Social cognitions about food choice in children aged five to eight years: Feasibility and predictive validity of an age appropriate measurement

Parent, child, and environmental predictors of vegetable consumption in Italian, Polish, and British preschoolers

This study compared the vegetable intake of preschool children from three European countries [Italy, Poland, and the United Kingdom (UK)] and explored the parent, child, and environmental factors that predicted intake in each country. A total of 408 parents of preschoolers (Italy: N = 61, Poland: N = 124, and UK: N = 225; child mean age = 32.2 months, SD = 9.47) completed an online survey comprising a set of standardised questionnaires. For all three countries, the questionnaires included measures of children's vegetable intake (VegFFQ), child eating behaviour (CEBQ-FF), parents' mealtime goals (FMGs), and sociodemographic questions about family background and environment. In the UK and Italy, additional questionnaires were used to assess child temperament (EAS-T) and parents' feeding practices (CFPQ). The results showed that the number of child-sized portions of vegetables consumed per day varied significantly across countries; Polish children consumed the most (∼3 portions) and Italian children the least (∼1.5 portions). Between-country differences were seen in parents' goals for family mealtimes; compared to Italian parents, Polish and UK parents were more motivated to minimise mealtime stress, increase family involvement in meal preparation, and share the same foods with family members. British and Italian parents also adopted different feeding practices; parents in the UK reported more use of healthy modelling behaviours and more use of foods to support their child's emotion regulation. In terms of child factors, Italian children were reported to be more emotional and more sociable than British children. Analyses of the relationships between the parent, child, and environmental factors and children's vegetable intake revealed both similarities and differences between countries. Negative predictors of vegetable intake included child food fussiness in the UK and Poland, child temperament (especially, shyness) in Italy, and the use of food as a reward and child emotionality in the UK. Positive predictors included the parental mealtime goal of 'family involvement' in the UK. These results highlight differences in the extent to which European preschoolers achieve recommended levels of vegetable intake, and in the factors that influence whether they do. The results suggest a need to develop healthy eating interventions that are adopted to meet the specific needs of the countries in which they are implemented.

Understanding fruit and vegetable consumption in children and adolescents. The contributions of affect, self-concept and habit strength

Affective processes and the role of automaticity are increasingly recognised as critical in determining food choice. This study investigated the association of affective attitude, self-identity and habit with fruit and vegetable (FV) intentions and intake in children. Previous studies have not fully explored their implications for children of different age groups and have not considered their independent contribution as part of a coherent model of behaviour that also controls for other psychosocial and environmental determinants of intake. Data was collected through face-to-face interviews with 362 children, 9-15 years old. Children were asked to report on measures of affective attitude, cognitive attitude, self-concept, social norms and facilitating factors following Triandis' Theory of Interpersonal Behaviour (TIB). Three stage least squares was used to estimate the independent association of affective attitude and self-concept with intentions and of intentions and habit with intake. Self-concept had the most prominent role in explaining intentions irrespective of age for both fruit and vegetables. The importance of affective attitude varied by age and with fruit and vegetables, with greater importance for vegetables and for children aged 11-13 years. Cognitive attitude was more relevant than affective attitude for 14 to 15 year-olds' fruit intentions. Intake was more strongly associated with habit than intentions, with stronger associations for 14 to 15 year-olds. The current findings support the importance of self-concept for FV motivations and provide further evidence on the importance of habit to FV intake in young and older children and adolescents. Results also support a targeted usefulness of affective attitude for fruit and vegetable intentions. The discussion considers potential ways in which these constructs can be incorporated into interventions to increase FV intake in children.

A feasibility study with process evaluation of a preschool intervention to improve child and family lifestyle behaviours

Background

Around a fifth of children starting school in England are now overweight/obese. There is a paucity of interventions with the aim of obesity prevention in preschool-age children in the UK. Previous research has demonstrated some positive results in changing specific health behaviours, however, positive trends in overall obesity rates are lacking. Preschool settings may provide valuable opportunities to access children and their families not only for promoting healthy lifestyles, but also to develop and evaluate behaviour-change interventions.

Methods

This paper presents a cluster randomised feasibility study of a theory based behaviour-change preschool practitioner-led intervention tested in four preschool centres in the North East of England. The primary outcome measures were to test the acceptability and feasibility of the data collection measures and intervention. Secondary measures were collected and reported for extra information. At baseline and post intervention, children’s anthropometric, dietary and physical activity measures as well as family ‘active’ time data were collected. The preschool practitioner-led intervention included family intervention tasks such as ‘family goal-setting activities’ and ‘cooking challenges’. Preschool activities included increasing physical activity and providing activities with the potential to change behaviour with increased knowledge of and acceptance of healthy eating. The process evaluation was an on-going monthly process and was collected in multiple forms such as questionnaires, photographs and verbal feedback.

Results

‘Gatekeeper’ permission and lower-hierarchal adherence were initially a problem for recruitment and methods acceptance. However, at intervention end the preschool teachers and parents stated they found most intervention methods and activities acceptable, and some positive changes in family health behaviours were reported. However, the preschool centres appeared to have difficulties with enforcing everyday school healthy eating policies.

Conclusions

The findings from the current study may have implications for nursery practitioners, nursery settings, Local Educational Authorities and policy makers, and contributes to the body of literature. However, further work with preschool practitioners is required to determine how personal attitudes and school policy application can be supported to implement successfully such an intervention.

Trial registration

ISRCTN12345678 (16/02/17) retrospectively registered.