Development of Parent and Adolescent Questionnaires to Assess Food Parenting Practices That Address Adolescent Consumption During Independent Eating Occasions

Parenting Practices Are Associated With Adolescent Food Choices During Independent Eating Occasions

BACKGROUND

Frequency of independent eating occasions (iEOs) has been linked to intake of unhealthy foods and overweight or obesity among adolescents. Parenting practices involving modeling healthy food intake and making healthy foods available have been associated with healthy food intake among adolescents; however, little is known about these associations during iEOs.

OBJECTIVE

To determine whether parenting practices involving structure (monitoring, availability, modeling, and expectations), lack of structure (indulgence), and autonomy support reported by adolescents or parents were associated with adolescent iEO intake of junk foods, sugar-sweetened beverages (SSBs), sugary foods, and fruit and vegetables.

DESIGN

Cross-sectional study measuring parenting practices and adolescent iEO food choices via an online survey and adapted food frequency questionnaire.

PARTICIPANTS/SETTING

Parent/adolescent dyads (n = 622) completed surveys (November-December 2021) using a national Qualtrics panel database. Adolescents were 11 to 14 years of age and had iEOs at least weekly.

MAIN OUTCOME MEASURES

Primary measures included parent- and adolescent-reported frequency of food parenting practices and adolescent-reported iEO intake of junk foods, sugary foods, SSBs, and fruits and vegetables.

STATISTICAL ANALYSES PERFORMED

Multivariable linear regression models were used to examine associations between parenting practices and iEO intake of foods/beverages, adjusting for adolescent's age, sex, race and ethnicity, iEO frequency, parent's education and marital status, and household food security status. Bonferroni multiple comparison corrections were conducted.

RESULTS

More than half of parents were female (66%) and 35 to 64 years of age (58%). Adolescents/parents identified as White/Caucasian (44%/42%), Black/African American (28%/27%), Asian (21%/23%), and Hispanic ethnicity (42%/42%). Positive associations were observed among adolescent-reported and parent-reported autonomy support, monitoring, indulgence and expectations parenting practices, and adolescent-reported daily iEO intake frequencies of junk foods, sugary foods, and fruits and vegetables (P < 0.001).

CONCLUSIONS

Structural and autonomy support parenting practices were positively associated with both healthy and unhealthy iEO food intake by adolescents. Interventions to improve adolescent iEO intake could promote positive practices associated with healthy food consumption.

Development and preliminary validation of the Adolescent Food Parenting Questionnaire: Parent and adolescent version

Suitable instruments for measuring Food Parenting Practices (FPP) among adolescents and their parents that also measure the perception of adolescents about their parent's FPP are rare. The current study describes the development and preliminary testing of a short 16-item Adolescent Food Parenting Questionnaire (AFPQ) for parents (AFPQ-p) and adolescents (AFPQ-a) that may enable future large-scale research on potentially eminent parent-child FPP discrepancy. Participants included 381 parents (73.8 % mothers; M_age 45.9, 26.2% fathers; M_age 49.1) and their adolescent children (aged 12-16) who participated in the Dutch "G(F)OOD together" study. Most parents finished higher professional education (mothers: 44.3 %; fathers: 34.4 %) and performed a paid job of 32 h per week or more (mothers: 22.1 %; fathers: 60.0 %). The theoretical framework of Vaughn (2016) was leading in the development of the AFPQ. Exploratory factor analysis (EFA) was performed on a random split sample of parent-adolescent dyads and confirmatory factor analysis (CFA) was performed on the other half. The EFA in both parent and adolescent samples resulted in a clear 5 factor solution explaining 61.6 % (AFPQ-p) and 64.2 % (AFPQ-a) of the variance respectively, representing the factors Autonomy Support (α = 0.79/.82), Coercive Control (α = 0.85/.83), Snack Structure (α = 0.79/75), Healthy Structure (α = 0.78/74) and Modelling (α = 0.69/85). CFA confirmed good model fit for the AFPQ-p and the AFPQ-a. Associations with adolescent self-reported food intake were in the expected direction, confirming the preliminary convergent validity of the instrument among a moderate to highly educated group of parent-adolescent dyads. Although the AFPQ provides a promising short instrument, future research in more diverse samples is needed to build evidence on the instrument's psychometric characteristics in other groups.

An Ecological Perspective of Food Choice and Eating Autonomy Among Adolescents

Adolescence is an important developmental period marked by a transition from primarily parental-controlled eating to self-directed and peer-influenced eating. During this period, adolescents gain autonomy over their individual food choices and eating behavior in general. While parent-feeding practices have been shown to influence eating behaviors in children, little is known about how these relationships track across adolescent development as autonomy expands. The purpose of this qualitative study was to identify factors that impact food decisions and eating autonomy among adolescents. Using the food choice process model as a guide, four focus groups were conducted with 34 adolescents. Focus group discussion was semi-structured, asking teens about influences on their food choices across different food environments, their involvement with food purchasing and preparation, and perceived control over food their choices. Focus group transcripts were analyzed using deductive and inductive code creation and thematic analysis. This study found six leading influences on adolescents' food choices and identified additional factors with prominence within specific environmental contexts. This study distinguished a broader spectrum of factors influencing adolescent food choice that extend beyond “convenience” and “taste” which have previously been identified as significant contributors. The degree of control that teens reported differed by eating location, occasion, and social context. Finally, adolescents demonstrated various levels of engagement in behaviors related to their eating autonomy. Identifying the emergent themes related to adolescent autonomy was the first step toward the goal of developing a scale to evaluate adolescent eating autonomy.