Abstract
Background
Caregivers’ feeding behavior plays a crucial role in the development of overweight
and obesity in preschoolers. However, to date, there is no broadly accepted scale
or questionnaire for assessing preschoolers’ caregivers’ feeding behavior in China.
Objective
To develop a scale that can be used to assess preschoolers’ caregivers’ feeding behavior
in China and to conduct a preliminary evaluation of the scale’s reliability, validity,
and discriminative ability.
Design
The scale was created through a literature review and qualitative interviews with
the target population. Items were reviewed by 50 caregivers of preschoolers and 10
experienced pediatricians, and 95 items were selected to form a draft scale. The draft
scale underwent three rounds of investigation, and the results from these evaluations
were used to select items that formed the final scale.
Participants/setting
Three groups of caregivers (n=175, 400, and 912) were sampled and stratified from
urban and suburban kindergartens in the cities of Jinan and Xi’an between March 2016
and October 2017 to participate in evaluations of the draft scale. From these caregiver
groups, 146, 362, and 768 participants completed valid questionnaires, respectively,
which were used in the scale’s evaluation.
Primary outcome measures
The general demographic data of the participants and scores of each item in the scale
were the primary outcome measures.
Statistical analyses performed
Exploratory factor analysis and variability analysis were used to evaluate the draft
scale, based on data from two rounds of investigation. The structure of the scale
was explored through confirmatory factor analysis, and its reliability, construct
validity, and discriminative ability were evaluated based on data from a third round
of investigation.
Results
The Chinese Preschoolers’ Caregivers’ Feeding Behavior Scale (CPCFBS) consisted of
35 items and seven dimensions; the total cumulative variance contribution rate was
58.6%; the Cronbach’s α coefficient was .91; the split-half reliability coefficient
was 0.89; and the test–retest reliability coefficient was 0.85. The age and weight
status of the children and the caregivers’ age and education levels, as well as family
incomes and child-caregiver relationships, were correlated with feeding behavior.
Conclusions
The CPCFBS appeared to have good reliability and construct validity in specific Chinese
populations. Future studies are needed to confirm existing findings in different Chinese
populations with larger sample sizes.
Keywords
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References
- Prevalence of obesity among adults and youth: United States, 2015-2016.NCHS Data Brief. 2017; : 1-8
- Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: A systematic analysis for the Global Burden of Disease Study 2013.Lancet. 2014; 384: 766-781
- Interpretation of nutrition and chronic diseases in Chinese people (2015).Acta Nutrimenta Sinica. 2016; 38: 525-529
- Childhood obesity and adult cardiovascular disease risk factors: A systematic review with meta-analysis.BMC Public Health. 2017; 17: 1-24
- Childhood obesity affects adult metabolic syndrome and diabetes.Endocrine. 2015; 50: 87-92
- Complications of obesity in children and adolescents.Int J Obes. 2009; 33: S60-S65
- The health consequences of obesity in young adulthood.Curr Obes Rep. 2016; 5: 30-37
- Associations between parental concerns about preschoolers’ weight and eating and parental feeding practices: results from analyses of the Child Eating Behavior Questionnaire, the Child Feeding Questionnaire, and the Lifestyle Behavior Checklist.PLoS One. 2016; 11: 1-20
- Children’s eating behavior, feeding practices of parents and weight problems in early childhood: Results from the population-based Generation R Study.Int J Behav Nutr Phys Act. 2012; 130: 1-12
- Development of eating behaviors among children and adolescents.Pediatrics. 1998; 3 Pt 2: 539-549
- Comprehensive feeding practices questionnaire: Validation of a new measure of parental feeding practices.J Pediatr Psychol. 2007; 32: 960-972
- Confirmatory factor analysis of the Child Feeding Questionnaire: A measure of parental attitudes, beliefs and practices about child feeding and obesity proneness.Appetite. 2001; 36: 201-210
- Parental feeding style and the inter-generational transmission of obesity risk.Obes Res. 2002; 10: 453-462
- Maternal feeding practices and beliefs and their relationships to overweight in early childhood.Feeding Practices and Child Overweight. 2001; 22: 392-408
- Revisiting a neglected construct: parenting styles in a child-feeding context.Appetite. 2005; 44: 83-92
- Confirmatory factor analysis of a questionnaire measuring control in parental feeding practices in mothers of Head Start children.Appetite. 2011; 56: 594-601
- Development of a theory-based questionnaire to assess structure and control in parent feeding (SCPF).Int J Behav Nutr Phys Act. 2017; 14: 1-11
- Chinese translation and validation of a parental feeding style questionnaire for parents of Hong Kong preschoolers.BMC Public Health. 2014; 14: 1194
- Associations between parental feeding styles and childhood eating habits: A survey of Hong Kong pre-school children.PLoS One. 2015; 10: e124753
- Feeding beliefs and practices of Chinese immigrant mothers. Validation of a modified version of the Child Feeding Questionnaire.Appetite. 2014; 80: 55-60
- Association between feeding practices and weight status in young children.BMC Pediatr. 2015; 15: 1-10
- China joins the fatter nations.Int J Pediatr Obes. 2010; 5: 362-364
- The role of grandparents in childhood obesity in China—Evidence from a mixed methods study.Int J Behav Nutr Phys Act. 2015; 12: 1-9
- Eating behaviour patterns in Chinese children aged 12-18 months and association with relative weight—Factorial validation of the Children’s Eating Behaviour Questionnaire.Int J Behav Nutr Phys Act. 2012; 9: 5
- Prevalence and behavioral risk factors of overweight and obesity among children aged 2–18 in Beijing, China.Int J Pediatr Obes. 2010; 5: 383-389
- Hot Beverage and food intake and esophageal cancer in southern China.Asian Pac J Cancer Prev. 2011; 12
- EpiData. [Computer program].The EpiData Association, Odense, Denmark2008
- IBM SPSS Statistics for Windows. [Computer program]. IBM Corp, Armonk, NY2012
- Body mass index growth curves for Chinese children and adolescents aged 0 to 18 years.Chinese J Pediatr. 2009; 47: 493-498
- Accuracy of body mass index as a screening standard for obesity.China Prev Med. 2014; 15: 571-575
- Quality criteria were proposed for measurement properties of health status questionnaires.J Clin Epidemiol. 2007; 60: 34-42
- The study of statistical methods used for item selection.Chinese J Health Stat. 2004; 21: 18-20
- Thirteen ways to look at the correlation coefficient.The American Statistician. 1988; 42: 59-66
- Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives.Struct Equ Modeling. 1999; 6: 1-55
- Coefficient Alpha and the internal structure of tests.Psychometrik. 1951; 16: 297-334
- Exploratory and confirmatory factor analysis: Understanding concepts and applications.Struct Equ Modeling. 2008; 15: 729-734
- Fit indices in covariance structure modeling: Sensitivity to underparameterized model misspecification.Psychological Methods. 1998; 3: 424-453
- Goodness-of-fit indexes in confirmatory factor analysis: The effect of sample size.Psychological Bulletin. 1988; 103: 391-410
- Factor structure and psychometric properties of the Child Feeding Questionnaire in Australian preschool children.Appetite. 2008; 51: 474-481
- A pilot survey of socio-economic differences in child-feeding behaviours among parents of primary-school children.Public Health Nutr. 2008; 11: 1030-1036
- Relationship between parental feeding styles and eating behaviours of Dutch children aged 6–7.Appetite. 2010; 54: 30-36
- Influencing factors and prevention strategies of obesity in preschool children.Shanghai Med Pharm J. 2017; 38: 59-62
- Analysis of parental feeding behavior and its influencing factors in preschool children.Matern Child Health Care China. 2015; 30: 2784-2787
- Caregiver feeding practices and weight status among African American adolescents: The Jackson Heart KIDS Pilot Study.Eat Behav. 2017; 27: 33-38
- Eat this, not that! Parental demographic correlates of food-related parenting practices.Appetite. 2013; 60: 140-147
- Immigrating to the US: what Brazilian, Latin American and Haitian Women have to say about changes to their lifestyle that may be associated with obesity.J Immigr Minor Health. 2013; 15: 357-364
- Parental feeding practices in Mexican American families: Initial test of an expanded measure.Int J Behav Nutr Phys Act. 2013; 10: 1-11
- More controlling child-feeding practices are found among parents of boys with an average body mass index compared with parents of boys with a high body mass index.J Am Diet Assoc. 2005; 105: 1411-1416
- Associations between children’s appetitive traits and maternal feeding practices.J Am Diet Assoc. 2010; 110: 1718-1722
Biography
J. Yuan is a deputy director, Department of Medical Information, General Hospital of Jinan Military Area Command, Jinan, China; at the time of the study, she was a PhD candidate, Department of Health Statistics, School of Public Health, Fourth Military Medical University, Xi’an, China.
Biography
Y. Zhang is a professor of Health Statistics, School of Public Health, Fourth Military Medical University, Xi’an, China.
Biography
L. Shang is a professor of Health Statistics, School of Public Health, Fourth Military Medical University, Xi’an, China.
Biography
T. Xu, is a master degree candidate of Department of Health Statistics, School of Public Health, Fourth Military Medical University, Xi’an, China.
Biography
H. Zhang, is a master degree candidate of Department of Health Statistics, School of Public Health, Fourth Military Medical University, Xi’an, China.
Biography
Z. Lu is a master degree candidate of Department of Health Statistics, School of Public Health, Fourth Military Medical University, Xi’an, China.
Biography
M. Hu is a PhD candidate, Department of Health Statistics, School of Public Health, Fourth Military Medical University, Xi’an, China.
Biography
Lifen Yu is a PhD candidate, Department of Health Statistics, School of Public Health, Fourth Military Medical University, Xi’an, China.
Biography
X. Yang is a research associate, Prevention and Control Centre for Disease, Chengdu Military Command, Chengdu, China.
Biography
Lili Yu is a director, Department of Medical Information, General Hospital of Jinan Military Area Command, Jinan, China.
Biography
X. Jiang is a professor of pediatrics, Tangdu Hospital, Fourth Military Medical University, Xi’an, China.
Article info
Publication history
Published online: May 08, 2019
Accepted:
March 8,
2019
Received:
May 20,
2018
Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT This study was supported by National Natural Science Funds (No. 81773540, No. 81573252) and Social Development Research Funds of Shaanxi Province (No. 2017SF-005, No. 2016SF-192). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Identification
Copyright
© 2019 by the Academy of Nutrition and Dietetics.
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