Review and meta-analysis for the caregiver's feeding styles questionnaire administered to low-income families

Authors: LOPEZ, BRIANA - University Of North Florida; NICHOLSON, JODY - University Of North Florida; GARCIA, RAYNA - University Of North Florida; JOHNSON, HEATHER - University Of North Florida; POWER, THOMAS - Washington State University; HUGHES, SHERYL - Children'S Nutrition Research Center (CNRC)

Submitted to: Eating Behaviors
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 7/26/2022
Publication Date: 7/29/2022
Citation: Lopez, B.A., Nicholson, J.S., Garcia, R.N., Johnson, H.R., Power, T.G., Hughes, S.O. 2022. Review and meta-analysis for the caregiver's feeding styles questionnaire administered to low-income families. Eating Behaviors. 46:101659. https://doi.org/10.1016/j.eatbeh.2022.101659.
DOI: https://doi.org/10.1016/j.eatbeh.2022.101659

Interpretive Summary: The Caregiver's Feeding Styles Questionnaire (CFSQ) is a well-known assessment tool that is used to classify parents from low-income levels into one of four feeding style categories (authoritative, authoritarian, indulgent, and uninvolved). The initial goal of this study was to compare established median cutoff scores for the two CFSQ dimensions of responsiveness and demandingness (based on 5 different samples) to those from a larger set (based on 19 different samples). The second goal was to examine relations between child weight, the demandingness and responsiveness scores, and parent feeding style categories among the 19 different samples. Results indicated that the cutoff scores for responsiveness and demandingness based on five studies of low-income families did not differ significantly from those based on the 19 studies. Child weight scores were above average for all four parent feeding styles and highest for indulgent parents. This was consistent with the literature showing children from families with low incomes to be at a higher risk for obesity and children of indulgent parents being particularly at risk. This confirmed the relationship between parent feeding styles and child weight. It further confirmed that children from low-income backgrounds were heavier than their same-aged peers.

Technical Abstract: The Caregiver's Feeding Styles Questionnaire (CFSQ) is a well-established measure which uses scores along two dimensions of demandingness and responsiveness to classify low-income parents into one of four feeding style typologies (authoritative, authoritarian, indulgent, and uninvolved; Hughes, et al., 2005). The measure is widely used by researchers to explore the relationship between feeding style and child weight status but has not been evaluated comprehensively in a review or meta-analysis. The aims of this study were to 1) compare established median cutoffs for responsiveness and demandingness in parent feeding (k = 5; see Hughes et al., 2012) to current median splits along these two dimensions for a larger sample of articles (k = 19) and 2) evaluate the relation between children's BMI, demandingness and responsiveness, and parent feeding style categories. Results indicated that the cutoffs for responsiveness and demandingness initially established based on five studies of low-income families did not differ significantly with the addition of 19 studies. Child BMI z-scores (k = 8) were above average for all four parent feeding style categories and highest for indulgent parents, which was consistent with the literature outlining low-income children at higher risk for obesity and children of indulgent parents being particularly at risk. While heterogeneity of samples should be considered, study results suggested that the CFSQ distribution for responsiveness and demandingness was relatively generalizable across low-income samples, though heterogeneity was higher among caregiver's feeding style categories. Furthermore, the study confirmed that parent feeding styles were related to child weight status in a meaningful way, but all children in these low-income samples, on average, were heavier than their same-aged peers across all parent feeding styles.