Validation of the Comprehensive Feeding Practices Questionnaire among Brazilian Families of School-Aged Children

Abstract

IntroductionChildren’s eating behaviors are influenced by parents, who are the first nutritional educators. The comprehensive feeding practices questionnaire (CFPQ) was developed to measure feeding practices among parents, but has not yet been validated in Brazil, where child obesity rates are steeply increasing. The aim of the study was to test the validity of the CFPQ among Brazilian parents of school-aged children and propose a new version of the instrument.MethodsTranscultural adaptation included translation into Portuguese, back translation, content validity, testing for semantic equivalence, and piloting. Questionnaire data were obtained for 659 parents of 5- to 9-year olds. Confirmatory and exploratory factor analyses and psychometric analyses (tests for internal consistency, factor correlations, item-discriminant and convergent validity, and test–retest reliability) were conducted.ResultsConfirmatory factor analysis demonstrated a poor fit of the data to the original 12-factor model. Exploratory factor analysis generated a 6-factor model composed of 42 items: healthy eating guidance, monitoring, restriction for weight control, restriction for health, emotion regulation/food as reward, and pressure. This factor solution was supported by internal consistency tests (α = 0.71–0.91) and factor correlations (ρ = −0.16 to 0.32). Item-discriminant and convergent validity tests showed that parents who used coercive practices had more overweight children and were more concerned about their child’s weight (ρ = 0.09–0.40). Test–retest reliability was acceptable (intraclass correlation coefficient = 0.45–0.77).ConclusionSince parental practices are highly culturally and age group sensitive, it is essential to conduct careful evaluations of questionnaires when introduced into specific age groups within new cultural settings. This modified six-factor model of the CFPQ is valid to measure parental feeding behaviors of school-aged children in urban Brazilian settings.

Parents Matter: Associations of Parental BMI and Feeding Behaviors With Child BMI in Brazilian Preschool and School-Aged Children

“…This study was part of the Estudo de Práticas Alimentares (EPA), a cross-sectional study aiming to adapt and validate the Comprehensive Feeding Practices Questionnaire (CFPQ) for middle- and high-income Brazilian families of preschool ( 32 ) and school-aged children ( 33 ). Parents of 2-to-8-year-old children, whose children's anthropometric data was complete, were included in this study.…”

“…In one school, the questionnaires were administered and completed by parents before a parents–teachers meeting. More details about the procedures are described elsewhere ( 32 , 33 ). This research received ethical approval from the Federal University of São Paulo (UNIFESP) ethics committee.…”

“…Response options for the CFPQ questions were “never,” “rarely,” “sometimes,” “mostly,” and “always,” or “disagree,” “slightly disagree,” “neutral,” “slightly agree,” and “agree,” on a Likert scale ranging from 1 to 5. The process of transcultural adaptation and validation of the questionnaire is described elsewhere ( 32 , 33 ). All the CFPQ scores were analyzed as continuous variables, ranging from 1 to 5.…”

Parental Feeding Practices in Relation to Maternal Education and Childhood Obesity

“…The present study hypothesizes the existence of association between the parents' perceptions, concerns, and feeding practices with children's BMI z-score and maternal education in elementary school-aged children. The age groups (6 to 10 years) of the study participants reflect when the child matures and starts to eat outside the house environment, though they still are affected by parents' control in their feeding practice and selection of food [31].…”

Adolescents' perception of parental feeding practices: Adaptation and validation of the Comprehensive Feeding Practices Questionnaire for Brazilian adolescents—The CFPQ-Teen

“…The Comprehensive Feeding Practices Questionnaire (CFPQ) is a validated scale designed to measure feeding practices for young children (2–8 years old). This instrument was developed by Musher-Eizenman and Holub (2007) and it has been widely used, having been validated in several countries [ 5 , 9 , 16 , 17 ] including two recent versions in Brazil [ 18 , 19 ]. The cross-cultural validation of an instrument of adolescent feeding practices provides a more comprehensive understanding of adolescent health and can contribute to the prevention and treatment of diseases such as obesity which prevalence has been increasing in the world [ 2 ].…”