A Comprehensive Assessment of Food Parenting Practices: Psychometric Properties of the Portuguese Version of the HomeSTEAD Family Food Practices Survey and Associations with Children’s Weight and Food Intake

Abstract

The Home Self-Administered Tool for Environmental Assessment of Activity and Diet (HomeSTEAD) survey evaluates a broad spectrum of food parenting practices related to parental use of control, autonomy support, and structure. This study aims to test the psychometric properties of the Portuguese version of the HomeSTEAD family food practices survey in parents of 3–12 year old children. Data were collected from 184 parents/caregivers. We performed an exploratory factor analysis (EFA), calculated the internal consistency coefficients of each subscale, and tested for associations with children’s food intake and weight. Based on the EFA, 61 items were included in the Portuguese version of the HomeSTEAD family food practices survey, and were distributed among four Coercive Control Practices (16 items); five Autonomy Support Practices (17 items); and nine Structure Practices (28 items). All scales demonstrated an acceptable level of internal consistency. A higher body mass index (BMI) SD score in children was associated with higher levels of restriction and weight talk by parents and distractions during meals. Higher levels of distractions during meals were also associated with higher sweets intake in children. Additionally, higher levels of parental modeling and the establishment of rules and limits were associated with lower intake of sugar-sweetened beverages. These associations provide preliminary evidence of the HomeSTEAD family food practices survey’s construct validity and attest to its potential to assess parental strategies and provide useful information to improve children’s eating.

Parental food communication and child eating behaviours: A systematic literature review

“…Child eating behaviours were measured with a variety of tools. Five studies used a Food Frequency Questionnaire 23,24,39,42,43 however, four of these studies targeted specific foods using sub-scales only (eg sugar-sweetened drinks, fruit) and therefore used less than ten items. These FFQs were also parent-reported, thus providing a lower validity compared with the child report version.…”

“…Table 1 provides an overview of the reviewed studies' characteristics. The included articles were published between 1995 22 and 2020 23 with 65% (15/23) in 2015 or after. 6,[23][24][25][26][27][28][29][30][31][32][33][34][35][36] They were conducted in a range of countries, including: the United States of Am erica 6,22,[24][25][26][27][32][33][34]37,38 (11/23, 45%), Netherlands, 28,39 Portugal, 23 Israel, 29 Japan, 40 Norway, 30,41 Austria, 31 Belgium, 42,43 and Canada.…”

“…The included articles were published between 1995 22 and 2020 23 with 65% (15/23) in 2015 or after. 6,[23][24][25][26][27][28][29][30][31][32][33][34][35][36] They were conducted in a range of countries, including: the United States of Am erica 6,22,[24][25][26][27][32][33][34]37,38 (11/23, 45%), Netherlands, 28,39 Portugal, 23 Israel, 29 Japan, 40 Norway, 30,41 Austria, 31 Belgium, 42,43 and Canada. 35,36 Slightly less than half of the studies were conducted with young children aged <5 years 27,29,30,[33][34][35][36][37]42,43 (45%, 10/23), 36% (8/23) included childre...…”

“…35,36 Slightly less than half of the studies were conducted with young children aged <5 years 27,29,30,[33][34][35][36][37]42,43 (45%, 10/23), 36% (8/23) included children aged 5-12 years 22,23,25,28,31,32,39,41 and five studies (18%, 5/23) targeted those over 13 years. 24,26,30,38,40 The majority of studies were observational and cross-sectional in design 6,[22][23][24][25][26]28,30,[33][34][35][36][37][38][39][40][41][42][43] (82%, 19/23). Three studies 25,35,37 involved observing parent/child dyads and the remaining were questionnaire based.…”

“…35,37 In contrast, DeJesus and colleagues 25 Body mass index Z-scores (BMIz) were used as a proxy for nutritional status in children, 48 in 12 of the 23 studies. 6,[22][23][24][25]27,28,31,32,[35][36][37][38] This is a problematic practice, as BMIz and nutritional or health status are poorly correlated and public health practice suggests moving away from using BMI as a proxy for nutritional status. 49 A dearth of studies focusing on child disordered eating was apparent, with only five studies specifically measuring disordered eating behaviours in children.…”