Maternal, Perinatal and Pediatric Nutrition
Objectives : Family childcare homes (FCCH) are a commonly used form of childcare in the US, yet little is known about this setting, particularly the practices that Hispanic providers use when feeding children. Therefore, the goal was to examine the validity of the Environmental Policy Assessment Observation Tool (EPAO) to assess provider feeding practices.
Data from an ongoing cluster-randomized trial were used. FCCH provider feeding practices were assessed over 2 days using a modified version of the EPAO (adapted for use in FCCH with expanded assessment of feeding practices). The EPAO captures nutrition and physical activity environments in child-care (e.g., provisions, practices, policies); however, only the 44 feeding practices items recorded during meals were used in this study. For each meal and snack occasion, a weighted factor, which accounted for frequency and time spent in each meal for each feeding practice was created and then averaged across the two observation days to obtain a weighted average score. Exploratory factor analysis investigated the underlying factor structure of the feeding practices.
All FCCH providers were female (n=119) and the majority (72%) were Hispanic. A final 3-factor solution, which captured 34% of the variance, was examined. Factor 1 appeared to capture autonomy support practices with 14 items (e.g. Enthusiastic role modeling, eating the same foods, talking about foods being served, reasoning with children) with loadings ranging from 0.455-0.875 (eigenvalue=7.3). Factor 2 appeared to capture coercive control and indulgent feeding practices and emerged with 5 items (e.g. Insisting child eat foods on plate, pressuring child to eat, rushing child to eat) with loadings ranging from 0.410-0.817 (eigenvalue=3.7). Factor 3 appeared to capture a mix of overt control and negative structure behaviors with 5 items (e.g. Enforcing table manners, encouraging children to sit at the table, removing the plate before child was done) with loadings ranging from 0.37-0.66 (eigenvalue=3.2).
Conclusions : The emerging autonomy supportive and coercive controlling factors are consistent with recent research conducted with FCCH providers in North Carolina. Future research should continue to refine this model and explore associations with child diet.
Funding Sources : National Heart Lung and Blood Institute, Grant # R01 HL123016