Teresia M. O’Connor

Parents' perceptions of preschool children's ability to regulate eating. Feeding style differences.

Parent feeding styles have been associated with childrens eating behaviors and weight status across multiple studies. However, little is known about the mechanism through which parent feeding styles influence child weight status. Childrens ability to self-regulate their eating may be the mechanism that links these two constructs. This study examined the relationship between parent feeding styles, child self-regulatory ability, and weight status to determine whether self-regulatory ability mediated the relationship between parent feeding styles and child weight status in a group of 296 parents and their preschool aged children. Indulgent feeding style was related to children having lessened satiety responsiveness and higher enjoyment of food (two components of self-regulation around eating) compared to other parent feeding styles. Children of parents with an indulgent feeding style were also higher in weight status compared to other feeding styles. Mediation analyses revealed that satiety responsiveness and enjoyment of food mediated the relationship between parent feeding style and child BMI z-score such that children of parents with indulgent feeding styles had lessened ability to self-regulate around eating and higher BMI z-scores. Findings from this study suggest that childrens ability to self-regulate eating might be an important mechanism by which parent feeding style and child weight are related to each other.

Development of the Comprehensive General Parenting Questionnaire for caregivers of 5-13 year olds

BackgroundDespite the large number of parenting questionnaires, considerable disagreement exists about how to best assess parenting. Most of the instruments only assess limited aspects of parenting. To overcome this shortcoming, the “Comprehensive General Parenting Questionnaire” (CGPQ) was systematically developed. Such a measure is frequently requested in the area of childhood overweight.MethodsFirst, an item bank of existing parenting measures was created assessing five key parenting constructs that have been identified across multiple theoretical approaches to parenting (Nurturance, Overprotection, Coercive control, Behavioral control, and Structure). Caregivers of 5- to 13-year-olds were asked to complete the online survey in the Netherlands (N = 821), Belgium (N = 435) and the United States (N = 241). In addition, a questionnaire regarding personality characteristics (“Big Five”) of the caregiver was administered and parents were asked to report about their child’s height and weight. Factor analyses and Item-Response Modeling (IRM) techniques were used to assess the underlying parenting constructs and for item reduction. Correlation analyses were performed to assess the relations between general parenting and personality of the caregivers, adjusting for socio-economic status (SES) indicators, to establish criterion validity. Multivariate linear regressions were performed to examine the associations of SES indicators and parenting with child BMI z-scores. Additionally, we assessed whether scores on the parenting constructs and child BMI z-scores differed depending on SES indicators.ResultsThe reduced questionnaire (62 items) revealed acceptable fit of our parenting model and acceptable IRM item fit statistics. Caregiver personality was related as hypothesized with the GCPQ parenting constructs. While correcting for SES, overprotection was positively related to child BMI. The negative relationship between structure and BMI was borderline significant. Parents with a high level of education were less likely to use overly forms of controlling parenting (i.e., coercive control and overprotection) and more likely to have children with lower BMI. Based on several author review meetings and cognitive interviews the questionnaire was further modified to an 85-item questionnaire.ConclusionsThe GCPQ may facilitate research exploring how parenting influences children’s weight-related behaviors. The contextual influence of general parenting is likely to be more profound than its direct relationship with weight status.

Using the RE-AIM framework to evaluate physical activity public health programs in México

BackgroundPhysical activity (PA) public health programming has been widely used in Mexico; however, few studies have documented individual and organizational factors that might be used to evaluate their public health impact. The RE-AIM framework is an evaluation tool that examines individual and organizational factors of public health programs. The purpose of this study was to use the RE-AIM framework to determine the degree to which PA programs in Mexico reported individual and organizational factors and to investigate whether reporting differed by the program’s funding source.MethodsPublic health programs promoting PA were systematically identified during 2008–2013 and had to have an active program website. Initial searches produced 23 possible programs with 12 meeting inclusion criteria. A coding sheet was developed to capture behavioral, outcome and RE-AIM indicators from program websites.ResultsIn addition to targeting PA, five (42%) programs also targeted dietary habits and the most commonly reported outcome was change in body composition (58%). Programs reported an average of 11.1 (±3.9) RE-AIM indicator items (out of 27 total). On average, 45% reported reach indicators, 34% reported efficacy/effectiveness indicators, 60% reported adoption indicators, 40% reported implementation indicators, and 35% reported maintenance indicators. The proportion of RE-AIM indicators reported did not differ significantly for programs that were government supported (M = 10, SD = 3.1) and programs that were partially or wholly privately or corporately supported (M = 12.0, SD = 4.4).ConclusionWhile reach and adoption of these programs were most commonly reported, there is a need for stronger evaluation of behavioral and health outcomes before the public health impact of these programs can be established.

Predicting use of effective vegetable parenting practices with the Model of Goal Directed Behavior.

OBJECTIVE To model effective vegetable parenting practices using the Model of Goal Directed Vegetable Parenting Practices construct scales. DESIGN An Internet survey was conducted with parents of pre-school children to assess their agreement with effective vegetable parenting practices and Model of Goal Directed Vegetable Parenting Practices items. Block regression modelling was conducted using the composite score of effective vegetable parenting practices scales as the outcome variable and the Model of Goal Directed Vegetable Parenting Practices constructs as predictors in separate and sequential blocks: demographics, intention, desire (intrinsic motivation), perceived barriers, autonomy, relatedness, self-efficacy, habit, anticipated emotions, perceived behavioural control, attitudes and lastly norms. Backward deletion was employed at the end for any variable not significant at P<0·05. SETTING Houston, TX, USA. SUBJECTS Three hundred and seven parents (mostly mothers) of pre-school children. RESULTS Significant predictors in the final model in order of relationship strength included habit of active child involvement in vegetable selection, habit of positive vegetable communications, respondent not liking vegetables, habit of keeping a positive vegetable environment and perceived behavioural control of having a positive influence on childs vegetable consumption. The final models adjusted R 2 was 0·486. CONCLUSIONS This was the first study to test scales from a behavioural model to predict effective vegetable parenting practices. Further research needs to assess these Model of Goal Directed Vegetable Parenting Practices scales for their (i) predictiveness of child consumption of vegetables in longitudinal samples and (ii) utility in guiding design of vegetable parenting practices interventions.

Psychometric validity of the parent's outcome expectations for children's television viewing (POETV) scale.

BackgroundTV and other screen use are common among elementary school aged children with both potential benefits and harms. It is not clear why some parents restrict their children’s screen use and others do not. Parent’s outcome expectations for allowing their child to watch TV and other screen media, i.e. the perceived ‘costs’ and ‘benefits,’ may be influential. Our objective was to develop a measure of Parent’s Outcome Expectations for Children’s TV Viewing (POETV) and test the psychometrics of the resulting instrument among parents with children 6-12 years old.MethodsAn ethnically diverse sample (n = 311) of parents from Harris County, Texas completed measures for POETV, demographics, and parent and child TV viewing and other screen media use via an internet survey. The sample was randomly split and an exploratory factor analysis (EFA) was conducted among the first half of the sample separately for Positive and Negative POETV. A confirmatory factor analysis (CFA) assessed the fit of the resulting factors with the data in the second half of the sample. Internal reliabilities and Spearman partial correlations (controlling for confounders) of children’s TV and other screen use with the resulting POETV factors were calculated for the full sample.ResultsEFA identified two factors for Positive POETV (Parent Centered; Child Centered) and two factors for Negative POETV (TV & Content Exposure; Prevent Other Activities). Follow up CFA confirmed moderate to good psychometric properties for both factor structures with the addition of four correlated errors in the Positive POETV model. Internal reliabilities were appropriate (Cronbach’s alpha >0.7). Parent Centered Positive POETV and Child Centered Positive POETV were correlated with children’s TV viewing on weekdays (0.14, p < 0.05) and weekends (0.17, p < 0.01) respectively. Both also correlated with other screen media use on weekends (0.20 and 0.21, p < 0.001). Prevent Other Activities Negative POETV was negatively correlated with children’s TV viewing on weekdays (-0.16, p < 0.01), weekends (-0.14, p < 0.05) and other screen media on weekends (-0.14, p < 0.05).ConclusionsThe Positive and Negative POETV scales offer a new tool to better define predictors of screen media parenting practices and child screen media use behaviors.

Associations between objective and self-report measures of traffic and crime safety in Latino parents of preschool children

Differences in subjective and objective safety may be explained by moderators that shape parental perceptions of the environment. This study examined associations between subjective and objective measures of traffic and crime safety in preschool parents (N = 240) and potential moderators. Community cohesion, social control, and physical activity parenting practices were measured. Objective measures of crime and traffic were measured at the block-group level. Linear models revealed perceived traffic was negatively associated with the traffic hazards (b = −0.03; 95 % CI: −0.05, −0.01; p = .041). Acculturation moderated the relationship between perceptions of disorder and crime (b = 0.001; 95 % CI: 0.000, 0.003; p = .044). Poor community cohesion moderated the relationship between perceptions of disorder and crime (b = 0.0015; 95 % CI: 0.0002, 0.0028; p = .028). Perceived traffic safety was associated with the traffic hazard index in parents of boys (b = −0.04; 95 % CI: −0.07, −0.01; p = .027). Acculturation and community cohesion can be used to align misperceptions of safety to actual safety to promote outdoor play.

A child-centered scale of informal social control for Latino parents of preschool-age children: development and validation

Perceived neighborhood informal social control may determine whether parents allow their young children to be physically active in the neighborhood. We developed and validated a scale of neighborhood child-centered informal social control appropriate for Latino parents of preschool-age children. The scale was administered to 240 Latino parents, mainly mothers, recruited from neighborhoods cross-stratified by objectively measured crime and traffic safety. Participants completed measures of community cohesion, perceived signs of physical and social disorder, traffic safety and hazards, and perceived stranger danger. A subsample was reassessed 1 week later to determine test-retest reliability. Confirmatory factor analyses (CFAs) were conducted to examine the fit of the data to a priori measurement models. Construct validity was assessed by estimating the associations of the scale with the other measures. The scale showed good test-retest reliability, and factorial and construct validity. The scale needs to be cross-validated on other samples and Latino fathers.

Food parenting practices for 5 to 12 year old children: a concept map analysis of parenting and nutrition experts input

BackgroundParents are an important influence on children’s dietary intake and eating behaviors. However, the lack of a conceptual framework and inconsistent assessment of food parenting practices limits our understanding of which food parenting practices are most influential on children. The aim of this study was to develop a food parenting practice conceptual framework using systematic approaches of literature reviews and expert input.MethodA previously completed systematic review of food parenting practice instruments and a qualitative study of parents informed the development of a food parenting practice item bank consisting of 3632 food parenting practice items. The original item bank was further reduced to 110 key food parenting concepts using binning and winnowing techniques. A panel of 32 experts in parenting and nutrition were invited to sort the food parenting practice concepts into categories that reflected their perceptions of a food parenting practice conceptual framework. Multi-dimensional scaling produced a point map of the sorted concepts and hierarchical cluster analysis identified potential solutions. Subjective modifications were used to identify two potential solutions, with additional feedback from the expert panel requested.ResultsThe experts came from 8 countries and 25 participated in the sorting and 23 provided additional feedback. A parsimonious and a comprehensive concept map were developed based on the clustering of the food parenting practice constructs. The parsimonious concept map contained 7 constructs, while the comprehensive concept map contained 17 constructs and was informed by a previously published content map for food parenting practices. Most of the experts (52%) preferred the comprehensive concept map, while 35% preferred to present both solutions.ConclusionThe comprehensive food parenting practice conceptual map will provide the basis for developing a calibrated Item Response Modeling (IRM) item bank that can be used with computerized adaptive testing. Such an item bank will allow for more consistency in measuring food parenting practices across studies to better assess the impact of food parenting practices on child outcomes and the effect of interventions that target parents as agents of change.

Engaging Latino Fathers in Children’s Eating and Other Obesity-Related Behaviors: a Review

Purpose of ReviewThere is a growing evidence of the important role that fathers play in influencing their children’s eating and other weight-related behaviors. Latino children are at high risk for obesity and associated medical conditions. Engaging Latino fathers is a potentially important and unique way to help promote healthy lifestyles for Latino children, but doing so requires a culturally sensitive understanding both of fathers’ current role and the family perceptions of this role.Recent FindingsHere, we review recent data and argue that there are subtle but important differences between the qualitative and quantitative research conducted regarding the role Latino fathers may play in promoting healthy eating and physical activity for their children. We suggest how to synthesize these findings and also present qualitative results for ways to best engage Latino fathers in research studies with a focus on physical activity.SummaryResults from the review support that Latino fathers are important potential targets for child obesity prevention, but our findings stress the importance of considering cultural values when trying to recruit, engage and retain Latino fathers for such research.

Parents’ Qualitative Perspectives on Child Asking for Fruit and Vegetables

Children can influence the foods available at home, but some ways of approaching a parent may be better than others; and the best way may vary by type of parent. This study explored how parents with different parenting styles would best receive their 10 to 14 years old child asking for fruits and vegetables (FV). An online parenting style questionnaire was completed and follow-up qualitative telephone interviews assessed home food rules, child influence on home food availability, parents’ preferences for being asked for food, and common barriers and reactions to their child’s FV requests. Parents (n = 73) with a 10 to 14 years old child were grouped into authoritative, authoritarian, permissive, or uninvolved parenting style categories based on responses to questionnaires, and interviewed. Almost no differences in responses were detected by parenting style or ethnicity. Parents reported their children had a voice in what foods were purchased and available at home and were receptive to their child’s asking for FV. The most important child asking characteristic was politeness, especially among authoritarian parents. Other important factors were asking in person, helping in the grocery store, writing requests on the grocery shopping list, and showing information they saw in the media. The barrier raising the most concern was FV cost, but FV quality and safety outside the home environment were also considerations.