Methodological considerations for observational coding of eating and feeding behaviors in children and their families

Abstract Background Behavioral coding of videotaped eating and feeding interactions can provide researchers with rich observational data and unique insights into eating behaviors, food intake, food selection as well as interpersonal and mealtime dynamics of children and their families. Unlike self-report measures of eating and feeding practices, the coding of videotaped eating and feeding behaviors can allow for the quantitative and qualitative examinations of behaviors and practices that participants may not self-report. While this methodology is increasingly more common, behavioral coding protocols and methodology are not widely shared in the literature. This has important implications for validity and reliability of coding schemes across settings. Additional guidance on how to design, implement, code and analyze videotaped eating and feeding behaviors could contribute to advancing the science of behavioral nutrition. The objectives of this narrative review are to review methodology for the design, operationalization, and coding of videotaped behavioral eating and feeding data in children and their families, and to highlight best practices. Methods When capturing eating and feeding behaviors through analysis of videotapes, it is important for the study and coding to be hypothesis driven. Study design considerations include how to best capture the target behaviors through selection of a controlled experimental laboratory environment versus home mealtime, duration of video recording, number of observations to achieve reliability across eating episodes, as well as technical issues in video recording and sound quality. Study design must also take into account plans for coding the target behaviors, which may include behavior frequency, duration, categorization or qualitative descriptors. Coding scheme creation and refinement occur through an iterative process. Reliability between coders can be challenging to achieve but is paramount to the scientific rigor of the methodology. Analysis approach is dependent on the how data were coded and collapsed. Conclusions Behavioral coding of videotaped eating and feeding behaviors can capture rich data “in-vivo” that is otherwise unobtainable from self-report measures. While data collection and coding are time-intensive the data yielded can be extremely valuable. Additional sharing of methodology and coding schemes around eating and feeding behaviors could advance the science and field.https://deepblue.lib.umich.edu/bitstream/2027.42/140067/1/12966_2017_Article_619.pd

Obesity‐Related Hormones in Low‐Income Preschool‐Age Children: Implications for School Readiness

Mechanisms underlying socioeconomic disparities in school readiness and health outcomes, particularly obesity, among preschool‐aged children are complex and poorly understood. Obesity can induce changes in proteins in the circulation that contribute to the negative impact of obesity on health; such changes may relate to cognitive and emotion regulation skills important for school readiness. We investigated obesity‐related hormones, body mass index ( BMI ), and school readiness in a pilot study of low‐income preschoolers attending Head Start (participating in a larger parent study). We found that the adipokine leptin was related to preschoolers' BMI z ‐score, the appetite‐regulating hormones ghrelin and glucagon‐like peptide 1 ( GLP ‐1), and pro‐inflammatory cytokines typically associated with early life stress; and that some of these obesity‐related biomarkers were in turn related to emotion regulation. Future work should evaluate how obesity may affect multiple domains of development, and consider modeling common physiological pathways related to stress, health, and school readiness.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/101799/1/mbe12034.pd

Prenatal predictors of objectively measured appetite regulation in low-income toddlers and preschool-age children

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/152019/1/ijpo12554_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/152019/2/ijpo12554.pd

Child cortisol moderates the association between family routines and emotion regulation in lowâ income children

Biological and social influences both shape emotion regulation. In 380 lowâ income children, we tested whether biological stress profile (cortisol) moderated the association among positive and negative home environment factors (routines; chaos) and emotion regulation (negative lability; positive regulation). Children (M ageâ =â 50.6, SDâ =â 6.4 months) provided saliva samples to assess diurnal cortisol parameters across 3 days. Parents reported on home environment and child emotion regulation. Structural equation modeling was used to test whether cortisol parameters moderated associations between home environment and child emotion regulation. Results showed that home chaos was negatively associated with emotion regulation outcomes; cortisol did not moderate the association. Child cortisol level moderated the routinesâ emotion regulation association such that lack of routine was most strongly associated with poor emotion regulation among children with lower cortisol output. Findings suggest that underlying child stress biology may shape response to environmental influences.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135499/1/dev21471_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/135499/2/dev21471.pd

Maternal nicotine dependence is associated with longitudinal increases in child obesogenic eating behaviors

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/152014/1/ijpo12541.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/152014/2/ijpo12541_am.pd

Enhancing self-regulation as a strategy for obesity prevention in Head Start preschoolers: the growing healthy study

Abstract Background Nearly one in five 4-year-old children in the United States are obese, with low-income children almost twice as likely to be obese as their middle/upper-income peers. Few obesity prevention programs for low-income preschoolers and their parents have been rigorously tested, and effects are modest. We are testing a novel obesity prevention program for low-income preschoolers built on the premise that children who are better able to self-regulate in the face of psychosocial stressors may be less likely to eat impulsively in response to stress. Enhancing behavioral self-regulation skills in low-income children may be a unique and important intervention approach to prevent childhood obesity. Methods/design The Growing Healthy study is a randomized controlled trial evaluating two obesity prevention interventions in 600 low-income preschoolers attending Head Start, a federally-funded preschool program for low-income children. Interventions are delivered by community-based, nutrition-education staff partnering with Head Start. The first intervention (n = 200), Preschool Obesity Prevention Series (POPS), addresses evidence-based obesity prevention behaviors for preschool-aged children and their parents. The second intervention (n = 200) comprises POPS in combination with the Incredible Years Series (IYS), an evidence-based approach to improving self-regulation among preschool-aged children. The comparison condition (n = 200) is Usual Head Start Exposure. We hypothesize that POPS will yield positive effects compared to Usual Head Start, and that the combined intervention (POPS + IYS) addressing behaviors well-known to be associated with obesity risk, as well as self-regulatory capacity, will be most effective in preventing excessive increases in child adiposity indices (body mass index, skinfold thickness). We will evaluate additional child outcomes using parent and teacher reports and direct assessments of food-related self-regulation. We will also gather process data on intervention implementation, including fidelity, attendance, engagement, and satisfaction. Discussion The Growing Healthy study will shed light on associations between self-regulation skills and obesity risk in low-income preschoolers. If the project is effective in preventing obesity, results can also provide critical insights into how best to deliver obesity prevention programming to parents and children in a community-based setting like Head Start in order to promote better health among at-risk children. Trial registration number Clinicaltrials.gov Identifier: NCT01398358http://deepblue.lib.umich.edu/bitstream/2027.42/112539/1/12889_2012_Article_4758.pd

“You’ve got to settle down!”: Mothers’ perceptions of physical activity in their young children

Abstract Background Mothers are important mediators of children’s physical activity (PA) level and risk of obesity, however previous studies of maternal perceptions of child PA have been limited. Furthermore, it is unknown if maternal perceptions of child PA are predicted by family, mother and child characteristics. Therefore objectives of this study were to 1) evaluate maternal perceptions of PA in their children and 2) test associations of family, mother and child characteristics with these perceptions. Methods 278 low-income mothers of children (mean age 70.9 months) participated in an audio-taped semi-structured interview. Transcripts were systematically analyzed using the constant comparative method and themes were generated. A coding scheme to classify the themes appearing in each transcript was developed and reliably applied. Anthropometrics were measured. Demographics and questionnaires (the Confusion, Hubbub and Order Scale, The Parenting Scale, and the Child Behavior Questionnaire (CBQ)) were collected. Logistic regression models were used to test the associations of family, mother and child characteristics with each theme. Results In this sample of low-income United States mothers, two themes emerged: 1) Mothers perceive their children as already very active (87.8 %, n = 244), predicted by the child being younger, the child not being overweight, and higher child CBQ Activity Level; and 2) Mothers view their children’s high activity level as problematic (27.0 %, n = 75), predicted by lower Parenting Laxness, the child being male and lower child CBQ Inhibitory Control. Conclusions Low-income United States mothers have unique perceptions of PA in their children; these beliefs are associated with characteristics of the child and mother but not characteristics of the family. Further understanding of contributors to maternal perceptions of child PA may inform future childhood obesity interventions. The influence of these perceptions on physical activity outcomes in low-income children should be pursued in future research.http://deepblue.lib.umich.edu/bitstream/2027.42/114383/1/12887_2015_Article_466.pd

Observed restrictive feeding practices among low- income mothers of pre- adolescents

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/162798/2/ijpo12666_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/162798/1/ijpo12666.pd

Adolescent obesity and maternal and paternal sensitivity and monitoring

Objective . To determine if adolescent obesity is associated with parenting characterized by lower sensitivity and lower monitoring of adolescent activities. Methods . We used data from 744 adolescents in the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development. Height and weight were measured at age 15½ years and obesity defined as body mass index ≥ 95th percentile for age and sex. Maternal and paternal sensitivity were assessed by direct observation of a parent‐adolescent interaction task. Maternal and paternal monitoring were assessed by parent report. Lower sensitivity and lower monitoring were each defined as the lowest quartiles. Two separate multivariate logistic regression models were created to evaluate, individually for mothers and fathers, associations of sensitivity and monitoring with adolescent obesity, controlling for adolescent sex and race, family income‐to‐needs ratio, and parental obesity. Results . Fourteen percent of the adolescents were obese. Lower sensitivity was associated with adolescent obesity in the maternal parenting model (adjusted odds ratio [AOR] 2.36, 95% confidence interval [CI] 1.44–3.86, n = 709), but not paternal parenting model (AOR = 0.79, 95% CI 0.38–1.63, n = 460). Neither maternal nor paternal monitoring was associated with adolescent obesity (AOR = 1.03, 95% CI 0.63–1.68; AOR = 1.07, 95% CI 0.52–2.22, respectively). Conclusion . Lower maternal sensitivity, measured by direct observation of parent‐adolescent interactions, was associated with adolescent obesity. Efforts to prevent and treat childhood obesity, both at the practitioner level and the community level, may be enhanced by educating parents that their reactions to their children's behaviors may have consequences related to obesity.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/93554/1/ijpo_345_sm_Appendix.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/93554/2/17477166.2010.549490.pd

Associations between maternal depressive symptoms and child feeding practices in a cross-sectional study of low-income mothers and their young children

Background: Maternal depression may influence feeding practices important in determining child eating behaviors and weight. However, the association between maternal depressive symptoms and feeding practices has been inconsistent, and most prior studies used self-report questionnaires alone to characterize feeding. The purpose of this study was to identify feeding practices associated with maternal depressive symptoms using multiple methodologies, and to test the hypothesis that maternal depressive symptoms are associated with less responsive feeding practices. Methods: In this cross-sectional, observational study, participants (n = 295) included low-income mothers and their 4- to 8-year-old children. Maternal feeding practices were assessed via interviewer-administered questionnaires, semi-structured narrative interviews, and videotaped observations in home and laboratory settings. Maternal depressive symptoms were measured using the Center for Epidemiologic Studies-Depression scale (CES-D). Regression analyses examined associations between elevated depressive symptoms (CES-D score ≥16) and measures of maternal feeding practices, adjusting for: child sex, food fussiness, number of older siblings; and maternal age, body mass index (BMI), education, race/ethnicity, single parent status, perceived child weight, and concern about child weight. Results: Thirty-one percent of mothers reported depressive symptoms above the screening cutoff. Mothers with elevated depressive symptoms reported more pressuring of children to eat (β = 0.29; 95% Confidence Interval (CI): 0.03, 0.54) and more overall demandingness (β = 0.16; 95% CI: 0.03, 0.29), and expressed lower authority in child feeding during semi-structured narrative interview (Odds Ratio (OR) for low authority: 2.82; 95% CI: 1.55, 5.12). In homes of mothers with elevated depressive symptoms, the television was more likely audible during meals (OR: 1.91; 95% CI: 1.05, 3.48) and mothers were less likely to eat with children (OR: 0.48; 95% CI: 0.27, 0.85). There were no associations between maternal depressive symptoms and encouragement or discouragement of food in laboratory eating interactions. Conclusions: Mothers with elevated depressive symptoms demonstrated less responsive feeding practices than mothers with lower levels of depressive symptoms. These results suggest that screening for maternal depressive symptoms may be useful when counseling on healthy child feeding practices. Given inconsistencies across methodologies, future research should include multiple methods of characterizing feeding practices and direct comparisons of different methodologies