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Projeto de investigação
Food Parenting: study of a new web-based parent intervention
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SmartFeeding4Kids, an online self-guided parenting intervention to promote positive feeding practices and healthy diet in young children: study protocol for a randomized controlled trial
Publication . Gomes, Ana Isabel; Pereira, Ana Isabel; Guerreiro, Tiago; Branco, Diogo; Roberto, Magda Sofia; Pires, Ana; Sousa, Joana; Baranowski, Tom; Barros, Luísa
Background: Caregivers’ influence on young children’s eating behaviors is widely recognized. Nutritional interventions that focus on the promotion of children’s healthy diet should actively involve parents, focusing on their feeding behaviors and practices. Methods: This work aims to describe the development and study protocol of the SmartFeeding4Kids (SF4K) program, an online self-guided 7-session intervention for parents of young (2–6 years old) children. The program is informed by social cognitive, self-regulation, and habit formation theoretical models and uses self-regulatory techniques as self-monitoring, goal setting, and feedback to promote behavior change. We propose to examine the intervention efficacy on children’s intake of fruit, vegetables, and added sugars, and parental feeding practices with a two-arm randomized controlled with four times repeated measures design (baseline, immediately, 3 and 6 months after intervention). Parental perceived barriers about food and feeding, food parenting self-efficacy, and motivation to change will be analyzed as secondary outcomes. The study of the predictors of parents’ dropout rates and the trajectories of parents’ and children’s outcomes are also objectives of this work. Discussion: The SmartFeeding4Kids program relies on technological resources to deliver parents’ self-regulation techniques that proved effective in promoting health behaviors. The study design can enhance the knowledge about the most effective methodologies to change parental feeding practices and children’s food intake. As a selfguided online program, SmartFeeding4Kids might overcome parents’ attrition more effectively, besides being easy to disseminate and cost-effective.
Do Childcare Teachers Evaluate Children’s Weight Status More Accurately Than Parents? A Brief Report
Publication . Gomes, Ana Isabel; Lemos, Rosa; Miocevic, Milica; Pereira, Ana Isabel; Barros, Luísa
Purpose: Parents’ underestimation of young children’s weight can reduce their engagement and
readiness to implement changes in children’s diet and physical activity. Childcare teachers can
support parents’ identification of children at risk for being overweight only if they can accurately
do this themselves. Design: Quantitative, cross-sectional study. Setting: Fifteen kindergartens near
Lisbon, Portugal. Subjects: 319 parents, 32 teachers (47.5% and 100% response rate, respectively),
and 319 children. Measures: Caregivers classified the children's weight, considering their height
and age as underweight, healthy weight, or overweight; children’s body mass index (BMI) status
for age and sex was assessed. Analysis: Differences in caregivers’ accuracy of children’s weight
perception were assessed. Multilevel multivariate logistic regression models were used to analyze
the predictors of the accuracy of teachers’ and parents’ weight perception as a binary outcome.
Results: The proportion of children with overweight correctly assessed differed significantly (P =
.004) between teachers (31.1%) and parents (17.5%). The child’s BMI percentile was the only
significant positive predictor for both caregivers’ weight perception accuracy (P < .001 and P =
.004, for parents and teachers respectively), holding the child’s age and sex constant. Conclusion:
Although childcare teachers were better raters than parents when evaluating children’s weight
status, the percentage of children with overweight that childcare teachers misclassified was still
relatively high.
Intake of added sugar, fruits, vegetables, and legumes of Portuguese preschool children: baseline data from SmartFeeding4Kids randomized controlled trial participants
Publication . Charneca, Sofia; Gomes, Ana Isabel; Branco, Diogo; Guerreiro, Tiago; Barros, Luísa; Sousa, Joana
Introduction: The SmartFeeding4Kids (SF4K) program is an online self-guided intervention for parents with the propose of changing parental feeding practices and children's dietary intake, focusing on the intake of added sugars, fruit, vegetables, and legumes. This paper aims to describe children's dietary pattern at baseline through a 24-h food recall, the SmartKidsDiet24.
Methods: Overall, 89 participants recorded at least one meal of the 3-day food recall. Mean age was 36.22 ± 6.05 years and 53.09 ± 15.42 months old for parents and children, respectively. Of these, 22 participants were considered to have 2 days of near complete 24-h food recalls. Children's dietary intake are reported for these 22 participants based on parents reports and, thus, represent estimations only, as it remains unknown whether children consumed other non-reported foods.
Results: Fruit was the group with the highest daily intake among children (mean 1.77 ± 1.10 portions/day), followed by added sugar foods (mean 1.48 ± 0.89 portions/day), vegetables [median 1.27 (1.64) portions/day] and legumes [median 0.12 (0.39) portions/day]. Fruit intake was positively correlated with vegetable intake (p = 0.008). Regarding Dietary Reference Values accomplishment, 13.6% of children exceeded the daily safe and adequate intake of sodium, 77.3% did not meet potassium and fiber recommendations, and 31.8% did not meet vitamin C recommendations.
Discussion: All children did not meet calcium, vitamin B12 and vitamin D intake recommendations. Our findings further justify the need for dietary interventions in this field, to improve young children's diets.
Clinical trial registration: ClinicalTrials.gov, identifier NCT04591496.
Development and Psychometric Characteristics of an Instrument to Assess Parental Feeding Practices to Promote Young Children's Eating Self-Regulation: Results with a Portuguese Sample
Publication . Gomes, Ana Isabel; Roberto, M. S.; Pereira, Ana Isabel; Alves, Cátia; João, Patrícia; Dias, Ana Rita; Veríssimo, João; Barros, Luísa
A parental child-centered feeding approach is likely to keep children’s biological mechanisms activated while eating, protecting them in an obesogenic context. However, few feeding
practice measures assess parents’ behaviors to guide and prompt children to identify and respond
appropriately to their signs of hunger and satiety. We aimed to develop and study the reliability,
validity, and measurement invariance of a new scale to assess parental feeding practices to promote
children’s self-regulation of food intake. To pursue this aim, we conducted two descriptive, crosssectional, online studies in Portugal in an online format; a total of 536 parents of 2- to 6-year-old
children completed the evaluation protocol. Factorial analysis findings support the theoretical organization proposed for the scale. The confirmatory factorial analysis supported a first-order factor
structure with two subscales, Prompting for eating self-regulation and Teaching about eating consequences,
with eight items in total. Both scales presented good internal consistency and adequate temporal
stability, with a significant, positive, and moderate relationship. The results showed metric invariance
for the child’s sex. Both types of practices were positively correlated with the child’s enjoyment
of food. Prompting for eating self-regulation showed negative associations with parents’ emotional
lack of control, children’s satiety responsiveness, slowness in eating, and fussiness. Preliminary
studies confirmed both the validity and reliability of the instrument and the adequacy of adopting a
self-regulatory approach when assessing child-centered feeding practices. Combining this instrument
with others that assess coercive practices can be beneficial to capture ineffective parents’ behaviors on
children’s eating self-regulation.
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Entidade financiadora
Fundação para a Ciência e a Tecnologia
Programa de financiamento
3599-PPCDT
Número da atribuição
PTDC/PSI-GER/30432/2017