Date of Award

2018

Degree Type

Thesis

Degree Name

Master of Science in Nutrition and Food Science

Department

Nutrition and Food Sciences

First Advisor

Alison Tovar

Abstract

Objectives: To explore the relationship between three feeding practice constructs (role modeling, encouragement, and pressure to eat) of family child care home (FCCH) providers, and fruit and vegetable intake of the preschool-aged children in their care.

Participants: Subjects were family child care home providers and the children in their care. Participants were recruited from Providence, Rhode Island and surrounding areas of Rhode Island and Massachusetts.

Methods: Baseline data, collected during a two-day home visit from an ongoing cluster-randomized trial, Healthy Start/Comienzos Sanos, were used (n=61 FCCH). Feeding practice data was collected using the Environment and Policy Assessment and Observation (EPAO) tool. Child dietary intake was collected using the Dietary Observation in Child Care (DOCC) protocol. A score for each construct was created by summing the relevant feeding practice items (averaged across two days) for each and averaging across the number of items. Child whole fruit, total fruit (whole fruit plus fruit juice), and vegetable intake were averaged across both observation days and across all children observed within a home. Multiple linear regressions were used to examine the relationship between FCCH provider feeding practice constructs and diet variables.

Results: The majority of providers identified as Hispanic/Latina (83%), all were female, and the mean age of providers was 50.8±8.3 years. The majority of children were Hispanic/Latino (69%), and about half were female (48%). The mean age of children was 3.4±1.0 years. Mean whole fruit intake was 1.02±1.03 cups/day, mean total fruit intake was 1.35±1.07 cups/day, and mean vegetable intake was 0.54±0.41 cups/day. In adjusted multivariate models, encouragement was significantly positively associated with child vegetable intake (β =0.51, p=0.007), total fruit intake (β =0.45, p=0.02), and whole fruit intake (β =0.55, p=0.002), and fruit and vegetable intake combined (β =0.64, p=0.0004). In the adjusted model, pressure to eat was also significantly negatively associated with whole fruit intake (β =-0.27, p=0.05). No other provider practices were significantly associated with child whole fruit, total fruit, or vegetable intake.

Conclusions: FCCH provider encouragement was associated with a significant increase in child fruit and vegetable intake, and although the frequency of pressure to eat was low, it was associated with a significant decrease in child whole fruit intake. Future studies should further explore the relationship between provider feeding practices and child diet. With this information, interventions and training for FCCH providers can be better tailored to improve the diets of young children.

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