Predictors of outcomes following a brief Portuguese parental nutrition intervention

Ana Isabel Gomes, Luísa Barros, Ana Isabel Pereira

Abstract


Early childhood is largely recognized as a critical period for shaping the child’s eating patterns.
Although interventions studies that focus on first years of life are increasing, with positive impact,
the moderators of treatment gains and the relative importance of each determinant of the change
process have been rarely explored. This study aimed to identify potential predictors of outcomes
concerning children’s healthy and unhealthy eating behaviors after a parental school-based
intervention. An intervention longitudinal study with repeated measures at baseline and after
participation in the Red Apple program was performed. Parents and children were recruited in public
and state-funded kindergartens near Lisbon, Portugal. A total of 44 parents of 3- to 6-year-old children
agreed to participate in the study and 39 met the inclusion criteria. The Red Apple program included
four parental group sessions about young children’s growth, nutritional guidelines, and positive
parental feeding strategies, and adult-child activities and newsletters delivered to caregivers. Data
regarding children’s dietary intake, food preferences, neophobia/neophilia, parental concerns about
the child’s weight, and self-efficacy in promoting healthy dietary patterns in children were collected
before (T1) and after (T2) the intervention. Higher parental concerns about weight and self-efficacy
at T1 significantly predicted children’s healthy dietary intake at T2. The only significant contribution
for children’s unhealthy dietary intake at T2 was the previous consumption of those foods at T1.
Interventions that focus on parental cognitive variables might effectively contribute to positive changes in children’s dietary intake. Findings also suggest that specific targets of children’s diet may pose unlike challenges that respond differently to the mechanisms of influence of the intervention.

Keywords


Children's dietary intake, Predictores, Parental concernes about weight, Parental self-efficacy.

Full Text:

PDF

References


Ajzen, I. (1985). From intention to actions: A theory of planned behavior. In J. Kuhl & J. Beckman (Eds.), Action-control: From cognition to behavior (pp. 11-39). Heidelberg, Germany: Springer.

Bante, H., Elliott, M., Harrod, A., & Haire-Joshu, D. (2008). The use of inappropriate feeding practices by rural parents and their effect on preschoolers’ fruit and vegetable preferences and intake. Journal of Nutrition Education and Behavior, 40, 28-33. Retrieved from https://doi.org/10.1016/j.jneb.2007.02.007

Birch, L. L. (1998). Development of food acceptance patterns in the first years of life. Proceedings of the Nutrition Society, 57, 617-624.

Brown, T., Kelly, S., & Summerbell, C. (2007). Prevention of obesity: A review of interventions. Obesity Reviews, 8, 127-130. Retrieved from https://doi.org/10.1111/j.1467-789X.2007.00331.x

Campbell, K., & Hesketh, K. (2007). Strategies which aim to positively impact on weight, physical activity, diet and sedentary behaviours in children from zero to five years: A systematic review of the literature. Obesity Reviews, 8, 327-338. Retrieved from https://doi.org/10.1111/j.1467-789X.2006.00305.x

Campbell, K., Hesketh, K., Silverii, A., & Abbott, G. (2010). Maternal self-efficacy regarding children’s eating and sedentary behaviours in the early years: Associations with children’s food intake and sedentary behaviours. International Journal of Pediatric Obesity, 5, 501-508. Retrieved from https://doi.org/10.3109/17477161003777425

Cerin, E., Barnett, A., & Baranowski, T. (2009). Testing theories of dietary behavior change in youth using the mediating variable model with intervention programs. Journal of Nutrition Education and Behavior, 41, 309-318. Retrieved from https://doi.org/10.1016/j.jneb.2009.03.129

Cooke, L., Carnell, S.,& Wardle, J. (2006). Food neophobia and meal time food consumption in 4-5 year old children. International Journal of Behavioral Nutrition and Physical Activity, 3, 14. Retrieved from https://doi.org/10.1186/1479-5868-3-14

Cooke, L., Wardle, J., & Gibson, E. L. (2003). Relationship between parental report of food neophobia and everyday food consumption in 2-6-year-old children. Appetite, 41, 205-206. Retrieved from https://doi.org/10.1016/S0195-6663(03)00048-5

Fisher, J. O., Mitchell, D. C., Smiciklas-Wright, H., & Birch, L. L. (2002). Parental influences on young girls’ fruit and vegetable, micronutrient, and fat intakes. Journal of the American Dietetic Association, 102, 58-64. Retrieved from https://doi.org/10.1016/S0002-8223(02)90017-9

Fletcher, A., Wolfenden, L., Wyse, R., Bowman, J., McElduff, P., & Duncan, S. (2013). A randomised controlled trial and mediation analysis of the ‘Healthy Habits’, telephone-based dietary intervention for preschool children. International Journal of Behavioral Nutrition and Physical Activity, 10, 43-54. Retrieved from https://doi.org/10.1186/1479-5868-10-43

Gerards, S., Sleddens, E. F., Dagnelie, P. C., Vries, N. K., & Kremers, S. P. (2011). Interventions addressing general parenting to prevent or treat childhood obesity. International Journal of Pediatric Obesity, 6, e28-e45. Retrieved from https://doi.org/10.3109/17477166.2011.575147

Golan, M., & Crow, S. (2004). Parents are key players in the prevention and treatment of weight-related problems. Nutrition Reviews, 62, 39-50. Retrieved from https://doi.org/10.1301/nr.2004.jan.39-50

Golley, R., Hendrie, G. A., Slater, A., & Corsini, N. (2011). Interventions that involve parents to improve children’s weight‐related nutrition intake and activity patterns-what nutrition and activity targets and behaviour change techniques are associated with intervention effectiveness?. Obesity Reviews, 12, 114-130. Retrieved from https://doi.org/10.1111/j.1467-789X.2010.00745.x

Gomes, A. I., Barros, L., & Pereira, A. I. (2017). Predictors of parental concerns about child weight in parents of healthy-weight and overweight 2-6 year olds. Appetite, 108, 491-497. Retrieved from https://doi.org/10.1016/j.appet.2016.11.008

Gomes, A. I., Barros, L., Pereira, A. I., & Roberto, M. S. (2018). Effectiveness of a parental school-based intervention to improve young children’s eating patterns: A pilot study. Public Health Nutrition, 21, 2485-2496. Retrieved from https://doi.org/10.1017/S1368980018000952

Gomes, A. I., Barros, L., Pereira, A. I., Roberto, M. S., & Mendonça, M. (2018). Assessing children’s willingness to try new foods: Validation of a Portuguese version of the Child’s Food Neophobia Scale for parents of young children. Food Quality and Preference, 63, 151-158. Retrieved from https://doi.org/10.1016/j.foodqual.2017.09.002

Hildebrand, D. A., & Betts, N. M. (2009). Assessment of stage of change, decisional balance, self-efficacy, and use of processes of change of low-income parents for increasing servings of fruits and vegetables to preschool-aged children. Journal of Nutrition Education and Behavior, 41, 110-119. Retrieved from https://doi.org/10.1016/j.jneb.2008.09.007

Hingle, M., O’Connor, T., Dave, J., & Baranowski, T. (2010). Parental involvement in interventions to improve child dietary intake: A systematic review. Preventive Medicine, 51, 103-111. Retrieved from https://doi.org/10.1016/j.ypmed.2010.04.014

Ice, C. L., Neal, W. A., & Cottrell, L. (2014). Parental efficacy and role responsibility for assisting in child’s healthful behaviors. Education and Urban Society, 46, 699-715. Retrieved from https://doi.org/10.1177/0013124512468004

Lopes, C., Oliveira, A., Afonso, L., Moreira, T., Durão, C., Severo, M., . . . Barros, H. (2014). Consumo alimentar e nutricional de crianças em idade pré-escolar: Resultados da coorte geração 21 [Food and nutritional intake of preschool children: Results from the 21 generation cohort]. Porto: Instituto de Saúde Pública da Universidade do Porto.

Matheson, D., Spranger, K., & Saxe, A. (2002). Preschool children’s perceptions of food and their food experiences. Journal of Nutrition and Education Behavior, 34, 85-92.

McClain, A. D., Chappuis, C., Nguyen-Rodriguez, S. T., Yaroch, A. L., & Spruijt-Metz, D. (2009). Psychosocial correlates of eating behavior in children and adolescents: A review. International Journal of Behavioral Nutrition and Physical Activity, 6, 54-74. Retrieved from https://doi.org/10.1186/1479-5868-6-54

McGowan, L., Croker, H., Wardle, J., & Cooke, L. J. (2012). Environmental and individual determinants of core and non-core food and drink intake in preschool aged children in the United Kingdom. European Journal of Clinical Nutrition, 66, 322-328. Retrieved from https://doi.org/10.1038/ejcn.2011.224

Michaelsen, K. F., Weaver, L., Branca, F., & Robertson, A. (2000). Feeding and nutrition of infants and young children: Guidelines for the WHO european region, with emphasis on the former Soviet countries. Copenhagen, Denmark: WHO Regional Publications.

Moore, L., Harris, C., & Bradlyn, A. (2012). Exploring the relationship between parental concern and the management of childhood obesity. Maternal & Child Health Journal, 16, 902-908. Retrieved from https://doi.org/10.1007/s10995-011-0813-x

Nixon, C., Moore, H., Douthwaite, W., Gibson, E., Vogele, C., Kreichauf, S., . . . Summerbell, C. (2012). Identifying effective behavioural models and behaviour change strategies underpinning preschool and school-based obesity prevention interventions aimed at 4-6-year-olds: A systematic review. Obesity Reviews, 13, 106-117. Retrieved from https://doi.org/10.1111/j.1467-789X.2011.00962.x

Parekh, N., Henriksson, P., Delisle Nyström, C., Silfvernagel, K., Ruiz, J. R., Ortega, F. B., . . . Löf, M. (2017). Associations of parental self-efficacy with diet, physical activity, body composition, and cardiorespiratory fitness in Swedish preschoolers: Results from the MINISTOP trial. Health Education & Behavior, 1, 1-9. Retrieved from https://doi.org/10.1177/1090198117714019

Patrick, H., & Nicklas, T. (2005). A review of family and social determinants of children’s eating patterns and diet quality. Journal of the American College of Nutrition, 24, 83-92. Retrieved from https://doi.org/10.1080/07315724.2005.10719448

Pliner, P. (1994). Development of measures of food neophobia in children. Appetite, 23, 147-163. Retrieved from https://doi.org/10.1006/appe.1994.1043

Pocock, M., Trivedi, D., Wills, W., Bunn, F., & Magnusson, J. (2010). Parental perceptions regarding healthy behaviours for preventing overweight and obesity in young children: A systematic review of qualitative studies. Obesity Reviews, 11, 338-353. Retrieved from https://doi.org/10.1111/j.1467-789X.2009.00648.x

Prochaska, J. O., & Velicer, W. F. (1997). The transtheoretical model of health behavior change. American Journal of Health Promotion, 12, 38-48.

Rhee, K., DeLago, C., Arscott-Mills, T., Mehta, S., & Davis, R. K. (2005). Factors associated with parental readiness to make changes for overweight children. Pediatrics, 116, e94-e101. Retrieved from https://doi.org/10.1542/peds.2004-2479

Rogers, R. W. (1983). Cognitive and physiological processes in fear appeals and attitude change: A revised theory of protection motivation. In J. R. Cacioppo & R. E. Petty (Eds.), Social psychology: A source book (pp. 153-176). New York: Guilford Press.

Swyden, K., Sisson, S. B., Lora, K., Weedn, A., Sheffield Morris, A., DeGrace, B., & Copeland, K. A. (2015). Relationship between parental perception and concern for child weight and influence on obesogenic parenting practices. Advances in Pediatric Research, 2(2), 12-21. Retrieved from https://doi.org/10.12715/apr.2015.2.12

WHO. (2009). Infant and young child feeding: Model chapter for textbooks for medical students and allied health professionals. Geneva, Switzerland: World Health Organization Press.

Wyse, R., Wolfenden, L., & Bisquera, A. (2015). Characteristics of the home food environment that mediate immediate and sustained increases in child fruit and vegetable consumption: Mediation analysis from the healthy habits cluster randomised controlled trial. International Journal of Behavioral Nutrition and Physical Activity, 12, 118-129. Retrieved from https://doi.org/10.1186/s12966-015-0281-6




DOI: https://doi.org/10.14417/ap.1735

Refbacks

  • There are currently no refbacks.