. Only articles describing development of measures of parenting food practices designed for families with children 2-12 years old were retained for the current review. For each article, two reviewers extracted data and appraised the quality of processes used for instrument development and evaluation. The initial search yielded 28,378 unique titles; review of titles and abstracts narrowed the pool to 1,352 articles; from which 57 unique instruments were identified. The review update yielded 1,772 new titles from which14 additional instruments were identified. The extraction and appraisal process found that 49% of instruments clearly identified and defined concepts to be measured, and 46% used theory to guide instrument development. Most instruments (80%) had some reliability testing, with internal consistency being the most common (79%). Test-retest or inter-rater reliability was reported for less than half the instruments. Some form of validity evidence was reported for 84% of instruments. Construct validity was most commonly presented (86%), usually with analysis of associations with child diet or weight/BMI. While many measures of food parenting practices have emerged, particularly in recent years, few have demonstrated solid development methods. Substantial variation in items across different scales/constructs makes comparison between instruments extremely difficult. Future efforts should be directed toward consensus development of food parenting practices constructs and measures.
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Affiliation(s)
- Amber E Vaughn
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, 1700 Martin L, King Jr, Blvd,, CB 7426, Chapel Hill, NC 27599-7426, USA.
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21
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Russell CG, Worsley A. Why don't they like that? And can I do anything about it? The nature and correlates of parents' attributions and self-efficacy beliefs about preschool children's food preferences. Appetite 2013; 66:34-43. [PMID: 23474088 DOI: 10.1016/j.appet.2013.02.020] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Revised: 01/13/2013] [Accepted: 02/26/2013] [Indexed: 11/26/2022]
Abstract
Children's food preferences influence their food intakes, which then have important effects on their health status. Presently little is understood about the aetiology of children's food preferences within families. Parental beliefs are important in many domains of socialisation although their role in the development of children's food preferences has seldom been investigated. Parents of 2-5 year old children participated in semi-structured qualitative interviews, which were analysed with content analysis. The parents either had children with healthy food preferences (i.e. closely aligned with dietary guidelines) (N=20), unhealthy food preferences (i.e. not closely aligned with dietary guidelines) (N=18), or high levels of food neophobia (N=19). Parents described their beliefs about why children like and dislike foods (their attributions) and their ability to influence children's food preferences (their self-efficacy). Children's food preferences were attributed to (a) the influence of children's characteristics (e.g. food neophobia level and personality), (b) sensory attributes of foods (e.g. texture and appearance), and (c) socialisation experiences (e.g. peer modelling and parental feeding behaviours). Results provide preliminary evidence of differences in parents' attributions and self-efficacy beliefs in the feeding domain and highlight the need for greater understanding of the ways in which parents' beliefs affect children's food preferences.
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Affiliation(s)
- Catherine Georgina Russell
- School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia.
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