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Throm JK, Schilling D, Löchner J, Micali N, Dörsam AF, Giel KE. Parental verbal communication and modeling behavior during mealtimes shape offspring eating behavior - A systematic review with a focus on clinical implications for eating disorders. Appetite 2024; 200:107584. [PMID: 38944057 DOI: 10.1016/j.appet.2024.107584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 06/10/2024] [Accepted: 06/27/2024] [Indexed: 07/01/2024]
Abstract
OBJECTIVE The aim of this review is to provide an overview of parental communication patterns during mealtimes, with a special emphasis being placed on the differences between families with and without a history of eating disorders. METHODS The systematic review was conducted according to the PRISMA statement. A systematic literature search was carried out in PubMed, PubPsych and PsycINFO and the results were assessed for eligibility by two independent raters using the PICOS criteria. Only studies that included a mealtime observation were considered suitable for analysis of both explicit and implicit parental communication. RESULTS The results of the review suggest that mothers communicate more, with more complexity, and with a greater variety of words with their children during mealtimes compared to fathers. The intention and type of communication is diverse and heterogeneous. In general, parents often tried to encourage their children to eat. Verbal modeling and co-eating appeared to be common behaviors. Mothers with a history of eating disorders expressed more negative emotions during eating than mothers without eating disorders. Findings regarding the use of positive comments and controlling speech are contradicting. DISCUSSION The review outlines major fields of parent-child communication and modeling behavior around family meals which might be relevant to investigate and integrate into models of intergenerational transmission of eating behavior and disordered eating.
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Affiliation(s)
- Jana Katharina Throm
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Germany; Centre of Excellence for Eating Disorders Tuebingen (KOMET), University of Tuebingen, Germany.
| | - Denise Schilling
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Germany; Centre of Excellence for Eating Disorders Tuebingen (KOMET), University of Tuebingen, Germany
| | - Johanna Löchner
- German Center for Mental Health (DZPG), Germany; Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Psychiatry and Psychotherapy, Tuebingen, Germany
| | - Nadia Micali
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK; Mental Health Services of the Capital Region of Denmark, Center for Eating and Feeding Disorders Research, Ballerup Psychiatric Centre, Copenhagen, Denmark
| | - Annica Franziska Dörsam
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Germany; Centre of Excellence for Eating Disorders Tuebingen (KOMET), University of Tuebingen, Germany; Graduate Training Centre of Neuroscience, International Max Planck Research School, University of Tuebingen, Tuebingen, Germany
| | - Katrin Elisabeth Giel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Germany; Centre of Excellence for Eating Disorders Tuebingen (KOMET), University of Tuebingen, Germany; German Center for Mental Health (DZPG), Germany
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Wan AWL, Chung KKH, Li JB, Xu SS, Chan DKC. A report card assessment of the prevalence of healthy eating among preschool-aged children: a cross-cultural study across Australia, Hong Kong, Singapore, and the US. Front Nutr 2024; 11:1428852. [PMID: 39234293 PMCID: PMC11371745 DOI: 10.3389/fnut.2024.1428852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 08/12/2024] [Indexed: 09/06/2024] Open
Abstract
Objective This study aimed to initially adopt an International Healthy Eating Report Card for Preschool-Aged Children to assess the prevalence of healthy eating behaviours and favourable family home food environments (FHFEs) among preschool-aged children in Australia, Hong Kong, Singapore, and the US. We also examined which cultural contexts would exhibit significant differences in the report card scores among the four cultural contexts. Methods In this cross-cultural study, 2059 parent-child dyads, with approximately 500 dyads in each cultural context, were recruited. The parents were asked to complete the validated International Healthy Eating Report Card Scale to assess the dimensions of the Report Card [i.e., Indicator of Children's Eating Behaviours: (1) Children's Dietary Patterns and (2) Children's Mealtime Behaviours, and Indicator of FHFEs: (3) Parental Food Choices and Preparation, (4) Home Healthier Food Availability and Accessibility and (5) Family Mealtime Environments]. Each indicator received a letter grade [i.e., A (≥80%) = excellent, B (60-79%) = good, C (40-59%) = fair, D (20-39%) = poor, F (<20%) = very poor and including the plus (+) and minus (-) signs] to represent the proportion of participants who could meet the predefined benchmarks. We also employed ANCOVA and Bonferroni's post-hoc test to examine the differences in the report card scores between the four cultural contexts. A significance level was set at p < 0.05. Results The average overall report card grade across the four cultural contexts was "B-" (Good), ranging from "C+" (Singapore and the US) to "B-" (Australia and Hong Kong). The average grade for Children's Eating Behaviours was classified as Fair ("C-"), while the average grade for FHFEs was classified as Good ("B+") for all cultural contexts. A comparison of the overall report card scores revealed that Australia exhibited a significantly higher report card score than Singapore and the US, while Hong Kong achieved a significantly higher score than Singapore. Conclusion The International Healthy Eating Report Card provided an overview of the prevalence of healthy eating in different cultural contexts. We believe that the International Healthy Eating Report Card may offer new perspectives on interventions for fostering healthy eating in young children.
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Affiliation(s)
- Alison Wing Lam Wan
- Department of Early Childhood Education, The Education University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Kevin Kien Hoa Chung
- Department of Early Childhood Education, The Education University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Jian-Bin Li
- Department of Early Childhood Education, The Education University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Shebe Siwei Xu
- Department of Early Childhood Education, The Education University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Derwin King Chung Chan
- Department of Early Childhood Education, The Education University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Wan AWL, Chung KKH, Li JB, Xu SS, Chan DKC. An assessment tool for the international healthy eating report card for preschool-aged children: a cross-cultural validation across Australia, Hong Kong, Singapore, and the United States. Front Nutr 2024; 11:1340007. [PMID: 38562489 PMCID: PMC10982429 DOI: 10.3389/fnut.2024.1340007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 03/01/2024] [Indexed: 04/04/2024] Open
Abstract
Objective This study aimed to develop and validate a globally applicable assessment tool of the 43-item International Healthy Eating Report Card Scale (IHERCS) which was designed to assess preschool-aged children's eating behaviours and family home food environments (FHFEs) across different cultural settings. In particular, we examined the factor structure, internal consistency and measurement invariance of the IHERCS across four cultural samples, including Australia, Hong Kong, Singapore, and the US. Convergent and discriminant validity were then conducted. Methods In this cross-cultural study, a total of 2059 parent-child dyads from these four regions were recruited, and the parents were asked to complete the IHERCS. An exploratory structural equational modelling approach was employed to examine two higher-order factor models of children's eating behaviours and FHFEs in the IHERCS and its cross-cultural measurement invariance. Results The findings demonstrated robust factor structures of the scales of children's eating behaviours and FHFEs in the IHERCS (i.e., CFI and TLI > 0.90; RMSEA and SRMR < 0.08) and an acceptable level of internal consistency (i.e., Cronbach's α = 0.55-0.84). Full configural invariance and metric invariance were established across the four cultural contexts, but full scalar invariance was not achieved. Partial scalar invariance was found only in the scale of FHFEs. The convergent validity and discriminant validity were supported. Conclusion Overall, the current findings provided preliminary support for the construct validity and measurement invariance of the IHERCS. It provides a reliable, valid and comprehensive assessment of eating behaviours and FHFEs among children in different cultural settings.
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Affiliation(s)
| | | | | | | | - Derwin King Chung Chan
- Department of Early Childhood Education, The Education University of Hong Kong, Tai Po, Hong Kong SAR, China
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Almaatani D, Cory E, Gardner J, Alexanian-Farr M, Hulst JM, Bandsma RHJ, Van Den Heuvel M. Child and Maternal Factors Associated with Feeding Practices in Children with Poor Growth. Nutrients 2023; 15:4850. [PMID: 38004244 PMCID: PMC10675486 DOI: 10.3390/nu15224850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/10/2023] [Accepted: 11/17/2023] [Indexed: 11/26/2023] Open
Abstract
The development of adequate growth and healthy eating behaviors depends on nutritious food and responsive feeding practices. Our study examined (1) the relationship between maternal concern about child weight or perceived feeding difficulties and their feeding practices, and (2) the moderating role of child temperament and maternal mental health on their feeding practices. A cross-sessional study included mother-child dyads (n = 98) from a tertiary growth and feeding clinic. Children had a mean age of 12.7 ± 5.0 months and a mean weight-for-age z-score of -2.0 ± 1.3. Responsive and controlling feeding practices were measured with the Infant Feeding Styles Questionnaire. Spearman correlation and moderation analysis were performed. Maternal concern about child weight and perceived feeding difficulties were negatively correlated with responsive feeding (r = -0.40, -0.48, p < 0.001). A greater concern about child weight or perceived feeding difficulties was associated with greater use of pressure feeding practices when effortful control was low (B = 0.49, t = 2.47, p = 0.01; B = -0.27, p = 0.008). Maternal anxiety had a significant moderation effect on the relationship between feeding difficulty and pressure feeding (B = -0.04, p = 0.009). Higher maternal concern about child weight and perceived feeding difficulties were associated with less responsive satiety feeding beliefs and behaviors. Both child effortful control and maternal anxiety influenced the relationship between weight and feeding concerns and the use of pressure feeding practices.
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Affiliation(s)
- Dina Almaatani
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; (D.A.)
| | - Emma Cory
- Department of Paediatrics, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Julie Gardner
- Department of Paediatrics, University of Toronto, Toronto, ON M5S 1A1, Canada
| | | | - Jessie M. Hulst
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; (D.A.)
- Department of Paediatrics, University of Toronto, Toronto, ON M5S 1A1, Canada
- Division of Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Robert H. J. Bandsma
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; (D.A.)
- Department of Paediatrics, University of Toronto, Toronto, ON M5S 1A1, Canada
- Division of Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Meta Van Den Heuvel
- Department of Paediatrics, University of Toronto, Toronto, ON M5S 1A1, Canada
- Division of Paediatrics, Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
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Ziegler M, Wollwerth de Chuquisengo R, Mall V, Licata-Dandel M. [Early childhood mental disorders: excessive crying, sleep and feeding disorders, and interventions using the "Munich model" as an example]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2023:10.1007/s00103-023-03717-0. [PMID: 37401977 DOI: 10.1007/s00103-023-03717-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 05/09/2023] [Indexed: 07/05/2023]
Abstract
About 20% of all healthy infants and toddlers show problems in the area of mental health during their first years of life such as inconsolable crying (so-called cry-babies), sleeping problems, and feeding problems. The prevalence of enduring feeding problems and sleeping problems is distinctly higher in premature children and in children with neuropediatric disorders. These problems present a higher risk for the development of internalizing and externalizing disorders of mental health in later childhood. The parent-child relationship is often strained. Parents report experiencing severe exhaustion, extreme uncertainty, and helplessness.Pediatricians and midwives are the first points of contact for families. Outpatient clinics for cry-babies such as the "Munich Consultation for Cry-Babies," founded by Mechthild Papoušek in 1991 at the kbo-Children's Center Munich, provide a low-threshold service for the highly stressed families. They can contribute to the prevention of neglect, maltreatment, and psychological secondary disorders of the child. Intervention strategies are based on parent-infant and attachment research and integrate child- and parent-oriented approaches.During the COVID-19 pandemic, psychosocial stress factors in families increased. This development was also observable in the outpatient clinics for cry-babies.
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Affiliation(s)
- Margret Ziegler
- Sozialpädiatrisches Zentrum und Klinik für Sozialpädiatrie, Kbo-Kinderzentrum München, Heiglhofstr. 65, 81377, München, Deutschland
| | - Ruth Wollwerth de Chuquisengo
- Technische Universität München, München, Deutschland.
- Sozialpädiatrisches Zentrum und Klinik für Sozialpädiatrie, Kbo-Kinderzentrum München, Heiglhofstr. 65, 81377, München, Deutschland.
| | - Volker Mall
- Sozialpädiatrisches Zentrum und Klinik für Sozialpädiatrie, Kbo-Kinderzentrum München, Heiglhofstr. 65, 81377, München, Deutschland
| | - Maria Licata-Dandel
- Sozialpädiatrisches Zentrum und Klinik für Sozialpädiatrie, Kbo-Kinderzentrum München, Heiglhofstr. 65, 81377, München, Deutschland
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Evaluation and Management of Pediatric Feeding Disorder. GASTROINTESTINAL DISORDERS 2023. [DOI: 10.3390/gidisord5010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
Feeding disorders are increasingly common in children, especially as medical advancements improve the life expectancy of children born with prematurity and complex medical conditions. The most common symptoms include malnutrition, refusal to eat and drink, food pocketing, disruptive feeding behavior, slow feeding, food selectivity or rigid food preferences, limited appetite, and delayed feeding milestones. A unifying diagnostic definition of pediatric feeding disorder has been proposed by a panel of experts to improve the quality of health care and advance research. Referral to specialized care should be considered when feeding problems are complex or difficult to resolve. In this review, we provide an overview of the evaluation and management of pediatric feeding disorders and information that may be useful when considering whether referral to specialized care may be beneficial.
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Hua J, Williams GJ, Barnett AL, Zhang J, Jin H, Xu M, Chen J, Zhou Y, Gu G, Du W. Association of the Onset of Self-Feeding With Subsequent Suspected Developmental Coordination Disorder: A Prospective Cohort Study in China. Front Psychiatry 2022; 13:818771. [PMID: 35599757 PMCID: PMC9120420 DOI: 10.3389/fpsyt.2022.818771] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 03/31/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Successful self-feeding reflects the readiness of early motor development and environmental impacts, and the onset of self-feeding as a developmental milestone might be a predictor of subsequent motor development in children. In this study, we explored the association between the onset of self-feeding and childhood risk of Developmental Coordination Disorder in children from one-child and two-child families. METHODS We conducted a data-linkage prospective cohort study from 38 kindergartens in 6 cities in China. A total of 11,727 preschoolers aged 3-6 years old were included in the final analysis and were assessed with the Movement Assessment Battery for Children-second edition (MABC-2) Test. The information on early self-feeding onset was obtained from parents. The mixed and multi-level logistic models utilizing a random intercept were used to investigate the associations between the onset time of self-feeding and subsequent motor performance. RESULTS The results showed that, compared with those beginning self-feeding at or younger than 12 months of age, children starting self-feeding at 13-24, 25-36, and later than 36 months, showed a decrease in their total MABC-2 scores of 2.181, 3.026, and 3.874, respectively; and had an increased risk of suspected DCD by 36.0, 101.6, 102.6%, respectively; they also had 30.2, 46.6, 71.2% increased prevalence of at risk of suspected DCD, when adjusting for both child and family characteristics (each p < 0.05). Significant associations were observed in fine motor, gross motor, and balance subtests (each p < 0.05) in groups with a delayed onset of self-feeding. However, the strength of the associations was mitigated in the fine motor and balance subtests in children with a sibling. CONCLUSION The delayed onset time of self-feeding acts as an early behavioral marker for later childhood motor impairment. Moreover, children with a sibling may benefit from additional interaction and their motor developmental pattern may be affected by the presence of a sibling.
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Affiliation(s)
- Jing Hua
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Gareth J Williams
- School of Social Sciences, Nottingham Trent University, Nottingham, United Kingdom
| | - Anna L Barnett
- Centre for Psychological Research, Oxford Brookes University, Oxford, United Kingdom
| | - Jiajia Zhang
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Hua Jin
- Health Care Department of Suzhou Ninth People's Hospital, Suzhou, China
| | - Manyun Xu
- KLATASDS-MOE, School of Statistics, East China Normal University, Shanghai, China
| | - Juan Chen
- KLATASDS-MOE, School of Statistics, East China Normal University, Shanghai, China
| | - Yingchun Zhou
- KLATASDS-MOE, School of Statistics, East China Normal University, Shanghai, China
| | - Guixiong Gu
- Pediatrics Research Institution of Suzhou University, Suzhou, China
| | - Wenchong Du
- NTU Psychology, Nottingham Trent University, Nottingham, United Kingdom
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Silverman AH, Erato G, Goday P. The relationship between chronic paediatric feeding disorders and caregiver stress. J Child Health Care 2021; 25:69-80. [PMID: 32048866 DOI: 10.1177/1367493520905381] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Paediatric feeding disorders (PFDs) are common. Earlier studies have shown an association between PFD and caregiver stress, but these studies have been hampered by insufficient power. This study reports stress for caregivers of children diagnosed with PFD. These caregivers were then compared to community norms of the Parental Stress Index-Short Form. Caregivers also completed the Mealtime Behaviour Questionnaire, Child Behaviour Checklist and Child Development Inventory. Linear regression and hierarchical regression analyses assessed the relationship among the variables. Caregivers of 840 children with PFD responded. Negative child behaviours and lower child developmental function predicted higher levels of total parenting stress, parental distress, parent-child dysfunctional interaction and caregiver perceptions of their child as difficult. Higher rates of child internalizing and externalizing problems and child mealtime aggression were associated with parent perceptions of their child as difficult and contributed to total parental stress. Parents of older children reported higher levels of stress, whereas parents of younger children were more likely to be defensive responders. Overall, parents of children with PFD have more caregiver-related stress. These caregivers may benefit from consultations with mental health professionals to provide the most appropriate care to affected families.
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Affiliation(s)
- Alan H Silverman
- Department of Pediatrics, Division of Pediatric Gastroenterology and Nutrition, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Gina Erato
- Department of Pediatrics, Division of Pediatric Gastroenterology and Nutrition, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Praveen Goday
- Department of Pediatrics, Division of Pediatric Gastroenterology and Nutrition, Medical College of Wisconsin, Milwaukee, WI, USA
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Iwinski S, Cole NC, Saltzman JA, Donovan SM, Lee SY, Fiese BH, Bost KK. Child attachment behavior as a moderator of the relation between feeding responsiveness and picky eating behavior. Eat Behav 2021; 40:101465. [PMID: 33310487 PMCID: PMC10796209 DOI: 10.1016/j.eatbeh.2020.101465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 11/21/2020] [Accepted: 11/22/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Picky eating (PE) behavior is common in early childhood, but persistent PE is associated with unhealthy development and caregiver-child stress during feeding. Identifying modifiable feeding and parent-child relationship factors that impact PE is important for decreasing risks associated with PE. OBJECTIVE This study examined associations between caregiver Feeding Responsiveness (FR) and child PE behaviors using caregiver reports and observations of family mealtimes. An additional aim examined whether children's attachment behavior moderates this association. METHODS The analysis sample consisted of 110 families participating in a larger longitudinal study of nutrition and child health. Home observations were conducted when children were 18-24 months (52% females) to assess caregiver-child interactions. Caregivers were, on average, 30.9 years old and mostly White (73.6%). Family mealtimes were videotaped and coded for FR and child PE behaviors. Caregivers completed surveys regarding FR and PE behaviors. RESULTS Caregiver-reported FR was significantly correlated with observed FR, r (107) = 0.26, p = 0.007; and caregiver-reported PE was associated with observed PE, r (107) = 0.21, p = 0.029. Caregiver-reported FR was inversely related to observed PE, but only when children were characterized by observers to have more positively toned and smooth interactions with caregivers. Using observational data, child attachment significantly moderated the relationship between FR and PE behaviors. CONCLUSIONS The quality of caregiver-child interactions may impact the degree to which FR is effective in reducing PE. Future longitudinal studies that include more diverse populations, multiple caregivers, and potential mechanisms accounting for these associations are needed.
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Affiliation(s)
- Samantha Iwinski
- Department of Human Development and Family Studies, University of Illinois, Urbana, IL, United States of America.
| | - Natasha Chong Cole
- Division of Nutritional Sciences, University of Illinois, Urbana, IL, United States of America
| | - Jaclyn A Saltzman
- Department of Human Development and Family Studies, University of Illinois, Urbana, IL, United States of America; The MITRE Corporation, Bedford, MA, United States of America
| | - Sharon M Donovan
- Division of Nutritional Sciences, University of Illinois, Urbana, IL, United States of America; Food Science and Human Nutrition, University of Illinois, Urbana, IL, United States of America
| | - Soo-Yeun Lee
- Division of Nutritional Sciences, University of Illinois, Urbana, IL, United States of America; Food Science and Human Nutrition, University of Illinois, Urbana, IL, United States of America
| | - Barbara H Fiese
- Department of Human Development and Family Studies, University of Illinois, Urbana, IL, United States of America
| | - Kelly K Bost
- Department of Human Development and Family Studies, University of Illinois, Urbana, IL, United States of America
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Swindle T, Rutledge JM, Johnson SL, Selig JP, Curran GM. De-implementation of detrimental feeding practices: a pilot protocol. Pilot Feasibility Stud 2020; 6:181. [PMID: 33292711 PMCID: PMC7678218 DOI: 10.1186/s40814-020-00720-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 11/03/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Early childhood educators (ECEs) often use detrimental feeding practices and are slow to implement positive feeding practices. Nevertheless, few studies have aimed to understand and change ECEs' feeding practices. This gap needs to be addressed because implementation (i.e., adding new, evidence-based practices) and de-implementation (i.e., stopping low-value or harmful practices) are distinct processes that require unique strategies. METHODS We will develop a de-implementation strategy for detrimental feeding practices using evidence-based quality improvement (EBQI) sessions to engage stakeholders and draw on the Niven process model for de-implementation. Then, we will investigate the effects of the de-implementation strategy in a proof-of-principle study. The de-implementation strategy will be evaluated in 2 partnering childcare agencies using a pre-post, within-site design. For our primary outcome, we will interview educators throughout the school year to assess the feasibility and acceptability of the intervention and survey them with standard measures for assessing feasibility and acceptability. For secondary outcomes, we will investigate its effects on the use of detrimental and evidence-based feeding practices by teachers and impacts on child BMI and diet. DISCUSSION The current study will establish the feasibility and acceptability of our de-implementation approach and will provide preliminary data toward 3 predicted secondary outcomes: (1) decreased detrimental feeding practices by ECEs, (2) increased adoption of and fidelity to nutrition promotion practices, and (3) improved child dietary outcomes. These results are expected to contribute to the uptake and sustainability of mealtime interventions to improve the diets of young children. Results will also apply to the field of implementation science by informing processes for developing de-implementation approaches in a community setting.
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Affiliation(s)
- Taren Swindle
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St, #530, Little Rock, AR 72205-7199 USA
| | - Julie M. Rutledge
- College of Applied and Natural Sciences, Louisiana Tech University, Ruston, USA
| | - Susan L. Johnson
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, USA
| | - James P. Selig
- College of Public Health, Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Geoff M. Curran
- Department of Pharmacy Practice and Psychiatry, University of Arkansas for Medical Sciences, Central Arkansas Veterans Healthcare System, Little Rock, USA
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11
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Rendall S, Dodd H, Harvey K. Behavioural validation of a parent-report measure of child food fussiness. Appetite 2020; 154:104796. [PMID: 32712195 DOI: 10.1016/j.appet.2020.104796] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 06/26/2020] [Accepted: 07/01/2020] [Indexed: 12/28/2022]
Abstract
Food fussiness is the rejection of familiar and novel foods leading to consumption that is insufficient and/or inadequately varied. Its importance to children's nutrition and the development of food preferences means it has been the focus of extensive research. To measure food fussiness, research has predominantly relied on parent-report, though parents' reporting of their child's eating behaviour can be reliable, responses may also be subject to bias. Utilising data from video-recordings of sixty-seven mother-child dyads during a meal in the home environment, this study aimed to validate the most widely used parent-report questionnaire measuring food fussiness against independent observations of children's eating behaviour and, in so doing, determine its accuracy. Maternal reported food fussiness, assessed using the Food Fussiness subscale of the Children's Eating Behaviour Questionnaire (CEBQ; Wardle, Guthrie, Sanderson, & Rapoport, 2001) was compared to children's observed food rejection and acceptance behaviours. Bootstrapped Pearson's correlations revealed that maternal reports of food fussiness were significantly positively related to food rejection behaviours and significantly negatively related to food acceptance behaviours. Maternal reports of food fussiness were also found to be significantly negatively related to the proportion of familiar/appealing of familiar foods consumed by the child. There was no significant association between maternal reported food fussiness and the proportion of familiar/unappealing, unfamiliar/appealing and unfamiliar/unappealing foods consumed by the child or the meal duration. These findings support the CEBQ FF as a valid measure of food fussiness.
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Affiliation(s)
- Stella Rendall
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, RG6 6AL, UK
| | - Helen Dodd
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, RG6 6AL, UK
| | - Kate Harvey
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, RG6 6AL, UK.
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12
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Shorey S, Chan V. Effectiveness of healthy eating interventions among children: A quantitative systematic review. J Adv Nurs 2020; 77:583-594. [PMID: 33068061 DOI: 10.1111/jan.14606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 08/27/2020] [Accepted: 09/07/2020] [Indexed: 11/30/2022]
Abstract
AIMS This review aimed to evaluate the effectiveness of healthy eating interventions among normal-weight children. DESIGN A systematic review of randomized controlled trials. DATA SOURCES Seven databases were searched from the inception of each database until September 2019. REVIEW METHODS A systematic review of quantitative studies was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the PRISMA extension for reporting a synthesis without a meta-analysis. RESULTS Fifteen studies were included in this review. A meta-analysis could not be conducted because of the observed heterogeneity across studies. There were mixed effects of the included interventions on healthy eating habits, ranging from effective to not effective. Only a few studies found behavioural determinants effective in enhancing healthy eating. CONCLUSION Because of the observed heterogeneity and varied outcome variables, a meta-analysis could not be conducted, and the overall effectiveness of the included interventions could not be verified. Interventions that were theory based, parent focused, and delivered through the multimodal interactive approach were found to be effective in enhancing healthy eating habits among children. More studies involving peers that are institution based need to be conducted.
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Affiliation(s)
- Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore
| | - Valerie Chan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore
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13
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van Dijk M. A complex dynamical systems approach to the development of feeding problems in early childhood. Appetite 2020; 157:104982. [PMID: 33035592 DOI: 10.1016/j.appet.2020.104982] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 09/11/2020] [Accepted: 09/27/2020] [Indexed: 01/28/2023]
Abstract
Though it is commonly agreed upon that the development of feeding problems in early childhood is a complex process, much of the research on these problems has a component-oriented focus, and very little attention is paid to the mechanisms that lead to these kinds of problems in individual children. The aim of this theoretical paper is to interpret the development of feeding problems in early childhood from a complex dynamical systems viewpoint. In addition to its focus on self-organization and nonlinearity, this approach defines several central properties of development: soft-assembly, embodiment, iterativity, the emergence of higher-order properties, and intra-individual variability. In this paper, I argue that each of these properties is highly relevant for understanding feeding problems and discuss the implications of this for both clinical practice and research purposes.
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Affiliation(s)
- Marijn van Dijk
- Heymans Institute for Psychological Research, University of Groningen, Grote Kruisstraat 2/1, 9712, TS Groningen, the Netherlands.
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14
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Barone L, Carone N, Salazar-Jimenez JG, Ortíz Muñoz JA. Enhancing food habits via sensitivity in rural low-SES mothers of children aged 1-3 living in Colombia: a randomized controlled trial using video-feedback intervention. Attach Hum Dev 2020; 23:831-852. [PMID: 32597700 DOI: 10.1080/14616734.2020.1784243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
In a randomized controlled trial with 25 Colombian rural low-SES mothers and their children (aged 1-3 years), the effectiveness of the Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) in enhancing maternal sensitivity and food habits was tested pre-intervention, post-intervention, and at a 6-month follow-up. The study further verified whether maternal sensitivity represented a mechanism of change for food habits. Mixed models indicated that the VIPP-SD did promote higher maternal sensitivity and better food habits. Moreover, increased maternal sensitivity following the VIPP-SD predicted improved maternal food habits, both post-intervention and at the follow-up. The findings suggest that interventions aimed at preventing early inadequate parental food habits in low-SES communities should promote sensitive parenting during daily mother-child interactions, in addition to offering nutritional advice.
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Affiliation(s)
- Lavinia Barone
- Department of Brain and Behavioral Sciences, Lab on Attachment and Parenting LAG, University of Pavia, Pavia, Italy
| | - Nicola Carone
- Department of Brain and Behavioral Sciences, Lab on Attachment and Parenting LAG, University of Pavia, Pavia, Italy
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15
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Yilmaz G. Eating Behavior of Children and Feeding Attitudes of Mothers. EURASIAN JOURNAL OF FAMILY MEDICINE 2020. [DOI: 10.33880/ejfm.2020090207] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim: Nutritional problem is one of the most common behavioral problems in children. This study was carried out as a descriptive study in order to determine the eating behavior problems of infants and children and to determine the mothers' feelings, thoughts and approaches about feeding process.
Method: The population of the study consisted of mothers of children aged 9-72 months who applied to the children's outpatient clinics of a state hospital between April and June 2019; and the sample consisted of 217 mothers who agreed to participate in the study and met the selection criteria. Data were collected using the “Mother-Child Information Form”, “Behavioral Pediatric Feeding Assessment Scale” and “Mother’s Attitudes Towards the Feeding Process Scale”. Number, percentage distribution, mean and Pearson correlation analysis were used to evaluate the data.
Results: The total score of the mothers from the Behavioral Pediatric Feeding Assessment Scale was 84.16±16.10; and the total score of the Mother’s Attitudes Towards the Feeding Process Scale was 75.20±17.49. It was found that there was a statistically significant relationship between the mean Behavioral Pediatric Feeding Assessment Scalescore of the mothers and the mean Mother’s Attitudes Towards the Feeding Process Scale score.
Conclusion: The results of the study indicated that children have moderately problematic eating behavior and feeding habits. On the other hand, it shows that mothers have moderate problems related to their attitudes towards feeding process. It was also concluded that, as children's eating behavior problems increased, mothers' negative attitudes towards feeding process also increased.
Keywords: mothers, feeding, attitude, child, feeding behavior
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Affiliation(s)
- Gamze Yilmaz
- Ağrı İbrahim Çeçen Üniversitesi Sağlık Yüksekokulu Hemşirelik Bölümü
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16
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Jordan AA, Appugliese DP, Miller AL, Lumeng JC, Rosenblum KL, Pesch MH. Maternal prompting types and child vegetable intake: Exploring the moderating role of picky eating. Appetite 2019; 146:104518. [PMID: 31734294 DOI: 10.1016/j.appet.2019.104518] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 10/16/2019] [Accepted: 11/13/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND It is unknown if using different maternal prompting types is associated with vegetable intake in children perceived to be picky versus non-picky. OBJECTIVES 1) To test the correlation of counts of maternal prompting types with child vegetable intake, and picky eating, 2) to examine the interaction of prompting types and picky eating status on vegetable intake. DESIGN/METHODS Low-income mother-child dyads (N = 199, mean child age 6.0 years) participated in a videotaped laboratory eating protocol with green beans, a familiar vegetable. A coding scheme was developed and reliably applied to categorize mothers' prompting types. The prompting types were: Coercive Control (Sub-Categories: Reward and Pressure-to-Eat), Autonomy Promotion (Sub-Categories: Modeling, Reasoning, Praise, and Question), and Total Prompts (sum of all prompts). Mothers completed questionnaires. Bivariate analyses tested the association between counts of maternal prompting types with amount of green beans eaten, and picky eating. Regression analyses examined the interaction of picky eating status with counts of maternal prompting type on amount of green beans eaten. RESULTS Mothers used on average 1.66 prompts. Greater use of Coercive Control, Autonomy Promotion-Modeling, and Total Prompts were all inversely correlated with amount of green beans eaten. Greater use of Autonomy Promotion-Praise was directly correlated with amount of green beans eaten. In stratified models, greater use of Coercive Control prompts was negatively associated with amount of green beans eaten by the child in non-picky eaters, but not in picky eaters. There was no interaction between other prompting types and child picky eating status in predicting amount eaten. All p-values <0.05. CONCLUSIONS Mothers use different prompting types to encourage their children to eat vegetables depending on their picky eating status, most of which may be correlated with reduced intake.
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Affiliation(s)
- Ariel A Jordan
- Morehouse School of Medicine, 720 Westview Dr SW, Atlanta, GA, 30310, USA.
| | | | - Alison L Miller
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
| | - Julie C Lumeng
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan, Center for Human Growth and Development, University of Michigan, Department of Nutritional Sciences, School of Public Health, University of Michigan, 300 N. Ingalls Street, 10th Floor, Ann Arbor, MI, 48109-5406, USA.
| | - Katherine L Rosenblum
- Department of Psychiatry, Medical School, University of Michigan, Center for Human Growth and Development, University of Michigan. 4250 Plymouth Road, Rachel Upjohn Building, Ann Arbor, MI, 48109, USA.
| | - Megan H Pesch
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan, Center for Human Growth and Development, University of Michigan, 300 N. Ingalls Street, 1111 SE, Ann Arbor, MI, 48109-5456, USA.
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17
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Webb HJ. Maternal self-rated health and psychological distress predict early feeding difficulties: Results from the longitudinal study of Australian children. Int J Eat Disord 2018; 51:1312-1321. [PMID: 30488588 DOI: 10.1002/eat.22971] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 09/24/2018] [Accepted: 09/26/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND Drawing from the extended UNICEF model of children's eating and weight problems and growing empirical evidence, exposure to adversity may place mothers at increased risk for child feeding difficulties. AIM The aim of the present study of a community sample of mothers was to examine whether maternal psychological distress, exposure to stressful events, and poor self-rated health in their child's first year of life were associated with breastfeeding duration, as well as concurrent and prospective feeding problems. MATERIALS & METHODS Participants were 5107 Australian mother-child dyads from the infant cohort of the Longitudinal Study of Australian Children (LSAC). Data for the present study was drawn from questionnaires completed by the mother at Wave 1 and Wave 2 (conducted 2 years apart). On average, at Wave 1, mothers and children (51% male) were aged 31 years and 9 months, respectively; while at Wave 2 their ages were 33 years and 34 months, respectively. RESULTS Maternal psychological distress and poorer self-rated health were uniquely predictive of concurrent and prospective child feeding difficulties, while poorer self-rated health was also concurrently associated with a shorter duration of breastfeeding. DISCUSSION These findings suggest that poorer maternal functioning poses a significant risk for early child feeding difficulties, and highlights the potential benefit of screening and early intervention for mothers experiencing emotional and physical health problems. CONCLUSION Further research is needed that takes a broad view of maternal functioning, and examines reciprocal interactions between maternal and child characteristics in understanding the development of child feeding problems.
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Affiliation(s)
- Haley J Webb
- School of Applied Psychology & Menzies Health Institute of Queensland, Griffith University, Gold Coast, Australia
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18
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Swindle T, Sigman-Grant M, Branen LJ, Fletcher J, Johnson SL. About feeding children: factor structure and internal reliability of a survey to assess mealtime strategies and beliefs of early childhood education teachers. Int J Behav Nutr Phys Act 2018; 15:85. [PMID: 30200993 PMCID: PMC6131865 DOI: 10.1186/s12966-018-0717-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 08/27/2018] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Children spend a substantial amount of time in early care and education (ECE) settings and may eat a majority of their diet in this setting. While there are several instruments focused on measuring factors of the ECE environment that may influence diet and weight outcomes, there are few comprehensive, valid, and reliable measures for collecting self-report of ECE providers' feeding practices. The purpose of this study was to establish the factor structure and internal reliability of a survey developed to measure practices and beliefs of ECE providers relative to feeding children. METHODS Licensed ECE centers from CA, CO, ID and NV were included in this cross-sectional survey study. The sample was stratified by states and census regions to yield equal numbers of centers from each category. The total sample distribution included 1600 randomly selected centers and up to 8000 staff members (who represented teachers, aides, assistants, or cooks); 1178 surveys were completed. We conducted an exploratory, unrestricted factor analysis as well as parallel analyses to inform the number of factors to be extracted. RESULTS Factors within Structural Mealtime Strategies included Adult Control of Foods Consumed (Kuder-Richardson [KR] = 0.67), Bribing with Sweet Foods (KR = 0.70), and Supportive Adult Roles at Mealtime (KR = 0.55). Factors in Verbal Mealtime Strategies included Supporting Children's Eating Self-regulation (KR =0.61), Pressure to Eat (KR = 0.58), and Social Comparisons (KR = 0.59). Beliefs about Mealtime factors were Autonomy Promoting (α = 0.64), Coercive Beliefs (α = 0.77), and Concern-Based Control (α = 0.60). CONCLUSIONS The AFC Strategies and Beliefs Survey provides a promising self-report instrument with a strong factor structure consistent with the extant literature to measure practices and beliefs related to feeding and mealtimes in the ECE setting. Feeding young children in group settings differs in many ways from feeding in a family setting; hence it is important that measures such as the AFC Strategies and Beliefs Survey capture unique aspects of the ECE feeding environment.
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Affiliation(s)
- Taren Swindle
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, 521 Jack Stephens Drive, Little Rock, AR, 72205, USA.
| | - Madeleine Sigman-Grant
- University of Nevada Cooperative Extension, 2558 So Elizabeth Street, Salt Lake City, UT, 85406, USA
| | - Laurel J Branen
- Food and Nutrition, University of Idaho, Moscow, ID, 83844-3183, USA
| | - Janice Fletcher
- Child, Family and Consumer Studies, Center on Disabilities and Human Development, University of Idaho, 1187 Alturas Drive, Moscow, ID, 83844-1187, USA
| | - Susan L Johnson
- Department of Pediatrics, Anschutz Medical Campus, Section of Nutrition, F-561, University of Colorado-Denver, 12,631 E 17th Ave, Rm #2609, Aurora, CO, 80045, USA
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19
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Pesch MH, Berlin KS, Cesaro RJ, Rybak TM, Miller AL, Rosenblum KL, Lumeng JC. Maternal discouragement and child intake of a palatable dessert: A multilevel sequential analysis. Appetite 2018; 129:171-177. [PMID: 30009930 DOI: 10.1016/j.appet.2018.07.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 07/04/2018] [Accepted: 07/11/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Family mealtimes are often marked by parent-child conflict, which may arise when children's eating behaviors do not match parental expectations. Little is known about how children respond to parents' comments to discourage eating. OBJECTIVE The objective of this study was to examine the likelihood of a child taking a bite following a maternal statement to discourage child intake. METHODS 50 mother-child dyads (mean child age 71.8 months) participated in a laboratory eating task with cupcakes. Video recordings were reliably coded for maternal statements to discourage child intake (varying by domains of affective valence and directness) and child bites. Multilevel sequential analysis was performed to determine differences in pairs' antecedent statement to discourage child intake and a child's discouraged bite. RESULTS Children were significantly more likely to be non-compliant by taking a bite following negative (vs. positive), indirect (vs. direct) and negative direct (vs. positive direct) statements to discourage child intake (that is, a "discouraged bite"). There were no differences in children taking discouraged bites following a negative indirect vs. positive indirect statement to discourage child intake. CONCLUSIONS Children may be more apt to comply with their mother's mealtime commands if they are delivered with a direct approach and a positive affective valence. Future work should examine the longitudinal effects of using positive direct mealtime commands on children's food intake, weight gain and emotional health.
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Affiliation(s)
- Megan H Pesch
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics and Communicable Diseases, University of Michigan, Center for Human Growth and Development, University of Michigan, 300 N. Ingalls Street, 1109 SE, Ann Arbor, MI, 48109-5456, USA.
| | - Kristoffer S Berlin
- Department of Psychology, The University of Memphis, and Department of Pediatrics, University of Tennessee Health Science Center, 50 N. Dunlap, Rm 461R, Memphis, TN 38103, USA.
| | - Robert J Cesaro
- University of Michigan Medical School, M4101 Medical Science Building I - C Wing, 1301 Catherine Street, Ann Arbor, MI, 48109-5624, USA.
| | - Tiffany M Rybak
- Department of Psychology, The University of Memphis, 400 Innovation Dr #202, Memphis, TN 38152, USA.
| | - Alison L Miller
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, and Center for Human Growth and Development, University of Michigan. 3718 SPH Building I, Ann Arbor, MI, 48109-2029, USA.
| | - Katherine L Rosenblum
- Department of Psychiatry, Medical School, University of Michigan, and Center for Human Growth and Development, University of Michigan. 4250 Plymouth Road, Rachel Upjohn Building, Ann Arbor, MI, 48109, USA.
| | - Julie C Lumeng
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics and Communicable Diseases, University of Michigan, Center for Human Growth and Development, University of Michigan, and Department of Nutritional Sciences, School of Public Health, University of Michigan, 300 N. Ingalls Street, 10th Floor, Ann Arbor, MI, 48109-5406, USA.
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20
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Aldridge VK, Dovey TM, El Hawi N, Martiniuc A, Martin CI, Meyer C. OBSERVATION AND COMPARISON OF MEALTIME BEHAVIORS IN A SAMPLE OF CHILDREN WITH AVOIDANT/RESTRICTIVE FOOD INTAKE DISORDERS AND A CONTROL SAMPLE OF CHILDREN WITH TYPICAL DEVELOPMENT. Infant Ment Health J 2018; 39:410-422. [DOI: 10.1002/imhj.21722] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
| | | | | | | | | | - Caroline Meyer
- University of Warwick and Coventry and Warwickshire Partnership NHS Trust Coventry; United Kingdom
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21
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The Stability and Continuity of Maternally Reported and Observed Child Eating Behaviours and Feeding Practices across Early Childhood. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15051017. [PMID: 29783638 PMCID: PMC5982056 DOI: 10.3390/ijerph15051017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 05/11/2018] [Accepted: 05/11/2018] [Indexed: 12/02/2022]
Abstract
Given that many eating behaviours and food preferences develop early in childhood and track across childhood, adolescence and into adulthood, interest has grown in the developmental trajectory of these behaviours. The aims of this study were twofold. First, to explore whether maternal reports of child eating behaviour and feeding practices are validated by independent observations of these constructs. Second, to explore the continuity and stability of both maternally reported and independently observed child eating behaviours and maternal feeding practices during early childhood. Sixty-five mothers completed measures of their child’s eating behaviour and their own feeding practices and mother–child dyads were observed during a family mealtime at approximately 3 and 4 years of age. Maternal reports of their child’s eating behaviours were validated by independent observations, however maternally reported feeding practices were not validated by observations of these behaviours. Maternally reported and independently observed child eating behaviours and parental feeding practices remained stable and showed continuity between 3 and 4 years of age, with the exception of child difficulty to feed and maternal pressure to eat which both significantly decreased over time. Findings provide an insight into the validity of maternal reports of fussy eating behaviour and parental feeding practices and the developmental trajectory of these behaviours across early childhood.
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Tang A, Ji M, Zhang Y, Zou J, Li M, Yang L, Lin Q. Dietary Behaviors and Caregiver Perceptions of Overweight and Obesity among Chinese Preschool Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040716. [PMID: 29641437 PMCID: PMC5923758 DOI: 10.3390/ijerph15040716] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 04/08/2018] [Accepted: 04/09/2018] [Indexed: 01/12/2023]
Abstract
Introduction: Early childhood obesity in China has become a pressing public health concern. A substantial barrier to healthy weight management is poor parental recognition of child overweight. This study examined the relationship between caregiver perceptions of child weight and dietary practices. Methods: A total of 364 children between 2 and 6 years old from six urban preschools in Changsha (China) were included in a cross-sectional study. Information on household demographics, health behaviors, and caregiver attitudes was collected through a self-administered caregiver questionnaire. Chi-squared tests, t-tests, and multivariable logistic regression analysis were used to determine the relationship between caregiver perceptions, dietary behaviors, and child weight status. Results: Over 60% of caregivers with overweight/obese children underestimated their children's weight status. These caregivers were less likely to worry about weight and restrict their children's dietary intakes. Children of caregivers who incorrectly classified their weights were also more likely to have a poor appetite. Caregivers of male children and those from families with incomes between 7000 and 11,000 Ren Min Bi (RMB) were more likely to underestimate weight compared to caregivers with daughters and those from higher income households. Conclusions: Although accurate weight perception may be important for motivating healthy behavioral changes, it may also lead to greater restriction of children's diets, which has been linked to long-term weight gain. Interventions to improve awareness of child overweight should be coupled with efforts that teach caregivers about healthy weight management strategies.
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Affiliation(s)
- Amber Tang
- Department of Molecular, Cellular, and Developmental Biology, Yale University, 219 Prospect St., New Haven, CT 06511, USA.
| | - Meimei Ji
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, China.
| | - Yefu Zhang
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, China.
| | - Jiaojiao Zou
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, China.
| | - Mingzhi Li
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, China.
| | - Lina Yang
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, China.
| | - Qian Lin
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, China.
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Methodological considerations for observational coding of eating and feeding behaviors in children and their families. Int J Behav Nutr Phys Act 2017; 14:170. [PMID: 29246234 PMCID: PMC5732463 DOI: 10.1186/s12966-017-0619-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 11/19/2017] [Indexed: 11/30/2022] Open
Abstract
Background Behavioral coding of videotaped eating and feeding interactions can provide researchers with rich observational data and unique insights into eating behaviors, food intake, food selection as well as interpersonal and mealtime dynamics of children and their families. Unlike self-report measures of eating and feeding practices, the coding of videotaped eating and feeding behaviors can allow for the quantitative and qualitative examinations of behaviors and practices that participants may not self-report. While this methodology is increasingly more common, behavioral coding protocols and methodology are not widely shared in the literature. This has important implications for validity and reliability of coding schemes across settings. Additional guidance on how to design, implement, code and analyze videotaped eating and feeding behaviors could contribute to advancing the science of behavioral nutrition. The objectives of this narrative review are to review methodology for the design, operationalization, and coding of videotaped behavioral eating and feeding data in children and their families, and to highlight best practices. Methods When capturing eating and feeding behaviors through analysis of videotapes, it is important for the study and coding to be hypothesis driven. Study design considerations include how to best capture the target behaviors through selection of a controlled experimental laboratory environment versus home mealtime, duration of video recording, number of observations to achieve reliability across eating episodes, as well as technical issues in video recording and sound quality. Study design must also take into account plans for coding the target behaviors, which may include behavior frequency, duration, categorization or qualitative descriptors. Coding scheme creation and refinement occur through an iterative process. Reliability between coders can be challenging to achieve but is paramount to the scientific rigor of the methodology. Analysis approach is dependent on the how data were coded and collapsed. Conclusions Behavioral coding of videotaped eating and feeding behaviors can capture rich data “in-vivo” that is otherwise unobtainable from self-report measures. While data collection and coding are time-intensive the data yielded can be extremely valuable. Additional sharing of methodology and coding schemes around eating and feeding behaviors could advance the science and field.
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Rubio B, Rigal N. Parental concerns and attributions of food pickiness and its consequences for the parent-child relationship: A qualitative analysis. J Child Health Care 2017; 21:404-414. [PMID: 29110520 DOI: 10.1177/1367493517725832] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A qualitative study was conducted to identify how parents describe and attribute their toddler's food pickiness, a common pediatric problem during childhood. Parental strategies to respond to picky behaviors were also explored in this study. Focus groups were used with 38 parents of children aged 18-38 months. Results highlighted several consequences of child pickiness such as parental concerns about child's growth and health, conflicts at mealtime, and feelings of guilt. Parents attributed food pickiness mainly as a manifestation of opposition and assertiveness by their child. Some strategies known to be effective were applied by parents (such as repeated exposure, modeling, co-preparing meals, and using a flavor-based approach) but some strategies that are counterproductive were also highlighted (such as rewards for eating). Parents need to be better informed about food pickiness and the strategies that help to overcome it. Understanding parental beliefs may help pediatricians to offer appropriate guidance adapted to parental experiences and feelings.
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Affiliation(s)
- Bérengère Rubio
- 1 Département de psychologie, IFSTTAR, AME-LPC, Versailles, France
| | - Natalie Rigal
- 2 Département de psychologie, Université Paris Ouest Nanterre La Défense, Nanterre, France
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25
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Observed differences in child picky eating behavior between home and childcare locations. Appetite 2017; 116:123-131. [DOI: 10.1016/j.appet.2017.04.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 03/27/2017] [Accepted: 04/18/2017] [Indexed: 01/17/2023]
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Table Talk: development of an observational tool to assess verbal feeding communications in early care and education settings. Public Health Nutr 2017; 20:2869-2877. [PMID: 28803584 DOI: 10.1017/s1368980017001896] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Children's dietary intake impacts weight status and a range of short- and long-term health outcomes. Accurate measurement of factors that influence children's diet is critical to the development and evaluation of interventions designed to improve children's diets. The purpose of the current paper is to present the development of the Table Talk observational tool to measure early care and education teachers' (ECET) verbal feeding communications. DESIGN An observational tool to assess ECET verbal communication at mealtimes was deigned based on the extant literature. Trained observers conducted observations using the tool during lunch for both lead and assistant ECET. Descriptive statistics, test-retest for a subgroup, interclass correlations for each item, and comparisons between leads and assistants were conducted. SETTING Head Start centres, Southern USA. SUBJECTS Seventy-five Head Start educators. RESULTS On average, 17·2 total verbal feeding communications (sd 8·9) were observed per ECET. For lead ECET, the most prevalent Supportive Comment was Exploring Foods whereas for assistants Making Positive Comments was the most prevalent. Overall, lead ECET enacted more Supportive Comments than assistant ECET (F(2,72)=4·8, P=0·03). The most common Unsupportive Comment was Pressuring to Eat, with a mean of 3·8 (sd 4·3) and a maximum of 25. There was no difference in Unsupportive Comments between lead and assistant ECET. CONCLUSIONS Table Talk may be a useful tool to assess verbal feeding communications of ECET, with potential applications such as informing ECET training and assessing intervention efforts.
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Chao HC, Chang HL. Picky Eating Behaviors Linked to Inappropriate Caregiver-Child Interaction, Caregiver Intervention, and Impaired General Development in Children. Pediatr Neonatol 2017; 58:22-28. [PMID: 27215475 DOI: 10.1016/j.pedneo.2015.11.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 10/15/2015] [Accepted: 11/25/2015] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND To investigate the differences in eating behaviors between picky and nonpicky eaters, and to correlate parental management of children's eating problems with qualities of general development in children. METHODS This was a cross-sectional analysis of parental observations on their children's eating behavior, sampled from three major cities in Taiwan. We used a structured questionnaire during face-to-face interviews to collect information on each child's picky eating habits and behaviors, caregiver-child interaction and intervention during feeding, and the child's qualities of general development. Analysis of variance was used to determine significant differences between picky and nonpicky eaters. RESULTS Sixty-two percent of the children were considered to be picky eaters. Lack of appropriate caregiver-child interactions (e.g., repeated food attempt, persuasion, and encouragement) and the presence of inappropriate parental interactions (e.g., threatening, snacking, and nutrient supplementation) were significantly more common in picky eaters. Picky eaters also tended to exhibit low development quality in the domains of learning ability, interpersonal relationships, and physical performance, particularly in their attention span and uncooperativeness. CONCLUSION There is a relationship between inappropriate parental interaction and interventions in children's eating problems and the low quality of general development in picky eaters.
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Affiliation(s)
- Hsun-Chin Chao
- Division of Gastroenterology, Department of Pediatrics, Chang Gung Children's Medical Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
| | - Hsueh-Ling Chang
- Division of Pediatric Psychiatry, Department of Psychiatry, Chang Gung Children's Hospital, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
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Dovey TM, Aldridge VK, Martin CI, Wilken M, Meyer C. Screening Avoidant/Restrictive Food Intake Disorder (ARFID) in children: Outcomes from utilitarian versus specialist psychometrics. Eat Behav 2016; 23:162-167. [PMID: 27794273 DOI: 10.1016/j.eatbeh.2016.10.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 09/16/2016] [Accepted: 10/18/2016] [Indexed: 11/27/2022]
Abstract
This study assessed the specificity and sensitivity of two commonly used psychometric methods to assess ARFID in children. To achieve this, a sample of 329 mothers and one father completed the Behavioral Pediatrics Feeding Assessment Scale (BPFAS) and the Child Food Neophobia Scale (CFNS). A Receiver Operating Characteristic (ROC) analysis indicated that both measures were able to successfully differentiate a known clinical sample from those of typically developing population. Although the BPFAS was more accurate at differentiating ARFID from the general population, the CFNS was acceptable and on some metrics better than its longer counterpart. The ability of a food neophobia scale to differentiate clinical and population samples, and detect gradation of food avoidance within the population sample, suggests that the multitude of psychometric measures available may be measuring similar constructs. Therefore, confidence can be expected in cross-site comparisons despite each using different psychometric measures of food avoidance in children.
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Affiliation(s)
- Terence M Dovey
- Institute of Environment, Health & Societies, Department of Life Sciences, Marie Jahoda Building, Brunel University London, Uxbridge UB8 3PH, United Kingdom.
| | - Victoria K Aldridge
- UCL Institute of Child Health, 30 Guilford Street, London WC1N 1EH, United Kingdom
| | - Clarissa I Martin
- Midlands Psychology, Midland House, 19 Newport Road, Stafford, Staffordshire ST16 1BA, United Kingdom
| | - Markus Wilken
- Institute for Pediatric Feeding Tube Management and Weaning, Siegburg, Germany
| | - Caroline Meyer
- WMG, University of Warwick, Coventry, Warwickshire CV4 7AL, United Kingdom; Coventry and Warwickshire Partnership NHS Trust, Coventry, United Kingdom
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González ML, Stern K. Co-occurring behavioral difficulties in children with severe feeding problems: A descriptive study. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 58:45-54. [PMID: 27591974 DOI: 10.1016/j.ridd.2016.08.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 06/21/2016] [Accepted: 08/22/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Recent literature highlights the association between behavioral difficulties and the presence of feeding problems in children with an Autism Spectrum Disorder (ASD) relative to children with ASD without feeding problems. However, it is not clear to what extent behavior problems (outside of the meal setting) occur in children with feeding problems without comorbid ASD. AIMS The purpose is to describe co-occurring behavioral difficulties of a sample of children with severe food refusal/selectivity and examine potential predictors of behavioral difficulties outside of the meal context. METHOD AND PROCEDURES The medical charts of fifty-four patients were reviewed and data were collected on the frequency of caregiver coaching and/or behavioral intervention outside of the meal context. Age, presence of developmental delay/autism, and type of feeding problem were examined as potential predictors of behavioral support. OUTCOME AND RESULTS Approximately half of the sample received coaching or individualized intervention. The percentage of caregivers who received individualize coaching were similar across groups. Younger age at admission was a predictor of individual caregiver coaching. Presence of delay/ASD, age, and type of feeding problems were not significant predictors for individualized treatment programing. CONCLUSION AND IMPLICATIONS These data provide evidence of difficult caregiver-child interactions that occurs outside of the meal context for some children with severe feeding difficulties and suggest that this association may not be exclusive to children with ASD.
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Affiliation(s)
- Melissa L González
- Department of Behavioral Psychology, Kennedy Krieger Institute and Johns Hopkins School of Medicine, 707 North Broadway, Baltimore, MD 21205, United States.
| | - Karin Stern
- Department of Health and Human Services, University of Maryland Baltimore County, United States
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Estrem HH, Pados BF, Park J, Knafl KA, Thoyre SM. Feeding problems in infancy and early childhood: evolutionary concept analysis. J Adv Nurs 2016; 73:56-70. [PMID: 27601073 DOI: 10.1111/jan.13140] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2016] [Indexed: 12/14/2022]
Abstract
AIM The aim of this study was to report an analysis of the concept of pediatric feeding problems. BACKGROUND Reviews of the literature on pediatric feeding problems and disorders repeatedly reference the lack of a shared conceptualization of feeding problems. It is difficult to track aetiology, prevalence and incidence of a phenomenon when available definitions and diagnoses lack practical utility. DESIGN An evolutionary concept analysis. DATA SOURCES A search was conducted in October 2014 of Google Scholar, CINAHL, PubMed and Web of Science databases, with MeSH terms and key words including: failure to thrive, feeding disorder/difficulty/problems, infantile anorexia, oral aversion, mealtime behaviour and dysphagia. Inclusion criteria were: subject of feeding problems, index children 0-10 years of age, English language and full text. METHODS The articles (n = 266) were sorted into disciplines of authorship, including Psychology, Medicine, Nursing, Nutrition, Occupational Therapy, Speech Language Pathology or Other. The sample was divided into a historical sample (n = 42) for pre-2000 articles and current for those published post-2000. The current sample was later reduced to 100 and coded for surrogate terms, related concepts, attributes, antecedents and consequences. RESULTS The historical view of pediatric feeding problems shows a tradition of mother blame or parental culpability, both direct and indirect. Currently, there exist many different definitions and typologies, but none have sound validity or generalizability. Areas of attribute consensus across disciplines are problematic feeding behaviours and selective or restrictive intake. CONCLUSION A spectrum conceptualization of feeding problems is suggested for further development, with attributes that would be critical to have a feeding problem.
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Affiliation(s)
- Hayley H Estrem
- School of Nursing, Duke University, Durham, North Carolina, USA
| | - Britt F Pados
- School of Nursing, University of North Carolina at Chapel Hill, North Carolina, USA
| | - Jinhee Park
- Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts, USA
| | - Kathleen A Knafl
- University of North Carolina at Chapel Hill, North Carolina, USA
| | - Suzanne M Thoyre
- University of North Carolina at Chapel Hill, North Carolina, USA
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Olive ML. Assessment & Intervention for Young Children With Nonphysiological Feeding Concerns Melissa L. Olive, Ph.D., University of Texas at Austin. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/109625060400700402] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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van Dijk M, Bruinsma E, Hauser MP. The relation between child feeding problems as measured by parental report and mealtime behavior observation: A pilot study. Appetite 2016; 99:262-267. [DOI: 10.1016/j.appet.2016.01.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 01/16/2016] [Accepted: 01/18/2016] [Indexed: 10/22/2022]
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Aldridge VK, Dovey TM, Martin CI, Meyer C. RELATIVE CONTRIBUTIONS OF PARENT-PERCEIVED CHILD CHARACTERISTICS TO VARIATION IN CHILD FEEDING BEHAVIOR. Infant Ment Health J 2015; 37:56-65. [PMID: 26715180 DOI: 10.1002/imhj.21544] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Few studies have examined the relative impact of co-occurring child characteristics on problematic feeding behavior. The aim of the current study was to assess the relative contributions of parent-perceived child characteristics in multivariable models of child feeding behavior. One hundred sixty-one mothers reported on their child's feeding behavior and a number of key child characteristics. These characteristics were entered into controlled multivariable models of child feeding behavior, using child and parent frequency domains of the Behavioral Pediatrics Feeding Assessment Scale (BPFAS; W. Crist et al., 1994) as outcome measures. Child feeding problems were positively associated with food neophobia and external behavioral and social issues, but not with most domains of temperamental difficulty or sensory sensitivity. Feeding problem frequency was associated with externalizing symptoms whereas parental perceptions of problems and coping were associated with social-interaction problems in the child. Population feeding problems appear to be external and interactive problems rather than driven by innate or internalizing factors. The association with externalizing symptoms suggests that feeding problems at this level may fall within a wider profile of challenging behavior; however, the existence of problematic feeding behaviors may constitute a challenge for parents only when the child's social interactions also are seen to be deficient.
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Affiliation(s)
| | | | - Clarissa I Martin
- Midlands Psychology, The Hayes, 19 Newport Road, Stafford Staffordshire, ST16 1BA, United Kingdom
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Mealtime Observations and Parent-Report: Correspondence Across Measurement and Implications for Intervention. BEHAVIOUR CHANGE 2015. [DOI: 10.1017/bec.2015.9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This study explored the relationship between self-reported and observed mealtime behaviour and examined concurrent predictors of observed child and parent mealtime behaviour. The sample consisted of 67 parents of 1.5- to 6-year-old children experiencing difficulties with their child's mealtime, and 33 parents who were not concerned with their child's mealtime behaviour. Parent-reported and observed mealtime data, and parent-reported mealtime cognitions were collected. Regression analyses indicated that consistent with hypotheses, observed and parent-reported mealtime behaviour were related. Observed child behaviour was predicted by self-reported parenting behaviour and observed positive parent behaviour, as well as parental cognitions. Observed parent behaviour was predicted only by self-reported parenting mealtime behaviour.
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Odar Stough C, Dreyer Gillette ML, Roberts MC, Jorgensen TD, Patton SR. Mealtime behaviors associated with consumption of unfamiliar foods by young children with autism spectrum disorder. Appetite 2015. [PMID: 26206175 DOI: 10.1016/j.appet.2015.07.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Parent and child mealtime behaviors associated with consumption of unfamiliar foods by children with ASD were examined. Families of 38 children aged 2 through 8 years old and diagnosed with ASD videotaped a typical home mealtime during which parents presented the child with an unfamiliar food and mealtime behaviors were subsequently coded through an observational coding system. The child taking sips of their drink was the only behavior related to whether the child took a bite of the unfamiliar food throughout the course of the meal. Parent direct commands and parents feeding the child were related to greater frequency of subsequent bites in a close temporal window, while child play, the child being away from the table, and child talk about things other than food related to lower frequencies of subsequent bites. Clinical interventions for food selectivity in children with ASD might provide parents education on effective mealtime parenting strategies and decreasing inappropriate child mealtime behaviors.
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Affiliation(s)
- Cathleen Odar Stough
- Clinical Child Psychology Program, University of Kansas, 2015 Dole Human Development Center, 1000 Sunnyside Avenue, Lawrence, KS 66045, USA.
| | - Meredith L Dreyer Gillette
- Division of Developmental and Behavioral Sciences, Children's Mercy Kansas City, 2401 Gillham Road, Kansas City, MO 64108, USA.
| | - Michael C Roberts
- Clinical Child Psychology Program, University of Kansas, 2015 Dole Human Development Center, 1000 Sunnyside Avenue, Lawrence, KS 66045, USA.
| | - Terrence D Jorgensen
- Department of Child Development and Education, University of Amsterdam, Postbus (P.O. Box) 15776, 1001NG Amsterdam, The Netherlands.
| | - Susana R Patton
- Department of Pediatrics, University of Kansas Medical Center, 3901 Rainbow Blvd, MS 4004, Kansas City, KS 66160, USA.
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Poppert KM, Patton SR, Borner KB, Davis AM, Dreyer Gillette ML. Systematic review: mealtime behavior measures used in pediatric chronic illness populations. J Pediatr Psychol 2015; 40:475-86. [PMID: 25622593 PMCID: PMC6281003 DOI: 10.1093/jpepsy/jsu117] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Revised: 12/04/2014] [Accepted: 12/09/2014] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE This systematic review evaluates the utility and psychometric properties of pediatric mealtime assessments (direct observation and parent-report measures) using evidence-based criteria developed by the Division 54 Evidence-Based Assessment Task Force. METHOD Measures of mealtime behavior used in at least one chronic illness pediatric population were eligible for inclusion. A total of 23 assessment measures were reviewed (16 parent-/self-report; 7 direct observation). RESULTS 3 parent-report and 4 direct observation measures were classified as well-established, 3 met criteria for approaching well-established, and 13 were categorized as promising. Measures have been primarily used in children with feeding disorders, cystic fibrosis, and autism spectrum disorders. CONCLUSIONS Overall, the literature of pediatric mealtime assessment tools shows a strong evidence base for many direct observation methods and subjective parent-report measures. Exploratory and confirmatory factor analyses are available for some measures; recommendations for future validation research and measure development across pediatric populations are discussed.
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Affiliation(s)
- Katrina M Poppert
- Clinical Child Psychology Program, University of Kansas, Department of Pediatrics, University of Kansas Medical Center, and Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Hospital, Kansas City, MO, USA Clinical Child Psychology Program, University of Kansas, Department of Pediatrics, University of Kansas Medical Center, and Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Hospital, Kansas City, MO, USA
| | - Susana R Patton
- Clinical Child Psychology Program, University of Kansas, Department of Pediatrics, University of Kansas Medical Center, and Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Hospital, Kansas City, MO, USA Clinical Child Psychology Program, University of Kansas, Department of Pediatrics, University of Kansas Medical Center, and Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Hospital, Kansas City, MO, USA
| | - Kelsey B Borner
- Clinical Child Psychology Program, University of Kansas, Department of Pediatrics, University of Kansas Medical Center, and Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Hospital, Kansas City, MO, USA Clinical Child Psychology Program, University of Kansas, Department of Pediatrics, University of Kansas Medical Center, and Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Hospital, Kansas City, MO, USA
| | - Ann M Davis
- Clinical Child Psychology Program, University of Kansas, Department of Pediatrics, University of Kansas Medical Center, and Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Hospital, Kansas City, MO, USA Clinical Child Psychology Program, University of Kansas, Department of Pediatrics, University of Kansas Medical Center, and Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Hospital, Kansas City, MO, USA
| | - Meredith L Dreyer Gillette
- Clinical Child Psychology Program, University of Kansas, Department of Pediatrics, University of Kansas Medical Center, and Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Hospital, Kansas City, MO, USA
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White HJ, Haycraft E, Madden S, Rhodes P, Miskovic-Wheatley J, Wallis A, Kohn M, Meyer C. How do parents of adolescent patients with anorexia nervosa interact with their child at mealtimes? A study of parental strategies used in the family meal session of family-based treatment. Int J Eat Disord 2015; 48:72-80. [PMID: 24965701 DOI: 10.1002/eat.22328] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 05/23/2014] [Accepted: 06/14/2014] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To examine the range and frequency of parental mealtime strategies used during the family meal session of Family-Based Treatment (FBT) for adolescent anorexia nervosa, and to explore the relationships between parental mealtime strategies, mealtime emotional tone and parental 'success' at encouraging adolescent food consumption. METHOD Participants were 21 families with a child aged between 12 and 18 years receiving FBT for adolescent anorexia nervosa. Video recordings of the family meal session (FBT session two) were coded using the Family Mealtime Coding System adapted in this study for use with adolescents (FMCS-A) to identify frequency of parental strategies, emotional tone of the meal (measured by adolescent positive and negative vocalisations) and frequency of prompted mouthfuls consumed by the adolescent (measured by the number of mouthfuls consumed by the adolescent immediately following parental interactions). RESULTS A range of parental mealtime strategies were in use. Those used repeatedly included direct eating prompts, non-direct eating prompts, physical prompts, and providing information or food-related choices. Several parental mealtime strategies (direct and non-direct eating prompts) were found to be consistently associated with the tone of adolescents' vocalisations and the number of mouthfuls consumed in response to a parental prompt. DISCUSSION Despite associations with negativity from the adolescent, the use of food-related prompts (both verbal and physical) seems to be associated with increased eating. This indicates the potentially important role of parental control of eating. Following replication, these findings might provide a focus for therapists when supporting and coaching parents during the family meal session.
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Affiliation(s)
- Hannah J White
- Loughborough University Centre for Research into Eating Disorders, Loughborough University, Loughborough, United Kingdom
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Adamson M, Morawska A, Wigginton B. Mealtime duration in problem and non-problem eaters. Appetite 2015; 84:228-34. [DOI: 10.1016/j.appet.2014.10.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 10/17/2014] [Accepted: 10/18/2014] [Indexed: 10/24/2022]
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Boquin M, Smith-Simpson S, Donovan SM, Lee SY. Mealtime behaviors and food consumption of perceived picky and nonpicky eaters through home use test. J Food Sci 2014; 79:S2523-32. [PMID: 25388752 DOI: 10.1111/1750-3841.12698] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Accepted: 09/15/2014] [Indexed: 12/20/2022]
Abstract
Picky eating has been investigated through numerous surveys and food recalls, but few studies have applied in-home meal evaluations as a method to investigate behaviors and food preferences of children perceived by their parent to be a picky eater (PE) or nonpicky eater (NPE). A 2-wk in-home meal study was completed to investigate differences in PE and NPE mealtime behaviors and food selections using real-time parental observations. Parents (n = 170) and their 2- to 4-y-old children (83 PE and 87 NPE) evaluated 5 standardized meals in-home. Parents recorded their child's and their own hedonic liking of the products and completed an assessment of their child's behavior and consumption at each meal. Significant differences were found between perceived PE and NPE children for all 16 behaviors assessed. On average, perceived NPE were assessed to consume a higher percentage of the meal served and to have higher acceptance scores for most of the foods evaluated. Some foods, though, like breaded chicken and plain pasta, were liked equally by PE and NPE. Several significant differences in hedonic liking were revealed when PE children were compared to their parents. Yet, few differences in liking occurred between NPE children and their parents or between the 2 parental groups. Because study participants evaluated meals real-time rather than memory recall, the differences and similarities found between perceived PE and NPE may be considered direct experiential evidence with reduced subjective bias as created when subjects recall past experiences. Thus, findings from this study can provide the foundation to establish an objective definition and classification of PE and NPE.
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Affiliation(s)
- Mandy Boquin
- Univ. of Illinois, 905 S. Goodwin Ave, Urbana, IL 61801, U.S.A. Dept. of Food Science and Human Nutrition, Univ. of Illinois, Urbana-Champaign, IL 61801, U.S.A, Nestlé/Gerber Nutrition, Fremont, MI, USA
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Aviram I, Atzaba-Poria N, Pike A, Meiri G, Yerushalmi B. Mealtime Dynamics in Child Feeding Disorder: The Role of Child Temperament, Parental Sense of Competence, and Paternal Involvement. J Pediatr Psychol 2014; 40:45-54. [DOI: 10.1093/jpepsy/jsu095] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Behavioural Parent Training Versus Dietary Education in the Treatment of Children with Persistent Feeding Difficulties. BEHAVIOUR CHANGE 2014. [DOI: 10.1017/s0813483900004514] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This controlled treatment-outcome study compared the effects of behavioural parent training (BPT) and standard dietary education (SDE) on the mealtime interaction, feeding behaviour, nutritional status, and adjustment of children with feeding disorders. Participants were 20 children (aged between 18 months and five years) with persistent feeding difficulties, and their families. Children underwent initial screening (involving medical assessment, behavioural observation of mealtime interaction, nutritional intake analysis, and self-report measures of parent and child adjustment) and were randomly assigned to BPT or SDE. Results indicated that children in both treatment conditions showed improvement on the child behaviour measures (e.g. food refusal, disruptive behaviour during mealtimes) at home and in mealtime observations in the clinic. Children in both conditions also showed an increase in the variety of foods sampled by follow-up. Following treatment, mothers who received BPT showed more positive mother–child interaction during mealtimes, and both parents were more satisfied with treatment than parents in SDE. Mothers in both conditions showed slight elevations in mood at posttest and follow-up, and increased marital satisfaction at posttest (which decreased by follow-up). All other treatment effects were maintained at a three- to four-month follow-up assessment.
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Must A, Curtin C, Hubbard K, Sikich L, Bedford J, Bandini L. Obesity Prevention for Children with Developmental Disabilities. Curr Obes Rep 2014; 3:156-70. [PMID: 25530916 PMCID: PMC4267572 DOI: 10.1007/s13679-014-0098-7] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The prevention of obesity in children with DD is a pressing public health issue, with implications for health status, independent living, and quality of life. Substantial evidence suggests that children with developmental disabilities (DD), including those with intellectual disabilities (ID) and autism spectrum disorder (ASD), have a prevalence of obesity at least as high if not higher than their typically developing peers. The paper reviews what is known about the classic and unique risk factors for childhood obesity in these groups of children, including dietary, physical activity, sedentary behavior, and family factors, as well as medication use. We use evidence from the literature to make the case that primary prevention at the individual/family, school and community levels will require tailoring of strategies and adapting existing intervention approaches.
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Affiliation(s)
- Aviva Must
- Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111
| | - Carol Curtin
- Eunice Kennedy Shriver Center, University of Massachusetts Medical School, 465 Medford Street, Suite 500, Charlestown, MA 02129
| | - Kristie Hubbard
- Friedman School of Nutrition Science and Policy, Tufts University, 75 Kneeland Street, 8 Floor, Boston, MA 02111
| | - Linmarie Sikich
- Department of Psychiatry, University of North Carolina at Chapel Hill, CB 7167 UNC-CH, Chapel Hill, NC 27599-7167
| | - James Bedford
- Department of Psychiatry, University of North Carolina at Chapel Hill, CB 7160 UNC-CH, Chapel Hill, NC 27599-7160
| | - Linda Bandini
- Eunice Kennedy Shriver Center, University of Massachusetts Medical School, 465 Medford Street, Suite 500, Charlestown, MA 02129
- Department of Health Sciences, Boston University, 635 Commonwealth Ave. Boston, MA 02115
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Berlin KS, Kamody RC, Banks GG, Silverman AH, Davies WH. Empirically Derived Parental Feeding Styles for Young Children and Their Relations to Weight, Mealtime Behaviors, and Childhood Behavior Problems. CHILDRENS HEALTH CARE 2014. [DOI: 10.1080/02739615.2014.891207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Morawska A, Adamson M, Hinchliffe K, Adams T. Hassle Free Mealtimes Triple P: A randomised controlled trial of a brief parenting group for childhood mealtime difficulties. Behav Res Ther 2014; 53:1-9. [DOI: 10.1016/j.brat.2013.11.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Revised: 11/25/2013] [Accepted: 11/26/2013] [Indexed: 10/25/2022]
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Screening for feeding disorders. Creating critical values using the behavioural pediatrics feeding assessment scale. Appetite 2013; 69:108-13. [DOI: 10.1016/j.appet.2013.05.019] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Revised: 05/24/2013] [Accepted: 05/26/2013] [Indexed: 11/18/2022]
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Musher-Eizenman DR, Kiefner A. Food parenting: a selective review of current measurement and an empirical examination to inform future measurement. Child Obes 2013; 9 Suppl:S32-9. [PMID: 23944922 PMCID: PMC3746246 DOI: 10.1089/chi.2013.0030] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Interactions between parents and children in regard to food are an important part of the development of food preferences and intake patterns for children. The measurement of this complex and multidimensional construct is very challenging. METHODS This article examines the current status of measurement in this domain in a selective review, considers qualitative input from parents and adolescents in an empirical examination of the topic, and makes concrete recommendations for the future. RESULTS Qualitatively, there were important differences between what the adolescents reported that their parents did to impact their eating habits, what parents of younger children report they currently do, and what researchers typically measure in research on parental feeding practices. CONCLUSIONS On the basis of these empirical findings and our review of the literature, we recommend that food parenting be measured on three levels: Feeding styles (e.g., authoritative), food parenting practices (e.g., restriction), and specific feeding behaviors (e.g., putting food out of the child's reach). Specific recommendations for future study are given for each level of measurement.
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Affiliation(s)
| | - Allison Kiefner
- Department of Psychology, Bowling Green State University, Bowling Green, OH
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Jones C, Bryant-Waugh R. The relationship between child-feeding problems and maternal mental health: a selective review. ACTA ACUST UNITED AC 2013. [DOI: 10.1080/21662630.2013.742972] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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49
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Childhood feeding difficulties: a randomized controlled trial of a group-based parenting intervention. J Dev Behav Pediatr 2013; 34:293-302. [PMID: 23751884 DOI: 10.1097/dbp.0b013e3182961a38] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Difficulty with feeding is common during early childhood. Behavioral techniques have shown considerable utility for difficult feeding, although large-scale studies of behavioral parenting interventions with typically developing young children, and in group formats, are limited. OBJECTIVE The current study aimed to evaluate the efficacy of a group-based, behavioral family intervention for typically developing healthy children with problem eating via a fully randomized 2-group design. METHODS : Ninety-six families of children aged 1.5 to 6 years with feeding difficulties participated in a trial of Hassle Free Mealtimes Triple P (A. Morawska and M.R. Sanders, unpublished data, 2008) in regional and metropolitan Queensland (Australia). RESULTS Results support the utility of a group-based behavioral parenting program for childhood feeding issues, with significant improvements to the mealtime and general behavior of target children, the mealtime and general practices of parents, parental confidence and cognitions, compared with a waitlist control. Six-month follow-up data and clinical and reliable change indices support the intervention's utility. Parents were also highly satisfied with the program. CONCLUSION The current study provides evidence of the efficacy of a group-based behavioral family intervention for mealtime difficulties, including observational and more extended outcome measures. Future directions and clinical implications of this research are discussed.
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Mitchell GL, Farrow C, Haycraft E, Meyer C. Parental influences on children’s eating behaviour and characteristics of successful parent-focussed interventions. Appetite 2013; 60:85-94. [DOI: 10.1016/j.appet.2012.09.014] [Citation(s) in RCA: 142] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Revised: 08/14/2012] [Accepted: 09/15/2012] [Indexed: 10/27/2022]
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