Consistency between parent-reported feeding practices and behavioral observation during toddler meals

Authors: FRIES, LISA - Nestle; VAN DER HORST, KLAZINE - Bern University Of Applied Sciences; MODING, KAMERON - University Of Colorado; HUGHES, SHERYL - Children'S Nutrition Research Center (CNRC); JOHNSON, SUSAN - University Of Colorado

Submitted to: Journal of Nutrition Education and Behavior
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 8/13/2019
Publication Date: 9/17/2019
Citation: Fries, L.R., Van Der Horst, K., Moding, K.J., Hughes, S.O., Johnson, S.L. 2019. Consistency between parent-reported feeding practices and behavioral observation during toddler meals. Journal of Nutrition Education and Behavior. 51:1159-1167. https://doi.org/10.1016/j.jneb.2019.08.005.
DOI: https://doi.org/10.1016/j.jneb.2019.08.005

Interpretive Summary: Researchers often use questionnaires to assess parent-feeding practices. Questionnaires allow researchers to assess a larger number of participants and provide a broader perspective of parent feeding behaviors. However, questionnaire data may introduce error due to incorrect interpretation of questions or response categories. Validating self-report measures with direct observation allows researchers to identify which feeding behaviors can be reported reliably in future studies of parent feeding and child eating. The main goal of this study was to assess whether parental responses on a feeding questionnaire reflected their feeding behaviors during an observation of a typical parent-child dinner meal. The secondary goal was to explore how well the response categories on the questionnaire reflected their actual feeding behaviors. In this study, researchers asked seventy-five parents to complete questionnaires on feeding and coded observed behaviors from video recordings during feeding. Notable differences were seen between self-reported and observed parental behaviors. Questionnaire responses suggesting rare or frequent feeding behaviors were consistently reported and demonstrated for six out of 14 feeding practices. These included allowing the child to eat as much as he/she wanted, helping the child eat, prompting the child to eat, television/screens on during mealtime, offering nonfood rewards, and hurrying the child. Vague response expressions such as sometimes or often remain challenging to interpret and interpretations by parents depended on the behavior being targeted. In this study, the use of the sometimes response varied across different types of behaviors. Overall, self-reports of sometimes exhibiting a behavior may not be as useful for predicting behavior and likely requires additional exploration with the respondent. The self-report questionnaire used in this study was reliable for some but not all of the feeding behaviors queried. The use of the sometimes response was used inconsistently across behaviors. Questionnaire developers may benefit from using less vague response categories.

Technical Abstract: To assess whether feeding questionnaire responses reflect observed mealtime behavior. Cross-sectional associations between self-reported and observed behaviors. Participants' homes. Parents (n = 75) of toddlers (mean age = 24.7 months) in the US. Feeding behavior questionnaires and coded videos of children's dinner meals. Parents' questionnaire responses of never (or rarely) considered consistent with video observation if behavior was not observed; responses of always (or most of the time) if behavior observed at least once. Proportion (percentage) of participants observed performing each behavior was calculated for the groups of parents reporting that they never, sometimes, or always used that feeding practice. These were compared across the 3 response groups. Parents reported 6 behaviors consistently (greater than or equal to 70 percent agreement): allowing child to eat as much as wanted, helping child eat, prompting child to eat, television/screens on during meal, nonfood rewards, and hurrying child. The remaining 8 behaviors fell below the threshold. For many behaviors, all response groups (never, sometimes, always) had similar rates of participants demonstrating the behavior. Only 5 behaviors had observed rates falling in the expected direction (frequency of always greater than sometimes greater than never). For some behaviors, the sometimes group had a higher (e.g., clean plate) or lower (praise) frequency than the other 2 groups. Self-reported questionnaire responses predicted whether some, but not all, behaviors were observed. Parents' use of sometimes remains difficult to interpret as parents may use "sometimes" inconsistently across behaviors and perhaps to mitigate socially undesirable responses. Self-reports of sometimes performing a behavior may have limited utility for prediction of behavior and likely requires additional exploration with the respondent.