Low‐income mothers' feeding goals predict observed home mealtime and child feeding practices_2016.pdf

AbstractBackground Mothers’ goals are important for health behavior change, and engagement in childobesity interventions. It is unknown if maternal feeding goals are associated with observed homemealtime or feeding practices. The objective of this study was to examine the association of fourcommon feeding goals (restrict junk food, promote fruit or vegetable intake, promote autonomy ineating and prevent obesity) with mothers’ observed home mealtime and feeding practices.Methods Low-income mothers (N = 265) of children (mean child age 70.8months) participated in asemi-structured interview about child feeding. A coding scheme was developed and reliably appliedto identify mothers’ feeding goals from transcripts. Mothers’ observed home mealtime and feedingpractices were reliably coded from home mealtimes and a laboratory eating protocol. Motherscompleted a questionnaire and reported demographics. Participant weights and heights wereobtained. Regression models were used to test the association of each feeding goal with observedmaternal practices, controlling for covariates.Results The goal of restricting junk food was associated with the child always eating at a table (OR2.87, 95% CI (1.39–5.96) p = 0.005), but not with the mother restricting junk food. The goal ofpromoting fruit or vegetable intake was associated with observationally promoting vegetables (OR1.41, 95% CI (1.09–1.84), p = 0.01). The goals of promoting autonomy and preventing obesity werenot associated with any observed maternal home mealtime or feeding practices.Conclusions While mothers’ goals to restrict junk food and promote fruit or vegetable intake wereassociated with observed home mealtime and feeding practices, promoting autonomy andpreventing obesity were not. Increased understanding of why low-income mothers may nottranslate certain feeding goals into practices may inform childhood obesity interventions.

**研究背景**：母亲的喂养目标对于健康行为改变以及参与儿童肥胖干预至关重要。目前尚不明确母亲的喂养目标是否与实际观察到的家庭进餐行为及喂养行为存在关联。本研究旨在探讨四种常见喂养目标——限制垃圾食品摄入、促进蔬果摄入、培养进食自主性以及预防肥胖——与母亲实际观察到的家庭进餐行为及喂养行为之间的关联。

**研究方法**：本研究纳入265名育有儿童的低收入母亲（样本量N=265，儿童平均年龄为70.8个月），所有母亲均参与了关于儿童喂养的半结构化访谈。研究开发了一套编码体系，并通过可靠编码从访谈转录文本中识别母亲的喂养目标。通过对家庭进餐场景与实验室进食范式的录像进行可靠编码，获取母亲实际的家庭进餐行为与喂养行为数据。所有母亲完成了人口统计学特征相关的问卷调查，研究人员还收集了受试者的身高与体重数据。本研究采用回归模型，在控制协变量的前提下，检验每种喂养目标与母亲实际喂养行为之间的关联。

**研究结果**：限制垃圾食品摄入的喂养目标与儿童始终在餐桌进餐存在显著关联（比值比OR=2.87，95%置信区间CI：1.39~5.96，p=0.005），但与母亲自身限制垃圾食品摄入的行为无显著关联。促进蔬果摄入的喂养目标与观察到的母亲鼓励儿童食用蔬菜的行为相关（OR=1.41，95%CI：1.09~1.84，p=0.01）。而培养进食自主性与预防肥胖的喂养目标，均未与观察到的母亲家庭进餐及喂养行为存在显著关联。

**研究结论**：尽管母亲限制垃圾食品摄入、促进蔬果摄入的喂养目标与实际观察到的家庭进餐及喂养行为存在关联，但培养进食自主性与预防肥胖的目标则未表现出此类关联。进一步明确低收入母亲无法将部分喂养目标转化为实际喂养行为的原因，可为儿童肥胖干预措施提供参考依据。