A model of goal directed vegetable parenting practices

Development of a New Questionnaire to Assess Parental Perceived Barriers When Promoting Healthy Eating Habits in Young Children: First Findings

Social cognitive models suggest a crucial role played by perceived barriers in promoting healthy behaviors, including healthy eating. We aimed to develop a new questionnaire to assess parental perceived barriers to healthy feeding in young children and perform the instrument's preliminary psychometric evaluation. The initial pool of items was developed based on reviews and qualitative studies. First, we conducted an online, descriptive, cross-sectional study with 278 parents of 2-6-year-old children to examine its factorial structure and internal consistency. Then, a second study with 168 parents from a similar population assessed convergent/discriminant and known-groups validity. The exploratory factorial analysis confirmed the scale's theoretical structure. Five scales were found: Child-Related Barriers, Parent-Related Barriers-Vegetables and Fruit, Parent-Related Barriers-Added Sugars, Social Context-Related Barriers, and Cost-Related Barriers. All scales presented adequate reliability. We found weak to moderate, negative, and significant correlations between child- and parent-related barriers regarding vegetables and fruits, feeding practices to promote children's eating self-regulation, and food parenting self-efficacy. Additionally, parents who perceived their children as easy and well-regulated reported significantly fewer child-related barriers than parents with poorly self-regulated and inhibited children. The results support the instrument's preliminary psychometric adequacy regarding its validity and reliability and corroborate earlier empirical studies about the main parental barriers when promoting young children's healthy eating habits.

Parental intentions to implement vegetable feeding strategies at home: A cross sectional study

In order to increase vegetable intake by children, parents are encouraged to implement strategies that promote trying and eating vegetables at mealtimes. Qualitative studies have previously highlighted barriers parents face in implementing healthy eating practices, such as time, monetary costs and child factors (e.g. fussy eaters). This study aimed to specify the relationships between child and parent factors and their effects on parental intentions to implement vegetable feeding strategies at mealtimes. Parental intentions to implement meal service (serving larger portions, offering variety, serving vegetables first) and experiential learning (repeated exposure, games, sensory play) strategies were examined. Parents (N = 302, 73 male, Mage = 33.5) also explained reasons why certain strategies may or may not work for their child (4-7y). For both types of strategy, higher food fussiness of the child predicted higher parental intentions to implement strategies at home. However, this was competitively mediated by low beliefs that the strategy would work for their child, resulting in weaker overall positive effects on intentions. In the meal service model, parental beliefs that healthy eating is important for their child had a positive, indirect effect on higher intentions, through involved parental feeding practices. However, this was not significant in the experiential learning strategies model. Written parental responses suggest that this may be due to meal service approaches being viewed as easier to implement, with little additional effort required. Increasing parental confidence to implement strategies successfully and managing expectations around successful outcomes of strategies (e.g. tasting, eating) may be important focuses of future interventions to support parents implementing vegetable feeding strategies at mealtimes.

Development and Psychometric Characteristics of an Instrument to Assess Parental Feeding Practices to Promote Young Children's Eating Self-Regulation: Results with a Portuguese Sample

A parental child-centered feeding approach is likely to keep children’s biological mechanisms activated while eating, protecting them in an obesogenic context. However, few feeding practice measures assess parents’ behaviors to guide and prompt children to identify and respond appropriately to their signs of hunger and satiety. We aimed to develop and study the reliability, validity, and measurement invariance of a new scale to assess parental feeding practices to promote children’s self-regulation of food intake. To pursue this aim, we conducted two descriptive, cross-sectional, online studies in Portugal in an online format; a total of 536 parents of 2- to 6-year-old children completed the evaluation protocol. Factorial analysis findings support the theoretical organization proposed for the scale. The confirmatory factorial analysis supported a first-order factor structure with two subscales, Prompting for eating self-regulation and Teaching about eating consequences, with eight items in total. Both scales presented good internal consistency and adequate temporal stability, with a significant, positive, and moderate relationship. The results showed metric invariance for the child’s sex. Both types of practices were positively correlated with the child’s enjoyment of food. Prompting for eating self-regulation showed negative associations with parents’ emotional lack of control, children’s satiety responsiveness, slowness in eating, and fussiness. Preliminary studies confirmed both the validity and reliability of the instrument and the adequacy of adopting a self-regulatory approach when assessing child-centered feeding practices. Combining this instrument with others that assess coercive practices can be beneficial to capture ineffective parents’ behaviors on children’s eating self-regulation.

Food and beverage offerings by parents of preschoolers: A daily survey study of dinner offerings during COVID-19

The COVID-19 pandemic is likely to have altered parents' daily feeding practices, including what and how much they feed their children, which may have negative implications for children's weight. The primary aim of this study was to examine patterns of and variation in parents' daily food and beverage offerings at dinner across 10 days during the COVID-19 pandemic using descriptive analysis and non-parametric tests. Ninety-nine parents (M_age = 32.90, SD_age = 5.60) of children ages 2–4 years (M = 2.82, SD = 0.78) completed an online baseline survey and 10 daily surveys (929 completed surveys) assessing their daily food and beverage offerings at dinner. On average, parents did not offer recommended foods and beverages on a daily basis; parents offered vegetables and protein most often across the 10 days, however, less than 50% of parents offered the recommended serving size for each group. The intraclass correlations and random sampling plots revealed considerable within-parent variation in food and beverage offerings. Eating dinner as a family, planning dinner in advance, and preparing a homemade dinner were associated with more vegetable and protein offerings, while processed, fast, or fried foods were offered less often when dinner was planned or homemade. Dairy, water, and refined grains were offered more often when dinner was homemade, while whole grains, processed, fast, or fried foods, and sugar-sweetened beverages were offered less often when dinner was homemade. The results provide documentation of parents' daily food and beverage offerings at dinner within the context of COVID-19 and point towards the importance of examining predictors and consequences of parents' daily feeding practices.

Precision Food Parenting: A Proposed Conceptual Model and Research Agenda

Precision medicine, nutrition and behavioral interventions are attempting to move beyond the specification of therapies applied to groups, since some people benefit, some do not and some are harmed by the same therapy. Instead, precision therapies are attempting to employ diverse sets of data to individualize or tailor interventions to optimize the benefits for the receiving individuals. The benefits to be achieved are mostly in the distant future, but the research needs to start now. While precision pediatric nutrition will combine diverse demographic, behavioral and biological variables to specify the optimal foods a child should eat to optimize health, precision food parenting will combine diverse parent and child psychosocial and related variables to identify the optimal parenting practices to help a specific child accept and consume the precision nutrition specified foods. This paper presents a conceptual overview and hypothetical model of factors we believe are needed to operationalize precision food parenting and a proposed research agenda to better understand the many specified relationships, how they change over the age of the child, and how to operationalize them to encourage food parenting practices most likely to be effective at promoting healthy child food choices.

Life course learning experiences and infant feeding practices in rural Rwanda

Most studies about infant and young child feeding (IYCF) practices are often perceived as an individual choice depending on mothers' or caregivers' knowledge or attitudes and are focused on mothers' failure rather than successes in adequately feeding their children. However, the role of life course experiences in IYCF is less investigated. Applying a Salutogenic Model of Health, this study on 14 mothers looks at women's life course learning experiences shaping appropriate IYCF practices during the first year of child's life in a rural district of Rwanda. Transcripts from in‐depth interviews were analysed using thematic analysis. Results indicate that positive social interaction with parents or grandmothers during childhood such as sharing meals, parental role models for dietary choices and cooking skills gained by participating in household food preparation played a role in shaping appropriate IYCF practices. Negative experiences during childhood also had a positive influence on IYCF practices for some participants by converting life course constraints into learning opportunities. Motherhood increased mothers' sense of responsibility over their children's health and nutrition. Moreover, mothers' participation in community cooking classes and role modelling approach were strong avenues that enabled their learning through positive interactions and encouragement. Nutrition promotion interventions should consider tailoring nutrition advice to the complexity of mothers' life course experiences by creating opportunities for positive learning experiences of appropriate IYCF practices.

Impact of a Nordic diet on psychological function in young students

BACKGROUND

There has been a rapid increase in the prevalence of psychiatric and psychological disease, and this has attracted interest in identifying modifiable lifestyle factors that may affect an individual's mood. Diet is one potential lifestyle factor that may affect psychological function.

AIM

This study aimed to investigate the relationship between adherence to the health-promoting Nordic diet (ND) with neuropsychological function in young women.

METHODS

The study comprised 181 female students aged between 18 and 25 years. Psychological function was evaluated using a series of standardized questionnaires, including the Cognitive Ability Questionnaire, Depression Anxiety Stress Scale, Insomnia Severity Index, Epworth Sleep Scale and Quality of Life Questionnaire. A validated food frequency questionnaire, which included 65 types of foods, was used to evaluate the amount of different foods consumed.

RESULTS

Evaluation of the dietary composition of the participants showed that the rate of adherence to the ND was positively associated with total energy, carbohydrates, protein, fibre, iron, magnesium, potassium, zinc, folate, phosphorus, vitamin C, thiamine, riboflavin, niacin, vitamins B6 and B12, carotene, whole grain, legumes, cabbage/vegetables, vegetables and fruit (p<0.05). Linear regression showed cabbage/vegetable consumption was inversely related to scores of stress (β=-0.04; p=0.038) and anxiety (β=-0.02; p=0.049) and directly associated with the quality-of-life score (0.02; p=0.036).

CONCLUSIONS

Adherence to a ND with a high intake of cabbage/vegetables was inversely associated with stress and anxiety scores and directly associated with health-related quality of life.

Exploring Determinants of Parent Behaviors During Eating Episodes

OBJECTIVE

To develop a conceptual model of determinants of parent feeding behaviors with preschoolers.

DESIGN

Semistructured in-depth interviews were collected and transcribed verbatim.

SETTING

University of Houston.

PARTICIPANTS

Parents of preschool-aged children (aged 2-5 years).

PHENOMENON OF INTEREST

Determinants of parent behaviors during eating episodes with preschoolers.

ANALYSIS

Trained coders conducted thematic analysis with constant comparison of all interviews.

RESULTS

The final sample (n = 20) included predominantly white (60%), married (70%) mothers (75%) from middle socioeconomic conditions (100% had at least some college education; 70% had a household income >$50,000). Five categories of themes emerged: child behaviors, proactive parent behaviors, reactive parent behaviors, contextual factors, and parent beliefs. The themes were organized into a conceptual model to describe how parents and children influenced each other's behaviors depending on the context and parent beliefs of themselves and their child.

CONCLUSIONS AND IMPLICATIONS

A conceptual model outlining several determinants of parent feeding behaviors among preschoolers was developed. Next steps in the research are to validate the conceptual model identified in this qualitative study on a large, nationally representative sample.

Model of goal directed behavior for limiting Latino preschoolers' television viewing: validity and reliability

Background

Accurately measuring parents’ attitudes and beliefs regarding limiting their children’s TV viewing is important to inform the design and evaluation of effective interventions. This manuscript assesses the internal consistency reliability, test-retest reliability, convergent validity, and construct validity of the Model of Goal Directed Behavior (MGDB) scales among parents of Latino preschoolers to characterize Latino parents’ attitudes and beliefs toward limiting their preschoolers’ TV viewing.

Method

Participants included parents of Latino preschoolers in the United States, 3–5 years old (n = 186). Parents completed a socio-demographic survey and the 105-item MGDB questionnaire (Attitudes, Perceived Positive/Negative Behavioral Control, Subjective Norms, Positive and Negative Anticipated Emotions, Habits, Self-Efficacy, Desires, and Intentions surrounding their child’s TV viewing) which was used to measure internal consistency reliability and construct validity. A subsample of participants completed the questionnaire twice to measure test-retest reliability. Further, parents completed a 7-day TV viewing diary for their preschooler, and a TV parenting practices questionnaire as measures of convergent validity.

Results

Internal consistency reliability was generally acceptable for the MGDB scales (Cronbach’s alphas> 0.7), except for the Desires scale, which was revealed to have two factors and the Attitudes and Perceived Behavioral Control scales. Test-retest reliability over 2 months had negligible to moderate correlations (r’s = 0.28 to 0.61). Two structural equation models were conducted. One yielded acceptable model fit (x² (97) = 113.65, p = .119) and the other had questionable model fit (x² (97) = 125.39; p = .028). Testing convergent validity, only two MGDB scales (Habits and Self-Efficacy) were positively correlated with the TV parenting practices questionnaire (r’s = 0.33 to 0.51), and none were meaningfully correlated with preschoolers’ mean daily TV viewing.

Conclusions

Initial reliability and validity for some of the MGDB scales appear acceptable among parents of Latino preschoolers. Refinement of the instrument and testing among larger samples is necessary to fully evaluate psychometric properties. This instrument may be useful for characterizing Latino parents’ attitudes and beliefs toward limiting their preschoolers’ TV viewing and informing future TV reduction interventions.

Trial registration

Clinical Trials NCT01216306 Registered October 6, 2010.

A Cross-Sectional Study on the Relationship between the Family Nutrition Climate and Children's Nutrition Behavior

Background: Parents influence their children’s nutrition behavior. The relationship between parental influences and children’s nutrition behavior is often studied with a focus on the dyadic interaction between the parent and the child. However, parents and children are part of a broader system: the family. We investigated the relationship between the family nutrition climate (FNC), a family-level concept, and children’s nutrition behavior. Methods: Parents of primary school-aged children (N = 229) filled in the validated family nutrition climate (FNC) scale. This scale measures the families’ view on the consumption of healthy nutrition, consisting of four different concepts: value, communication, cohesion, and consensus. Parents also reported their children’s nutrition behavior (i.e., fruit, vegetable, water, candy, savory snack, and soda consumption). Multivariate linear regression analyses, correcting for potential confounders, were used to assess the relationship between the FNC scale (FNC-Total; model 1) and the different FNC subscales (model 2) and the child’s nutrition behavior. Results: FNC-Total was positively related to fruit and vegetable intake and negatively related to soda consumption. FNC-value was a significant predictor of vegetable (positive) and candy intake (negative), and FNC-communication was a significant predictor of soda consumption (negative). FNC-communication, FNC-cohesion, and FNC-consensus were significant predictors (positive, positive, and negative, respectively) of water consumption. Conclusions: The FNC is related to children’s nutrition behavior and especially to the consumption of healthy nutrition. These results imply the importance of taking the family-level influence into account when studying the influence of parents on children’s nutrition behavior. Trial registration: Dutch Trial Register NTR6716 (registration date 27 June 2017, retrospectively registered), METC163027, NL58554.068.16, Fonds NutsOhra project number 101.253.

Feeding Infants and Toddlers: A Qualitative Study to Determine Parental Education Needs

Background: Limited evidence-based guidance is available to parents regarding optimal child feeding practices to prevent early childhood obesity from birth to 24 months of age (B-24). The objective of this qualitative study was to determine current child feeding practices, barriers to implementation, and educational needs of parents of varying socioeconomic backgrounds as it relates to responsive feeding to prevent early obesity in children of ages B-24. Methods: One-on-one interviews were conducted with parents (n = 66) of children ages B-24 from both low-and non-low-income households. Interviews were audiorecorded, transcribed verbatim, and analyzed with NVivo using classical qualitative analysis. Results: Participants were primarily female (91%), married (53%), low-income (59%), and were not first-time parents (72%). The results revealed overarching themes, including parents' reported need for information on preparing child meals, optimal dietary intake, affordable healthy foods, promoting child self-feeding, and food and nutrition knowledge. Low-income parents more frequently requested guidance about identifying affordable healthy options and overfeeding while non-low-income parents requested information about food allergens, transitioning to solids, and creating structured mealtimes. Conclusions: Additional and focused outreach to parents of children ages B-24 regarding optimal feeding practices is needed especially on topics related to complementary feeding during the transition to solid food.

Mothers' Vegetable Consumption Behaviors and Preferences as Factors Limiting the Possibility of Increasing Vegetable Consumption in Children in a National Sample of Polish and Romanian Respondents

Increasing the insufficient intake of vegetables in children may be difficult, due to the influence of parents and at-home accessibility. The aim of this study was to analyze the association between self-reported vegetable consumption behaviors and preferences of mothers and the behaviors and preferences of their children, as declared by them. The nationally representative Polish (n = 1200) and Romanian (n = 1157) samples of mothers of children aged 3-10 were obtained using the random quota sampling method, and interviewed for their and their children's general frequency of consumption and preferences of vegetables in years 2012-2014. A 24 h dietary recall of vegetable consumption was conducted for mothers and their children. Associations were observed for general number of servings consumed per day by mother-child pairs (p < 0.0001; R = 0.6522, R = 0.6573 for Polish and Romanian samples, respectively) and number of types indicated as preferred (p < 0.0001; R = 0.5418, R = 0.5433). The share of children consuming specific vegetables was 33.1-75.3% and 42.6-75.7% while their mothers also consumed, but 0.1-43.2% and 1.2-22.9% while their mothers did not. The share of children preferring specific vegetables was 16.7-74.1% and 15.2-100% when their mother shared the preference, but 1.3-46.9% and 0-38.3% when their mother did not. The mothers' vegetable consumption behaviors and preferences may be a factor limiting the possibility of increasing vegetable consumption in their children.

Learning to like vegetables during breastfeeding: a randomized clinical trial of lactating mothers and infants

Background: What lactating mothers eat flavors breast milk and, in turn, modifies their infants' acceptance of similarly flavored foods.Objective: We sought to determine the effects of the timing and duration of eating a variety of vegetables during breastfeeding on the liking of vegetables in both members of the dyad.Design: We conducted a randomized controlled study of 97 mother-infant dyads. Lactating mothers drank vegetable, beet, celery, and carrot juices for 1 mo beginning at 0.5, 1.5, or 2.5 mo postpartum or for 3 mo beginning at 0.5 mo postpartum. The control group drank equal volumes of water and avoided drinking the juices. Mothers rated the tastes of the juices and self-reported dietary intakes at each monthly visit (0.5-4.5 mo). After weaning, when 7.9 mo of age, infants' acceptance of plain, carrot-flavor (exposed flavor), and broccoli-flavor (nonexposed flavor) cereals was assessed on separate days.Results: The timing of exposure affected the acceptance of the carrot flavor that did not generalize to the novel broccoli flavor. A relatively brief experience (1 mo) with vegetable flavors in mothers' milk, starting at 0.5 mo postpartum, was sufficient to shift the hedonic tone, which resulted in a faster rate of eating carrot-flavored cereal than that in infants who were exposed during subsequent months or not at all. One month of exposure had a greater effect than 3 mo of exposure or no exposure. Regardless of when exposure occurred, infants were less likely to display facial expressions of distaste initially when eating the carrot cereal. Over time, mothers liked the tastes of carrot, beet, and celery juices more, but no changes in dietary intake of vegetables were observed.Conclusions: Early life may be an optimum time for both infants and their mothers to learn to like the taste of healthy foods. More research is needed to facilitate the liking and eating of these foods by mothers, which will, in turn, increase the likelihood of their feeding these foods to their children. This trial was registered at clinicaltrials.gov as NCT01667549.

Variety of fruit and vegetables is related to preschoolers' overall diet quality

Children are encouraged to eat a specific amount of fruits and vegetables to optimize health. The purpose of this study was to assess whether consumption of a variety of fruits and vegetables, respectively, was associated with a greater diet quality among preschool-aged children. Analyses were performed using a cross-sectional, nationally representative sample of US children. Dietary intakes from 24-h dietary recalls of two-five year old children (n = 2595) in 2005–2010 NHANES were examined. Diet quality was evaluated using MyPlate equivalents and the Healthy Eating Index 2010 (HEI-2010). Variety categories were determined based on children's fruit, fruit juice, and vegetable consumption on the recalled day. Differences in diet quality were examined using t-tests. Variety of fruits and vegetables was linked to higher overall diet quality. Children who consumed whole fruit had better diet quality scores for total fruit, whole fruit, whole grains, dairy, seafood, refined grains, sodium, and empty calories (P ≤ 0.018). Significantly higher HEI-2010 scores for total fruit, whole fruit, fatty acids, sodium, and empty calories, but a lower dairy HEI-2010 score, were identified in children who drank fruit juice (P ≤ 0.038). Vegetable consumption was significantly associated with higher total vegetables, greens/beans, and empty calories, but a lower sodium score (P ≤ 0.027). Children who consumed whole fruit, fruit juice and non-starchy vegetables (P ≤ 0.017), but not white potatoes, had significantly higher total HEI-2010 scores. Reinforcing fruit and 100% fruit juice consumption may indirectly support healthier diets among children. However, underlying associations between fruit and vegetable intakes and overall diet quality should be examined further.

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Children's variety of fruit and vegetable intake resulted in better diet quality.

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Children who consumed whole fruit had better diet quality scores.

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Vegetable consumption was significantly associated with higher total vegetables.

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Children who consumed 100% fruit juice had higher total HEI-2010 scores.

Applying the Model of Goal-Directed Behavior, Including Descriptive Norms, to Physical Activity Intentions: A Contribution to Improving the Theory of Planned Behavior

The theory of planned behavior (TPB) has received its fair share of criticism lately, including calls for it to retire. We contribute to improving the theory by testing extensions such as the model of goal-directed behavior (MGDB, which adds desire and anticipated positive and negative emotions) applied to physical activity (PA) intention. We also test the inclusion of a descriptive norms construct as an addition to the subjective norms construct, also applied to PA, resulting in two additional models: TPB including descriptive norms (TPB + DN) and MGDB including descriptive norms (MGDB + DN). The study is based on an online survey of 400 young adult Internet users, previously enrolled in a subject pool. Confirmatory factor analysis (CFA) showed that TPB and TPB + DN were not fit for purpose, while MGDB and MGDB + DN were. Structural equation modelling (SEM) conducted on MGDB and MGDB + DN showed that the inclusion of descriptive norms took over the significance of injunctive norms, and increased the model's account of total variance in intention to be physically active.

Commentary: Writing and Evaluating Qualitative Research Reports

OBJECTIVE

To provide an overview of qualitative methods, particularly for reviewers and authors who may be less familiar with qualitative research.

METHODS

A question and answer format is used to address considerations for writing and evaluating qualitative research.

RESULTS AND CONCLUSIONS

When producing qualitative research, individuals are encouraged to address the qualitative research considerations raised and to explicitly identify the systematic strategies used to ensure rigor in study design and methods, analysis, and presentation of findings. Increasing capacity for review and publication of qualitative research within pediatric psychology will advance the field's ability to gain a better understanding of the specific needs of pediatric populations, tailor interventions more effectively, and promote optimal health.

Fruit and Vegetable Perceptions Among Caregivers of American Indian Toddlers and Community Stakeholders: a Qualitative Study

American Indians experience higher rates of obesity than any other ethnic group living in the USA. This disparity begins to develop in early childhood, and the excess weight carried by American Indian children contributes to health conditions that can affect their quality of life by the time they enter preschool. These children consume less than recommended amounts of fruits and vegetables, a dietary pattern that may be related to the development of obesity and other health conditions. This qualitative study explored the fruit and vegetable intake of American Indian toddlers through use of the information-motivation-behavioral skills (IMB) model. Focus groups with caregivers of American Indian toddlers and interviews with stakeholders in American Indian communities were conducted to investigate perceptions of knowledge, motivational, and behavioral skills related to the fruit and vegetable intake of American Indian toddlers. Study participants communicated that peer support, food insecurities, cultural norms, self-efficacy, and skills to prepare fruits and vegetables impact their ability to provide fruits and vegetables to toddlers. Study participants expressed a desire to increase their knowledge regarding fruits and vegetables, including variety, benefits, and recommendations for consumption. Findings from this qualitative study provide essential insights into perceptions of fruits and vegetables among caregivers of American Indian toddlers and stakeholders in American Indian communities. Future research will utilize these findings to develop a culturally appropriate IMB-model-based fruit and vegetable-focused nutrition education program for American Indian families.

Predicting habits of vegetable parenting practices to facilitate the design of change programmes

OBJECTIVE

Habit has been defined as the automatic performance of a usual behaviour. The present paper reports the relationships of variables from a Model of Goal Directed Behavior to four scales in regard to parents' habits when feeding their children: habit of (i) actively involving child in selection of vegetables; (ii) maintaining a positive vegetable environment; (iii) positive communications about vegetables; and (iv) controlling vegetable practices. We tested the hypothesis that the primary predictor of each habit variable would be the measure of the corresponding parenting practice.

DESIGN

Internet survey data from a mostly female sample. Primary analyses employed regression modelling with backward deletion, controlling for demographics and parenting practices behaviour.

SETTING

Houston, Texas, USA.

SUBJECTS

Parents of 307 pre-school (3-5-year-old) children.

RESULTS

Three of the four models accounted for about 50 % of the variance in the parenting practices habit scales. Each habit scale was primarily predicted by the corresponding parenting practices scale (suggesting validity). The habit of active child involvement in vegetable selection was also most strongly predicted by two barriers and rudimentary self-efficacy; the habit of maintaining a positive vegetable environment by one barrier; the habit of maintaining positive communications about vegetables by an emotional scale; and the habit of controlling vegetable practices by a perceived behavioural control scale.

CONCLUSIONS

The predictiveness of the psychosocial variables beyond parenting practices behaviour was modest. Discontinuing the habit of ineffective controlling parenting practices may require increasing the parent's perceived control of parenting practices, perhaps through simulated parent-child interactions.

Promotion and Prevention Focused Feeding Strategies: Exploring the Effects on Healthy and Unhealthy Child Eating

There is a general lack of research addressing the motivations behind parental use of various feeding practices. Therefore, the present work aims to extend the current literature on parent-child feeding interactions by integrating the traditional developmental psychological perspective on feeding practices with elements of Regulatory Focus Theory (RFT) derived from the field of motivational psychology. In this paper, we seek to explain associations between parental feeding practices and child (un)healthy eating behaviors by categorizing parental feeding practices into promotion and prevention focused strategies, thus exploring parent-child feeding interactions within the framework of RFT. Our analyses partly supported the idea that (1) child healthy eating is positively associated with feeding practices characterized as promotion focused, and (2) child unhealthy eating is negatively associated with feeding practices characterized as prevention focused. However, a general observation following from our results suggests that parents' major driving forces behind reducing children's consumption of unhealthy food items and increasing their consumption of healthy food items are strategies that motivate rather than restrict. In particular, parents' provision of a healthy home food environment seems to be essential for child eating.

Perceptions of how parents of early adolescents will personally benefit from calcium-rich food and beverage parenting practices

OBJECTIVE

To identify and rank perceived personal benefits from parenting practices that promote intake of calcium-rich foods and beverages (CRF/B) by early adolescents.

METHODS

A convenience sample of parents/caregivers (n = 133) of early adolescents (10-13 years) from 6 states (CA, HI, MN, OH, OR, UT) participated in a qualitative study using a Nominal Group Technique process. Benefits identified by parents/caregivers were ranked by importance, given a score weight, and summed to create a total weighted score across states.

RESULTS

The top benefit from making CRF/B available was parent emotional rewards. The top benefit perceived by parents from role modeling intake of CRF/B and setting expectations for intake of CRB was child health promotion.

CONCLUSIONS AND IMPLICATIONS

Child health promotion and parent emotional rewards were important perceived benefits derived from CRF/B parenting practices, and thus, should be included as the focus of education to increase the frequency of these practices.

Predicting use of effective vegetable parenting practices with the Model of Goal Directed Behavior

OBJECTIVE

To model effective vegetable parenting practices using the Model of Goal Directed Vegetable Parenting Practices construct scales.

DESIGN

An Internet survey was conducted with parents of pre-school children to assess their agreement with effective vegetable parenting practices and Model of Goal Directed Vegetable Parenting Practices items. Block regression modelling was conducted using the composite score of effective vegetable parenting practices scales as the outcome variable and the Model of Goal Directed Vegetable Parenting Practices constructs as predictors in separate and sequential blocks: demographics, intention, desire (intrinsic motivation), perceived barriers, autonomy, relatedness, self-efficacy, habit, anticipated emotions, perceived behavioural control, attitudes and lastly norms. Backward deletion was employed at the end for any variable not significant at P<0·05.

SETTING

Houston, TX, USA.

SUBJECTS

Three hundred and seven parents (mostly mothers) of pre-school children.

RESULTS

Significant predictors in the final model in order of relationship strength included habit of active child involvement in vegetable selection, habit of positive vegetable communications, respondent not liking vegetables, habit of keeping a positive vegetable environment and perceived behavioural control of having a positive influence on child's vegetable consumption. The final model's adjusted R 2 was 0·486.

CONCLUSIONS

This was the first study to test scales from a behavioural model to predict effective vegetable parenting practices. Further research needs to assess these Model of Goal Directed Vegetable Parenting Practices scales for their (i) predictiveness of child consumption of vegetables in longitudinal samples and (ii) utility in guiding design of vegetable parenting practices interventions.

Predicting use of ineffective vegetable parenting practices with the Model of Goal Directed Behavior

OBJECTIVE

Increasing a parent's ability to influence a child's vegetable intake may require reducing the parent's use of ineffective vegetable parenting practices. The present study was designed to understand the psychosocial influences on ineffective vegetable parenting practices.

DESIGN

A cross-sectional web-based survey was conducted to model use of ineffective vegetable parenting practices using validated scales from a Model of Goal Directed Vegetable Parenting Practices.

SETTING

The dependent variable was a composite ineffective vegetable parenting practices index. The independent variables included validated subscales of intention, habit, perceived barriers, desire, competence, autonomy, relatedness, attitudes, norms, perceived behavioural control and anticipated emotions. Models were analysed using block regression with backward deletion.

SUBJECTS

Parents of 307 pre-school children (3-5 years old).

RESULTS

Variables significantly positively related to ineffective vegetable parenting practices in order of relationship strength included habit of controlling vegetable practices (standardized β=0·349, P<0·0001) and desire (standardized β=0·117, P=0·025). Variables significantly negatively related to ineffective vegetable parenting practices in order of relationship strength included perceived behavioural control of negative parenting practices (standardized β=-0·215, P<0000), the habit of active child involvement in vegetable selection (standardized β=-0·142, P=0·008), anticipated negative parent emotional response to child vegetable refusal (standardized β=-0·133, P=0·009), autonomy (standardized β=-0·118, P=0.014), attitude about negative effects of vegetables (standardized β=-0·118, P=0·015) and descriptive norms (standardized β=-0·103, P=0·032). The model accounted for 40·5 % of the variance in use of ineffective vegetable parenting practices.

CONCLUSIONS

The present study is the first report of psychometrically tested scales to predict use of ineffective vegetable parenting practices. Innovative intervention procedures will need to be designed and tested to reduce ineffective vegetable parenting practices.

A qualitative investigation of teachers' information, motivation, and behavioral skills for increasing fruit and vegetable consumption in preschoolers

OBJECTIVE

Using the Information-Motivation-Behavioral Skills model as a framework, researchers qualitatively assessed preschool teachers' perceived motivation, facilitators, and barriers related to getting preschool children to eat fruits and vegetables (FV).

METHODS

Individual, semi-structured interviews with 28 Head Start teachers in central North Carolina.

RESULTS

Participants reported the need for FV-related information (Information) to improve FV consumption in children, perceived themselves to be parents at school (Motivation), and reported using conditional rewards and punishment statements to get preschoolers to eat FV (Behavioral Skills).

CONCLUSIONS AND IMPLICATIONS

Nutrition educators may use the Information-Motivation-Behavioral Skills model to develop education materials targeting increases in preschoolers' FV consumption. To motivate preschool teachers who see themselves as parents at school (Motivation), nutrition educators can provide teachers with FV-related information that was reported as their needs (Information), and supportive feeding practices (Behavioral Skills) to get preschoolers to consume FV.

Psychometric assessment of scales for a Model of Goal Directed Vegetable Parenting Practices (MGDVPP)

Background

Vegetable intake has been related to lower risk of chronic illnesses in the adult years. The habit of vegetable intake should be established early in life, but many parents of preschoolers report not being able to get their child to eat vegetables. The Model of Goal Directed Behavior (MGDB) has been employed to understand vegetable parenting practices (VPP) to encourage a preschool child’s vegetable intake. The Model of Goal Directed Vegetable Parenting Practices (MGDVPP) provides possible determinants and may help explain why parents use effective or ineffective VPP. Scales to measure effective and ineffective vegetable parenting practices have previously been validated. This manuscript presents the psychometric characteristics and factor structures of new scales to measure the constructs in MGDVPP.

Methods

Participants were 307 parents of preschool (i.e. 3 to 5 year old) children, used for both exploratory (EFA) and confirmatory factor analyses (CFA). Data were collected via an internet survey. First, EFA were conducted using the scree plot criterion for factor extraction. Next, CFA assessed the fit of the exploratory derived factors. Then, classical test theory procedures were employed with all scales. Finally, Pearson correlations were calculated between each scale and composite effective and ineffective VPP as a test of scale predictive validity.

Results

Twenty-nine subscales (164 items) within 11 scales were extracted. The number of items per subscale ranged from 2 to 13, with three subscales having 10 or more items and 12 subscales having 4 items or less. Cronbach’s alphas varied from 0.13 to 0.92, with 17 being 0.70 or higher. Most alphas <0.70 had only three or four items. Twenty-five of the 29 subscales significantly bivariately correlated with the composite effective or ineffective VPP scales.

Discussion

This was the initial examination of the factor structure and psychometric assessment of MGDVPP scales. Most of the scales displayed acceptable to desirable psychometric characteristics. Research is warranted to add items to those subscales with small numbers of items, test their validity and reliability, and characterize the model’s influence on child vegetable consumption.

Adapting the Trials of Improved Practices (TIPs) approach to explore the acceptability and feasibility of nutrition and parenting recommendations: what works for low-income families?

Interventions to prevent childhood obesity must consider not only how child feeding behaviours are related to child weight status but also which behaviours parents are willing and able to change. This study adapted Trials of Improved Practices (TIPs) to assess acceptability and feasibility of nutrition and parenting recommendations, using in-depth interviews and household trials to explore families' experiences over time. A diverse sample of 23 low-income parents of 3-11-year-olds was recruited following participation in nutrition and parenting education. Parents chose nutrition and parenting practices to try at home and were interviewed 2 weeks and 4-6 months later about behaviour change efforts. Qualitative analysis identified emergent themes, and acceptability and feasibility were rated based on parents' willingness and ability to try new practices. The nutrition goal parents chose most frequently was increasing children's vegetable intake, followed by replacing sweetened beverages with water or milk, and limiting energy-dense foods. Parents were less inclined to reduce serving sizes. The parenting practices most often selected as applicable to nutrition goals were role-modelling; shaping home environments, often with other adults; involving children in decisions; and providing positive feedback. Most recommendations were viewed as acceptable by meaningful numbers of parents, many of whom tried and sustained new behaviours. Food preferences, habits and time were common barriers; family resistance or food costs also constrained some parents. Despite challenges, TIPs was successfully adapted to evaluate complex nutrition and parenting practices. Information on parents' willingness and ability to try practices provides valuable guidance for childhood obesity prevention programmes.

Food parenting measurement issues: working group consensus report

Childhood obesity is a growing problem. As more researchers become involved in the study of parenting influences on childhood obesity, there appears to be a lack of agreement regarding the most important parenting constructs of interest, definitions of those constructs, and measurement of those constructs in a consistent manner across studies. This article aims to summarize findings from a working group that convened specifically to discuss measurement issues related to parental influences on childhood obesity. Six subgroups were formed to address key measurement issues. The conceptualization subgroup proposed to define and distinguish constructs of general parenting styles, feeding styles, and food parenting practices with the goal of understanding interrelating levels of parental influence on child eating behaviors. The observational subgroup identified the need to map constructs for use in coding direct observations and create observational measures that can capture the bidirectional effects of parent-child interactions. The self-regulation subgroup proposed an operational definition of child self-regulation of energy intake and suggested future measures of self-regulation across different stages of development. The translational/community involvement subgroup proposed the involvement of community in the development of surveys so that measures adequately reflect cultural understanding and practices of the community. The qualitative methods subgroup proposed qualitative methods as a way to better understand the breadth of food parenting practices and motivations for the use of such practices. The longitudinal subgroup stressed the importance of food parenting measures sensitive to change for use in longitudinal studies. In the creation of new measures, it is important to consider cultural sensitivity and context-specific food parenting domains. Moderating variables such as child temperament and child food preferences should be considered in models.

Dimensions of vegetable parenting practices among preschoolers

The objective of this study was to determine the factor structure of 31 effective and ineffective vegetable parenting practices used by parents of preschool children based on three theoretically proposed factors: responsiveness, control and structure. The methods employed included both corrected item-total correlations and confirmatory factor analysis. Acceptable fit was obtained only when effective and ineffective parenting practices were analyzed separately. Among effective items the model included one second order factor (effectiveness) and the three proposed first order factors. The same structure was revealed among ineffective items, but required correlated paths be specified among items. A theoretically specified three factor structure was obtained among 31 vegetable parenting practice items, but likely to be effective and ineffective items had to be analyzed separately. Research is needed on how these parenting practices factors predict child vegetable intake.

Predicting Use of Ineffective Responsive, Structure and Control Vegetable Parenting Practices with the Model of Goal Directed Behavior

This study reports the modeling of three categories of ineffective vegetable parenting practices (IVPP) separately (responsive, structure, and control vegetable parenting practices). An internet survey was employed for a cross sectional assessment of parenting practices and cognitive-emotional variables. Parents (n=307) of preschool children (3-5 years old) were recruited through announcements and postings. Models were analyzed with block regression and backward deletion procedures using a composite IVPP scale as the dependent variable. The independent variables included validated scales from a Model of Goal Directed Vegetable Parenting Practices (MGDVPP), including: intention, habit, perceived barriers, desire, competence, autonomy, relatedness, attitudes, norms, perceived behavioral control, and anticipated emotions. The available scales accounted for 26.5%, 16.7% and 44.6% of the variance in the IVPP responsive, structure and control subscales, respectively. Different sets of diverse variables predicted the three IVPP constructs. Intentions, Habits and Perceived Behavioral Control were strong predictors for each of the IVPP constructs, but the subscales were specific to each IVPP construct. Parent emotional responses, an infrequently investigated variable, was an important predictor of ineffective responsive vegetable parenting practices and ineffective structure vegetable parenting practices, but not ineffective control vegetable parenting practices. An Attitude subscale and a Norms subscale predicted ineffective responsive vegetable parenting practices alone. This was the first report of psychometrically tested scales to predict use of IVPP subscales. Further research is needed to verify these findings in larger longitudinal cohorts. Interventions to increase child vegetable intake may have to reduce IVPP.