Observational Ratings of Child Feeding Practices among Preschoolers

Jayne A. Fulkerson, Ph.D.
School of Nursing, University of Minnesota

The proposed study aims to comprehensively assess child feeding practices currently used by parents of at-risk preschoolers and develop a methodology that can be used to eventually test which child feeding practices are most effective in preventing excess weight gain among children. The proposed work directly addresses the early stages necessary to meet the goal put forth by the NIH Obesity Research Task Force, namely, using prospective observational studies to identify potentially modifiable behavioral determinants of excessive weight gain and obesity in children. The present study aims are to: 1) test the feasibility of recruiting preschool youth at risk for overweight; 2) test the feasibility of videotaping preschoolers’ home meals four times in a 1 week period; 3) revise an existing mealtime behavioral coding scheme used for children with chronic disease for important components of mealtime feeding practices among preschoolers at risk for overweight; 4) quantify the prevalence of specific child feeding practices in a community sample; and 5) identify previously uncoded feeding and eating behaviors in the videotapes and incorporate them into the coding scheme. Forty children aged 2 to 4 years who are at risk of becoming, or are, overweight and one parent/guardian per child will be recruited from local Minneapolis Park and Recreation Centers and Early Child and Family Education programs in Minneapolis, MN. Parents/guardians will inform project staff of their interest in the study and will be screened for eligibility. We will follow an existing successful videotape protocol of mealtime behavioral assessments used with children with cystic fibrosis. Four home visits will be scheduled by research staff. At the first home visit, parents will complete a consent form and a brief questionnaire, and the child and parent will have anthropometry assessed by staff. At all four home visits, research staff will collect videotape data of the child’s meals by setting up the video equipment and leaving the room/house until the meal ends. To assess reactivity to the video methodology, parents will be asked to rate the similarity of the videotaped dinner to routine meals in the home in terms of the child’s eating behavior and general interactions with family members, and typical meal data will be used for analysis. Trained staff will code parent and child mealtime behaviors viewed in the videotapes using the Dyadic Interaction Nomenclature for Eating (DINE) as the base. The observational methodology directly assesses parent-child interactions rather than relying solely on parent report, and can assess the bidirectional nature of parent-child interactions, an important concept in weight-related behaviors.