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Shinozaki N, Murakami K, Kimoto N, Masayasu S, Sasaki S. Association between meal context and meal quality: an ecological momentary assessment in Japanese adults. Eur J Nutr 2024; 63:2081-2093. [PMID: 38700576 PMCID: PMC11377557 DOI: 10.1007/s00394-024-03416-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 04/24/2024] [Indexed: 09/06/2024]
Abstract
PURPOSE The purpose was to assess the relationship between the quality of meals and its context. METHODS We conducted a cross-sectional study of 222 Japanese adults aged 30-76 years in 2021. The following information was obtained from the 4-d weighed dietary records: the recording day (working or not), meal type (breakfast, lunch, or dinner), eating companions (alone or with someone), eating location (at home or away from home), and screen-based activity (yes or no). The nutritional quality of each meal was evaluated using the Healthy Eating Index 2020 (HEI-2020). RESULTS The analysis included 1,295 meals for males and 1,317 for females. The mean HEI-2020 ranged from 43.0 (lunch) to 51.9 (dinner) in males and from 45.7 (breakfast) to 52.0 (dinner) in females. Multilevel linear regression showed that, in males, lunch had a significantly lower HEI-2020 score compared to breakfast (β = -1.81, 95% confidence interval [CI]: -3.42, - 0.20), while dinner had a significantly higher HEI-2020 score (β = 6.77, 95% CI: 5.34, 8.20). Eating with someone was significantly associated with a higher HEI-2020 score (β = 2.22, 95% CI: 0.76, 3.67). Among females, dinner had a higher HEI-2020 score than breakfast (β = 5.21, 95% CI: 3.72, 6.70). Eating away from home was associated with higher HEI-2020 scores (β = 2.14, 95% CI: 0.04, 4.24). CONCLUSION Meal type, location, and eating companions were associated with meal quality in this population, with differences between males and females. Incorporating these factors in nutrition education and interventions can enhance diet quality.
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Affiliation(s)
- Nana Shinozaki
- Department of Social and Preventive Medicine, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Kentaro Murakami
- Department of Social and Preventive Medicine, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
| | - Nana Kimoto
- Department of Social and Preventive Medicine, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Shizuko Masayasu
- Ikurien-naka, Sugaya, Naka-shi, Ibaraki, 3799-6, 311-0105, Japan
| | - Satoshi Sasaki
- Department of Social and Preventive Medicine, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
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López-Gil JF, Smith L, Tully MA, Álvarez-Pitti J, Gómez SF, Schröder H. Prevalence of daily family meals among children and adolescents from 43 countries. MATERNAL & CHILD NUTRITION 2024:e13706. [PMID: 39186933 DOI: 10.1111/mcn.13706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 06/19/2024] [Accepted: 07/08/2024] [Indexed: 08/28/2024]
Abstract
Prevalence studies about family meals, including large and representative samples of children and adolescents on this topic, are scarce. Therefore, the aim of this study was twofold: first, to determine the prevalence of daily family meals in large and representative samples of school-going children and adolescents from 43 countries, and second, to identify the sex, age, socioeconomic status (SES), family structure, immigrant status and parental labour market status inequalities associated with this prevalence. Using data from the 2017/2018 wave of the Health Behaviour in School-aged Children study, a total of 179,991 participants from 43 countries were involved in this cross-sectional study. Family meals were assessed by the following question: 'How often do you and your family usually have meals together?'. Participants had five different response options: 'every day', 'most days', 'about once a week', 'less often', and 'never'. The meta package was utilized for conducting a meta-analysis of single proportions, specifically applying the metaprop function. The analysis involved pooling the data using a random-effects model and presenting the outcomes through a forest plot generated using the inverse variance method. Moreover, we applied generalized linear mixed models to explore the relationships between the studied sociodemographic factors as fixed effects, country as a random effect and the status of daily family meals as an outcome. Overall, the prevalence of daily family meals was 49.12% (95% confidence interval [CI]: 45.00-53.25). A greater probability of having daily family meals was identified for children aged 10-12 years (61.55%; 95% CI: 57.44%-65.49%), boys (61.55%, 95% CI: 57.44%-65.49%), participants with high SES (64.66%, 95% CI: 60.65%-68.48%), participants with both parents at home (65.05%, 95% CI: 61.16%-68.74%) and those with both unemployed parents (61.55%, 95% CI: 57.44%-65.49%). In the present study, which included large representative samples of school-going children and adolescents from 43 countries, more than half of the participants did not have daily family meals.
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Affiliation(s)
| | - Lee Smith
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Mark A Tully
- School of Medicine, Ulster University, Londonderry, UK
| | - Julio Álvarez-Pitti
- Cardiovascular Risk Unit, Hospital General Universitario, University of Valencia, Valencia, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBER Obn), Instituto de Salud Carlos III, Madrid, Spain
| | - Santiago F Gómez
- Gasol Foundation Europe, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Cardiovascular Risk and Nutrition Research Group (CARIN), Hospital del Mar Research Institute, Barcelona, Spain
- Nursing and Physiotherapy Department, University of Lleida, Lleida, Spain
| | - Helmut Schröder
- Gasol Foundation Europe, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
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López-Gil JF, Ezzatvar Y, Ojeda-Rodríguez A, Galan-Lopez P, Royo JMP, Gaya AR, Agostinis-Sobrinho C, Martín-Calvo N. Is family meal frequency associated with obesity in children and adolescents? A cross-sectional study including 155 451 participants from 43 countries. Pediatr Obes 2024; 19:e13124. [PMID: 38798042 DOI: 10.1111/ijpo.13124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/04/2024] [Accepted: 04/15/2024] [Indexed: 05/29/2024]
Abstract
OBJECTIVE This study tried to examine the association between the frequency of family meals and excess weight using large and representative samples of children and adolescents from 43 countries. METHODS This cross-sectional study used data from the Health Behaviour in School-aged Children (HBSC), which included nationally representative samples of children and adolescents aged 10-17 years, involving a total of 155 451 participants (mean age = 13.6 years; standard deviation [SD] = 1.6; 51.4% girls). Family meal frequency was gauged through the following question: 'How frequently do you and your family typically share meals?' The possible responses were: 'never', 'less often', 'approximately once a week', 'most days' and 'every day'. The body weight and height of the participants were self-reported and utilized to calculate body mass index (BMI). Subsequently, BMI z-scores were computed based on the International Obesity Task Force criteria, and the prevalence of excess weight was defined as +1.31 SD for boys and + 1.24 SD for girls, with obesity defined as +2.29 SD for boys and + 2.19 SD for girls. Generalized linear mixed models were conducted to examine the associations between the frequency of family meals and excess weight or obesity. RESULTS The lowest predicted probabilities of having excess weight and obesity were observed for those participants who had family meals every day (excess weight: 34.4%, 95% confidence interval [CI] 31.4%-37.5%; obesity: 10.8%, 95% CI 9.0%-13.0%). CONCLUSIONS A higher frequency of family meals is associated with lower odds of having excess weight and obesity in children and adolescents.
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Affiliation(s)
| | - Yasmin Ezzatvar
- Department of Nursing, Universitat de València, Valencia, Spain
| | - Ana Ojeda-Rodríguez
- Lipids and Atherosclerosis Unit, Internal Medicine Unit, Reina Sofia University Hospital, Cordoba, Spain
- Department of Medical and Surgical Science, University of Cordoba, Cordoba, Spain
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain
- CIBER Fisiopatologia de la Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Pablo Galan-Lopez
- Department of Communication and Education, Universidad Loyola Andalucía, Seville, Spain
| | | | - Anelise Reis Gaya
- Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Cesar Agostinis-Sobrinho
- Polytechnic Institute Of Guarda, Guarda, Portugal
- Health Research and Innovation Centre, Faculty of Health Science, Klaipeda University, Klaipėda, Lithuania
| | - Nerea Martín-Calvo
- Department of Preventive Medicine and Public Health, Facultad de Medicina, Universidad de Navarra, Pamplona, Spain
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
- Pathophysiology of Obesity and Nutrition, Centro de Investigación Biomédica en Red, Instituto de Salud Carlos III, Madrid, Spain
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Robson SM, Alvarado AV, Baker-Smith CM. Family Meals and Cardiometabolic Risk Factors in Young Children. Curr Atheroscler Rep 2023; 25:509-515. [PMID: 37421580 DOI: 10.1007/s11883-023-01123-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2023] [Indexed: 07/10/2023]
Abstract
PURPOSE OF THE REVIEW Family meals represent a novel strategy for improving cardiovascular health in youth. The purpose of this paper is to describe the association between family meals, dietary patterns, and weight status in youth. REVIEW FINDINGS According to the American Heart Association's Life's Essential 8, poor diet quality and overweight/obesity status are key contributors to suboptimal cardiovascular health. Current literature highlights a positive correlation between the number of family meals and healthier eating patterns, including greater consumption of fruits and vegetables, and a reduced risk of obesity in youth. However, to date, the role of family meals in improving cardiovascular health in youth has been largely observational and prospective studies are needed to assess causality. Family meals may be an effective strategy for improved dietary patterns and weight status in youth.
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Affiliation(s)
- Shannon M Robson
- Department of Health Behavior and Nutrition Sciences, University of Delaware, 26 N College Avenue, Newark, DE, 19716, USA.
| | - Adriana Verdezoto Alvarado
- Department of Health Behavior and Nutrition Sciences, University of Delaware, 26 N College Avenue, Newark, DE, 19716, USA
| | - Carissa M Baker-Smith
- Pediatric Preventive Cardiology Program, Nemours Children's Health, Wilmington, DE, 19803, USA
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Litterbach EK, Laws R, Zheng M, Campbell KJ, Spence AC. "That's the routine": A qualitative exploration of mealtime screen use in lower educated Australian families with young children. Appetite 2023; 180:106377. [PMID: 36410562 DOI: 10.1016/j.appet.2022.106377] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 10/31/2022] [Accepted: 11/12/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Family meals are an opportune context for initiating healthy eating habits in young children. However, using screens at family mealtimes may negate some of the associated nutritional and social benefits. In High Income countries, frequent mealtime screen use is common, particularly in families of low socioeconomic position (SEP). This study aimed to explore experiences and acceptability of mealtime screen use in families of low SEP with young children. METHODS Qualitative interviews with 25 mothers of low SEP were conducted via telephone or Zoom™ using Photo Interviewing and a semi-structured interview script. Transcripts were analysed thematically using a Constructivist paradigm. RESULTS Many parents reported an eagerness for reducing family mealtime screen use. Three major themes were identified in explaining the reasons behind levels of engagement in family mealtime screen use. These included parental self-efficacy, such as parental confidence in saying no to screens at mealtimes, physical resources such as having enough space in the home for a functioning dining table without view of a television, and temporal priorities such as prioritising screen use for managing children's difficult behaviour at mealtimes over long-term health considerations. CONCLUSIONS This study highlights that although family mealtime screen use is likely linked with a range of child behaviours and parenting practices that may negatively influence children's dietary intake and social engagement, parents often considered screens acceptable at mealtimes. Nonetheless, parents' desire to reduce family mealtime screen use provides an important opportunity to determine how best to support parents to achieve this.
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Affiliation(s)
- Eloise-Kate Litterbach
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
| | - Rachel Laws
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Miaobing Zheng
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Karen J Campbell
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Alison C Spence
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
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Litterbach EK, Zheng M, Campbell KJ, Laws R, Spence AC. Mealtime TV Use Is Associated with Higher Discretionary Food Intakes in Young Australian Children: A Two-Year Prospective Study. Nutrients 2022; 14:nu14132606. [PMID: 35807787 PMCID: PMC9268203 DOI: 10.3390/nu14132606] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/29/2022] [Accepted: 06/17/2022] [Indexed: 02/05/2023] Open
Abstract
Background: Mealtime television use has been cross-sectionally associated with suboptimal diets in children. This study aimed to assess the two-year prospective association between baseline mealtime television use and subsequent diets in young children, and identify socioeconomic differences. Methods: Parents reported their child’s television use at meals, and fruit, vegetable, and discretionary food intakes. Multivariable linear and logistic regression analyses assessed the association between baseline mealtime television use and follow-up diet outcomes. Differences were assessed by socioeconomic position. Results: Participants were 352 Australian parents of children aged six months to six years. Daily mealtime television use (average frequency/day) was associated with higher daily frequency of discretionary food intakes (β 0.2, 95% confidence interval (CI) 0.07–0.67) at the 2-year follow-up. Individually, television use during breakfast and dinner (1–2 days/week compared to never) predicted higher daily intake frequency of discretionary food, β 0.36 (95% CI 0.12–0.60) and β 0.19 (95% CI 0.00–0.39), respectively. Similarly, 3–7 days/week of television use during breakfast and lunch predicted higher frequency of discretionary food intake, β 0.18 (95% CI 0.02–0.37) and β 0.31 (95% CI 0.07–0.55), respectively. Associations were not socioeconomically patterned. Conclusions: Investigating mealtime television use motivators across the socioeconomic spectrum could inform interventions targeting the high consumption of discretionary foods in children.
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Lee J, Friend S, Horning ML, Linde JA, Flattum C, Lindberg R, Fulkerson JA. Are patterns of family evening meal practices associated with child and parent diet quality and weight-related outcomes? Appetite 2022; 171:105937. [PMID: 35045323 PMCID: PMC8892840 DOI: 10.1016/j.appet.2022.105937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 01/07/2022] [Accepted: 01/13/2022] [Indexed: 11/20/2022]
Abstract
Family meal practices such as family member presence, fast food consumption and media usage have been associated with health outcomes. However, little is known about combinations of family meal practices and their effects on diet and health. This secondary data analysis aimed to identify patterns of family evening meal practices and examine their associations with family characteristics (e.g., demographics and chaos) and child and parent diet quality and weight-related outcomes. We used baseline data from a community-based randomized controlled trial with 7- to 10-year-old children and their parents in rural Minnesota (n = 114). Parent-reported structural (e.g. media usage) and interpersonal (e.g. mealtime routines) aspects of family evening meal practices were included in latent profile analyses to identify patterns. Diet quality was assessed by child Healthy Eating Index-2015 and parent fruit and vegetable intake. Weight-related outcomes were determined using measured body mass index (z-scores) and percent body fat. A 3-class model was the model of best-fit. The Unplanned Infrequent Family Evening Meals with Mixed Healthfulness class (C1) featured the least frequent family evening meals and the lowest scores for mealtime routines and planning skills. The Family Evening Meals with Fast Food class (C2) characterized having family evening meals four times a week, but fast food was often served. The Planful, Healthful and Frequent Family Evening Meals class (C3) reported the highest meal routine and planning scores as well as frequent family evening meals. Parents in C3 had higher consumption of fruits and vegetables and children in C3 had lower percent body fat, compared to those in other classes. Distinctly different patterns of family evening meal practices suggest a need for considering heterogeneity of family evening meal practices in developing tailored family-meal interventions.
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Affiliation(s)
- Jiwoo Lee
- School of Nursing, University of Minnesota, 308 Harvard St. S.E., Minneapolis, MN, 55455, USA.
| | - Sarah Friend
- School of Nursing, University of Minnesota, 308 Harvard St. S.E., Minneapolis, MN, 55455, USA.
| | - Melissa L Horning
- School of Nursing, University of Minnesota, 308 Harvard St. S.E., Minneapolis, MN, 55455, USA.
| | - Jennifer A Linde
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2nd St., Suite 300, Minneapolis, MN, 55454, USA.
| | - Colleen Flattum
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2nd St., Suite 300, Minneapolis, MN, 55454, USA.
| | - Rebecca Lindberg
- Rebecca E. Lindberg, LLC, 4629 Arden Avenue, Edina, MN, 55424, USA.
| | - Jayne A Fulkerson
- School of Nursing, University of Minnesota, 308 Harvard St. S.E., Minneapolis, MN, 55455, USA.
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REGO NDSILVA, RAVAGNOLI N, DIEZ-GARCIA RW. Food and Nutrition Education integrated in a holistic educational model. REV NUTR 2022. [DOI: 10.1590/1678-9865202235e220118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
ABSTRACT: Objective: To propose elements for the development of Food and Nutrition Education practices integrated to pedagogical activities for children. Methods: This is a qualitative case study, with participant observation and semi-structured interviews, carried out in a non-formal learning space, that is inspired in anthroposophy, Slow Food movement and Pikler approach. Participants were 13 children aged one to four years and three educators, and the data were interpreted by reflexive thematic analysis, using the Complex Thought as a theoretical framework. Results: The Food and Nutrition Education was consolidated in different pedagogical activities, such as cultivation practices, reverence in dealing with food, rituals and sharing, in an environmental and transdisciplinary approach. Conclusion: Nutrition education activities as part of a relationship with the environment and the planet, seen from a transdisciplinary perspective, is a differential in the formation of principles and values in early childhood education.
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Lohse B, Mitchell DC. Valid and Reliable Measure of Adherence to Satter Division of Responsibility in Feeding. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:211-222. [PMID: 33423902 DOI: 10.1016/j.jneb.2020.11.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 11/08/2020] [Accepted: 11/12/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To examine the validity and psychometrics of sDOR.2-6y, a 12-item measure of adherence to the Satter Division of Responsibility in Feeding (sDOR). DESIGN Cross-sectional survey. SETTING Online respondents in central Pennsylvania. PARTICIPANTS 117 parents (94% female, 77% White, 62% in ≥1 income-based assistance program) of preschoolers aged 2-6 years (28% moderate/high nutrition risk). MAIN OUTCOME MEASURES The sDOR.2-6y and Nutrition Screening Tool for Every Preschooler (NutriSTEP), a measure of child nutrition risk and other validated measures of eating behavior and parent feeding practices. ANALYSIS Relationships were evaluated with Pearson r, t tests, ANOVA, or chi-square. Factor structure was investigated using principal components analysis with varimax rotation. Binary logistic regression and general linear model controlling for low-income status compared with sDOR.2-6y and NutriSTEP scores. Linear regression predicted NutriSTEP and Satter Eating Competence Inventory 2.0 scores from sDOR.2-6y. RESULTS The sDOR.2-6y ranged from 16-32 (mean, 25.9 ± 3.3; n = 114). Parents of youth at nutrition risk had lower sDOR.2-6y scores (P = 0.004). Each 1 point sDOR.2-6y increase decreased nutrition risk odds by 21% (95% confidence interval, 0.675-0.918; P = 0.002). The sDOR.2-6y scores were higher with less restriction and pressure to eat (both P < 0.001) and were associated with feeding style. Specificity was 87% with sDOR.2-6y cutoff ≥24; sensitivity was 66% with cutoff ≥26. CONCLUSIONS AND IMPLICATIONS The sDOR.2-6y accurately and reliably indicated adherence of low-income mothers to sDOR. Larger, diverse samples for future studies are recommended.
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Affiliation(s)
- Barbara Lohse
- Wegmans School of Health and Nutrition, Rochester Institute of Technology, Rochester, NY.
| | - Diane C Mitchell
- Diet Assessment Center, Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA
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Use of an Observational Comparative Strategy Demonstrated Construct Validity of a Measure to Assess Adherence to the Satter Division of Responsibility in Feeding. J Acad Nutr Diet 2020; 121:1143-1156.e6. [PMID: 33349573 DOI: 10.1016/j.jand.2020.11.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 10/30/2020] [Accepted: 11/11/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND Currently developed parent feeding measures do not exclusively measure behaviors compatible with theoretical underpinnings of the Satter Division of Responsibility in Feeding for Children Aged 2 to 6 Years (sDOR.2-6y). A measure of adherence to sDOR.2-6y has been constructed and shown to have translational validity. OBJECTIVE To examine the construct validity of the 15 sDOR.2-6y items. DESIGN Observations from in-home mealtime video-capture in a household with a child aged 2 to 6 years were compared with parent sDOR.2-6y responses. One sDOR.2-6y item about mealtime regularity was compared with mealtime data provided in the Automated Self-Administered 24-Hour Dietary Assessment Tool that had been completed by a larger sample of parents that included the smaller sample of video-capture participants. PARTICIPANTS/SETTING Parents of preschool children aged 2 to 6 years in central Pennsylvania participated in Automated Self-Administered 24-Hour Dietary Assessment Tool online dietary assessment (n = 61) from May to November 2013 or in-home mealtime video-capture (n = 20) during October 2013 or both (n = 16). MAIN OUTCOME MEASURES Consensus of three trained sDOR coders of plausible parent sDOR.2-6y item responses after video viewing, parent responses to sDOR.2-6y items, and mealtime regularity from three Automated Self-Administered 24-Hour Dietary Assessment Tool recalls. STATISTICAL ANALYSIS Data analysis included identification of codeable 5-minute segments, coding by three sDOR experts, intraclass correlation coefficient, and determination of coder congruence to establish plausible sDOR.2-6y responses and comparison between coder-observed and parent sDOR.2-6y responses. RESULTS Video-capture participants were mostly women, White, and overweight with a mean ± standard deviation age of 35.3 ± 6.4 years. Postvideo debriefing supported the observed meal as typical in location, timing, and composition. Of 273 coding decisions, coder congruence was inadequate or dissonant for 3.7% and intraclass correlation coefficient was 0.81 (0.77 to 0.84; P < 0.001). Parent and congruent coder responses were in agreement for nearly 70% of the possible comparisons. Of the original 15 items, three were deemed not valid, nine of the remaining 12 were considered valid, and three could not be invalidated. CONCLUSIONS Congruence between observed and self-reported behaviors supported additional validation and scoring studies with the 12-item sDOR.2-6y to assess adherence of parents to sDOR.
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