Abstract
Background
National early childhood obesity prevention policies recommend that child-care providers
avoid controlling feeding practices (CFP) (eg, pressure-to-eat, food as reward, and
praising children for cleaning their plates) with children to prevent unhealthy child
eating behaviors and childhood obesity. However, evidence suggests that providers
frequently use CFP during mealtimes.
Objective
Using the Academy of Nutrition and Dietetics (2011) benchmarks for nutrition in child
care as a framework, researchers assessed child-care providers’ perspectives regarding
their use of mealtime CFP with young children (aged 2 to 5 years).
Design
Using a qualitative design, individual, face-to-face, semi-structured interviews were
conducted with providers until saturation was reached.
Participants/setting
Providers were selected using maximum variation purposive sampling from varying child-care
contexts (Head Start, Child and Adult Care Food Program [CACFP]–funded centers, non-CACFP
programs). All providers were employed full-time in Head Start or state-licensed center-based
child-care programs, cared for children (aged 2 to 5 years), and were directly responsible
for serving meals and snacks.
Main outcome measure
Child-care providers’ perspectives regarding CFP.
Statistical analyses performed
Thematic analysis using NVivo (version 9, 2010, QSR International Pty Ltd) to derive
themes.
Results
Providers’ perspectives showed barriers, motivators, and facilitators regarding their
use of mealtime CFP. Providers reported barriers to avoiding CFP such as CFP were
effective for encouraging desired behaviors, misconceptions that providers were encouraging
but not controlling children’s eating, and fear of parents’ negative reaction if their
child did not eat. Providers who did not practice CFP were motivated to avoid CFP
because they were unnecessary for encouraging children to eat, and they resulted in
negative child outcomes and obesity. Facilitators as an alternative to CFP included
practicing healthful feeding practices such as role modeling, peer modeling, and sensory
exploration of foods.
Conclusions
Training providers about negative child outcomes associated with CFP, children’s ability
to self-regulate energy intake, and differentiating between controlling and healthful
feeding strategies may help providers to avoid CFP.
Keywords
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Biography
D. A. Dev is an assistant professor in the Department of Child, Youth and Family Studies, University of Nebraska, Lincoln; at the time of the study, she was a doctoral student in the Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL.
Biography
B. A. McBride is a professor in the Department of Human Development and Family Studies, Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL.
Biography
K. E. Speirs is a postdoctoral research associate in the Family Resiliency Center, University of Illinois at Urbana-Champaign, Urbana, IL.
Biography
K. A. Blitch is a doctoral student, Department of Child, Youth and Family Studies, University of Nebraska, Lincoln.
Biography
N. A. Williams is an assistant professor, Department of Child, Youth and Family Studies, University of Nebraska, Lincoln.
Article info
Publication history
Published online: September 17, 2016
Accepted:
July 18,
2016
Received:
March 29,
2016
Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT This research was funded, in part, by grants from the US Department of Health and Human Services, Administration of Children and Families/ Office of Planning, Research and Evaluation (grant no. 90YR0052) and the Illinois Trans-Disciplinary Obesity Prevention Seed Grant Program.
Identification
Copyright
© 2016 by the Academy of Nutrition and Dietetics.
