Research reportClarifying concepts of food parenting practices. A Delphi study with an application to snacking behavior☆
Introduction
Considerable attention has been paid to investigating parental influences on children's diets (Ventura & Birch, 2008), revealing that parents are pivotal in shaping children's dietary intake (Faith et al, 2004, Ventura, Birch, 2008). Parents create their children's physical and social environment, for example, by buying foods, by setting rules about foods, by encouraging or discouraging their children to eat certain kinds of foods, and by modeling the consumption of foods (Pinard et al., 2012). Many researchers have tried to capture these food parenting practices (FPPs) to study their impact on children's dietary intake, food preferences, eating styles, or anthropometric outcomes. The ultimate goal of such investigations is to inform interventions to promote healthy eating among children.
Many different instruments to assess FPPs have been used, among which the Child Feeding Questionnaire (CFQ; Birch et al., 2001) is predominant (Corsini, Danthiir, Kettler, & Wilson, 2008). Other popular and validated instruments include the Comprehensive Feeding Practices Questionnaire (CFPQ; Musher-Eizenman & Holub, 2007) and the Parental Feeding Style Questionnaire (PFSQ; Wardle, Sanderson, Guthrie, Rapoport, & Plomin, 2002). When comparing instruments to measure FPPs, several measurement inconsistencies can be noted. First, the names of FPP concepts differ between studies, while referring to the same concept (e.g. “food as a reward”; Musher-Eizenman & Holub, 2007 vs. “instrumental feeding”; Wardle et al., 2002). Second, the operationalization of similar concepts differs between studies, for example, pressure to eat has been operationalized as “if I did not guide or regulate my child's eating, she would eat much less than she should” (Birch et al., 2001), but also with the conceptually different item, “when he/she says he/she is finished eating, I try to get my child to eat one more (two more, etc.) bites of food” (Musher-Eizenman & Holub, 2007). Third, concepts differ in their level of specificity, both across and within studies. Restriction (e.g. Birch et al., 2001), for example, could be regarded as a concept at a general level while the concept of availability (e.g. Gattshall et al, 2008, Vereecken et al, 2010) may be regarded as one of the multiple ways to restrict a child's unhealthy food intake. Fourth, concepts are operationalized at different dimensions, in which some items reflect behaviors (e.g. “I intentionally keep some foods out of my child's reach”), while other items reflect beliefs (e.g. “I have to be sure that my child does not eat too many high-fat foods”) (Corsini et al., 2008). Aside from these inconsistencies, many instruments have concentrated on a limited number of FPPs, most of which are controlling practices (Clark, Goyder, Bissell, Blank, & Peters, 2007). However, a wide range of FPPs seem to exist and FPPs related to concepts such as modeling, educating, and involving are often disregarded (Musher-Eizenman & Holub, 2007). An instrument measuring all potentially important FPPs is lacking.
Fundamental to these issues is the lack of clarity about the full range of FPPs and about what is understood by different FPP concepts. Therefore, initiatives aiming at reaching consensus on FPP concepts are required to solve the inconsistencies in conceptualization and operationalization of concepts (Vaughn, Tabak, Bryant, & Ward, 2013).
This study addresses the conceptualization of FPPs by consulting experts in the field of parenting. The focus of this study is on snacking-related FPPs, as a high intake of energy-dense snacks increases the risk of weight gain and obesity among children (World Health Organization, 2003). Furthermore, snack-related parent–child interactions are likely to occur on a daily basis and to involve a wide range of parenting behaviors (Brown & Ogden, 2004).
Section snippets
Overview
A three round Delphi study was conducted using an international group of experts and a series of online surveys. The Delphi method is considered to be an appropriate method when aiming at reaching consensus and when experts are located distantly (Adler & Ziglio, 1996). In addition, this method usually starts from a blank slate, without directing or narrowing the focus of the experts to frequently utilized concepts and thereby creating a wider perspective compared with a review of instruments.
Response and participant characteristics
In total, 36 experts participated in the first round (response rate = 38%; Table 1). In the second round, 53 experts participated (response rate = 41%), including 26 experts from the first round. Of these 53 experts, 43 completed both questions on all descriptions, and 10 experts partly filled in the questionnaire (ranging from both questions on 12 descriptions to both questions on 83 descriptions). Two experts did not share information on their expertise. In the third round, 39 experts
Discussion
Fundamental to the inconsistencies in measurements of food parenting is the lack of clarity about the scope of FPPs and about what is understood by different FPP concepts. This study sought to clarify FPP concepts with an application to snacking behavior.
An extensive set of FPPs, and related concepts, has been identified, establishing a wide range of distinct FPPs. Experts agreed on the concepts for a considerable number of FPPs by using 18 different concept names. Several of the concepts
References (30)
- et al.
Confirmatory factor analysis of the Child Feeding Questionnaire. A measure of parental attitudes, beliefs and practices about child feeding and obesity proneness
Appetite
(2001) Relationships between parenting style, feeding style and feeding practices and fruit and vegetable consumption in early childhood
Appetite
(2011)- et al.
Factor structure and psychometric properties of the Child Feeding Questionnaire in Australian preschool children
Appetite
(2008) - et al.
Measuring feeding in low-income African-American and Hispanic parents
Appetite
(2006) Current validity of the Delphi method in social sciences
Technological Forecasting and Change
(2006)- et al.
Parental feeding styles and adolescents’ healthy eating habits. Structure and correlates of a Costa Rican questionnaire
Appetite
(2010) - et al.
Associations of parenting styles, parental feeding practices and child characteristics with young children's fruit and vegetable consumption
Appetite
(2010) - et al.
Gazing into the oracle. The Delphi method and its application to social policy and public health
(1996) - et al.
Houston … We have a problem! Measurement of parenting
Childhood Obesity
(2013) - et al.
Children's eating attitudes and behaviour. A study of the modelling and control theories of parental influence
Health Education Research
(2004)
How do parents’ child-feeding behaviours influence child weight? Implications for childhood obesity policy
Journal of Public Health
Physical activity parenting measurement and research. Challenges, explanations, and solutions
Childhood Obesity
Factors underlying smoking relapse prevention. Results of an international Delphi study
Health Education Research
Parent-child feeding strategies and their relationships to child eating and weight status
Obesity Research
Validation of a survey instrument to assess home environments for physical activity and healthy eating in overweight children
International Journal of Behavioral Nutrition and Physical Activity
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2021, AppetiteCitation Excerpt :They serve as providers, models and regulators of the food environment (Birch & Fisher, 1998), exerting their influence through food parenting practices (FPP1). FPP are defined as context-specific acts of parenting concerning food and eating to socialize children toward certain behaviour (D. W. Gevers, Kremers, de Vries, & van Assema, 2014; Vaughn et al., 2016). Most studies on FPP have been conducted among (young) children and their parents, however FPP may also be important during adolescence.
Feeding practices demonstrated by parents of toddlers: An observational analysis of breakfast, lunch, dinner, and snacks
2020, AppetiteCitation Excerpt :For these reasons, the final aim of this study was to characterize the environment of meals and snacks in terms of whether other people are present and eating, as well as screen use (televisions, tablets, or other screens) during the eating occasions. In summary, parents and other family members influence the development of food preferences and attitudes towards food and eating through a range of feeding practices (Bergmeier et al., 2015; Gevers et al., 2014; Ventura & Birch, 2008). However, it is currently unknown whether parents exhibit similar feeding practices across meals (breakfast, lunch, and dinner) or between meals and snacks.
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Acknowledgments: We are very grateful to the experts who participated in our study. Our appreciation is expressed to Ciska Hoving for reviewing the invitations and questionnaires for clarity. The authors declare that they have no competing interests.