Purpose: Early childhood educators’ (ECEs’) dietary and feeding behaviors have the potential to influence children’s health outcomes. To date, there have been limited efforts to validate instruments to measure ECE feeding practices or examine how food insecurity (FI) may affect those practices. This study sought to (a) gather data on the properties and performance of the Child Feeding Questionnaire (CFQ) and Child Feeding Style Questionnaire (CFSQ) in ECEs (b) document rates of ECE Current and Childhood FI in the largest sample to date, and (c) examine relations between ECE FI and feeding practices.

Methods: The combination and modification of the CFQ and CFSQ for ECEs is termed the Educator Feeding Survey (EFS). Between 2015-2017, 634 EFSs were completed in two southern states in the US. Subsequently, seven subscales paralleling the CFQ and two subscales paralleling the CFSQ were assessed. Additionally, ECEs were categorized in four feeding style categories (Authoritarian, Authoritative, Indulgent, and Uninvolved). The FI measure was based on the USDA’s Household Food Security Survey Module; current FI and memories of Childhood FI were assessed.

Results: Educators were African American (55%), White (43%), Hispanic (19.8%), or other (2%). EFS mean patterns, ranges, and internal consistency values were consistent with those observed in CFQ/CFSQ samples. Consistent with the CFSQ sample, the majority of ECEs were Authoritarian (35.6%), followed by Indulgent (29.2%), Authoritative (17.9%), and Uninvolved (17.3%). T-tests indicated that ECEs who were Current FI were significantly different from ECEs who were Current FS on scales of perceived responsibility, concern about child weight, restriction, pressure to eat, monitoring, demandingness, and responsiveness (all p>.01).  Chi-square tests found that Current FI was associated with a greater occurrence of Authoritarian and less of Indulgent feeding styles; Childhood FI exhibited greater levels of Authoritarian and lesser Uninvolved feeding styles (all p<.001).

Conclusions: Analyses support the use of the EFS for measuring important elements of ECE feeding practices. Additionally, results demonstrate association between FI on ECEs' feeding practices. These results can inform the way classroom-based nutrition programs are developed and how ECEs are supported to lead them.

Purpose: A large range of questionnaires are available to assess parental feeding practices. Most have been developed for children aged two years and older. To measure and better understand trajectories of feeding and their relationship with child eating behaviours and weight in the long term, early assessments are desirable. While questionnaires also exist to measure feeding practices of parents with infants, no questionnaire is available that allows tracking of feeding practices from infancy to later childhood. This study aimed to develop a version of the Feeding Practices and Structure Questionnaire (FPSQ) for parents with infants and toddlers.

Methods: Constructs and items for the FPSQ for infants and toddlers were derived from the existing and validated FPSQ for older children and supplemented by a literature review on infant feeding questionnaires. Following expert review, two questionnaire versions were developed, one for milk feeding and one for (semi-)solid feeding parents. Data from two studies were combined (child ages 0-24 months) to test the derived constructs with Confirmatory Factor Analysis for the milk (N=731) and solid feeding (N=611) version. 

Results: The milk feeding version consisting of four factors (20 items) showed acceptable model fit and good internal reliability: 'feeding on demand vs. feeding routine' (Cronbach’s α= 0.87), 'using food to calm' (α= 0.86), 'persuasive feeding' (α= 0.71), 'parent-focused feeding' (α= 0.79). The same four factors showed acceptable model fit for the solid feeding version, likewise with good reliability (α= 0.74, 0.86, 0.85, 0.84 respectively). Two additional factors (19 items) were created for the solid feeding version that only appeared developmentally appropriate for children aged 12 months or older: 'family meal environment' (α= 0.81) and 'using (non-)food rewards' (α= 0.92). The majority of factor-factor correlations were in line with those of the original FPSQ.

Conclusions: The FPSQ milk and solid feeding versions are the first measures specifically developed as precursors to the FPSQ to measure parental feeding practices in children <2 years, particularly those related to responsiveness and structure. Further validation in more diverse samples is required.

Purpose: Current measures of parent feeding practices are typically survey-based and assessed as static/unchanging characteristics, failing to account for fluctuations in these behaviors across time and context. The current study uses ecological momentary assessment (EMA) to examine variability in, and predictors of, parent feeding practices within a low-income and diverse sample.

Methods: Children ages 5-7 years old and their parents (n=150 dyads) from six racial/ethnic groups (n=25 from each; African American, Hispanic, Hmong, Native American, Somali, White) were recruited for this mixed-methods study through primary care clinics. Parent feeding practices were measured using the Child Feeding Questionnaire, which was adapted to be used with EMA. Random effect logit models for panel data were applied to examine how categorical predictor variables were statistically related to dichotomous outcome variables. Pairwise comparisons were performed to describe statistical differences between levels of the predictor variables.

Results: Among parents who used restriction (49%) and pressure-to-eat (69%) feeding practices, these feeding practices were utilized about every other day. Contextual factors at the meal associated with parent feeding practices included: number of people at the meal, who prepared the meal, types of food served at meals (e.g., pre-prepared, homemade, fast food), meal setting (e.g., kitchen table, front room), and meal emotional atmosphere (p<0.05). Parents tended to restrict desserts and dairy and pressure children to eat fruits, vegetables, meat proteins, and refined grains (p<0.05). There were some significant differences by race/ethnicity across findings (p<0.01), with Hmong parents engaging in the highest levels of pressure-to-eat feeding practices.

Conclusions: Parent feeding practices varied across the week, indicating they are more likely to be context-specific, or state-like, than trait-like. There were some meal characteristics more strongly associated with engaging in restriction and pressure-to-eat feeding practices. Given that parent feeding practices appear to be state-like, future interventions and health care providers who work with parents and children may want to address contextual factors associated with parent feeding practices to decrease controlling parent feeding practices.