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Background: The present research aims to validate and discuss the reliability of Comprehensive Feeding Practices Questionnaire (CFPQ). Materials and Methods: In this cross-sectional study, 150 mothers with 3-6 year old children in the city of Rasht were selected through cluster random sampling from the public and private kindergartens in 2010. After being confident about the translation validity, the degree of validation (content and structure) and validity (test-retest reliability and internal consistency) of the questionnaire was examined. Results: The degree of validation of questionnaire content, except questions 2, 16 and 46, was at a high level and these three questions were omitted. The method of the consistency of factors and total scores of the questionnaire was used to study the validation of structure, which was satisfactory and varied between 0.30-0.72. The validity of questionnaire was examined through test-retest and Cronbach's alpha methods. The Intraclass Correlation Coefficient (ICC) was between 0.80-0.91 and Cronbach's alpha was between 0.80-0.90. Conclusion: In general, the Comprehensive Feeding Practices Questionnaire (CFPQ) was proved to be valid and with respect to the results obtained from the present research, it can be used in the research on child diet.
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42
Zahedan Journal of Research in Medical Sciences
Journal homepage: www.zjrms.ir
Validating and Investigating Reliability of Comprehensive Feeding Practices
Questionnaire
Saeid Doaei,P
*1
P Naser Kalantari,P
2
P Maryam Gholamalizadeh,P
3
P Bahram RashidkhaniP
2
P
1. Department of Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid
Beheshti University of Medical Sciences, Tehran, Iran
2. Department of Nutrition, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3. Department of Nutrition, School of health, Isfahan University of Medical Sciences, Isfahan, Iran
Article information
Abstract
Article history:
Received: 21 Apr 2011
Accepted: 11 July 2011
Available online: 30 Oct 2012
ZJRMS 2013; 15(3): 42-45
Background: The present research aims to validate and discuss the reliability of
Comprehensive Feeding Practices Questionnaire (CFPQ).
Materials and Methods: In this cross-sectional study, 150 mothers with 3-6 year old
children in the city of Rasht were selected through cluster random sampling from the
public and private kindergartens in 2010. After being confident about the translation
validity, the degree of validation (content and structure) and validity (test-retest reliability
and internal consistency) of the questionnaire was examined.
Results:
The degree of validation of questionnaire content, except questions 2, 16 and 46,
was at a high level and these three questions were omitted. The method of the consistency
of factors and total scores
of the questionnaire was used to study the validation of
structure, which was satisfactory and varied between 0.30-
0.72. The validity of
questionnaire was examined through test-retest and Cronbach's
alpha methods. The
Intraclass Correlation Coefficient (ICC) was between 0.80-0.91 and Cronbach's alpha was
between 0.80-0.90.
Conclusion: In general, the Comprehensive Feeding Practices Questionnaire (CFPQ) was
proved to be valid and with respect to the results obtained from the present research, it can
be used in the research on child diet.
Copyright © 2013 Zahedan University of Medical Sciences. All rights reserved.
Keywords:
Validity
Reliability
Questionnaire
Preschool Child
*Corresponding author at:
Students’ research committee,
National Nutrition and Food
Technology Research
Institute, Faculty of Nutrition
Sciences and Food
Technology, Shahid Beheshti
University of Medical
Sciences, Tehran, Iran.
E-mail: sdoaee@yahoo.com
Introduction
he children nutrition may be impressed by parents,
friends, media and personal preferences of children
at pre-school ages [1, 2]. The influence of parents,
who play the role of providers, executors and models for
child nutrition at the early stages of childhood, has been
recognized as the most important effective factor [3, 4].
During the pre-school ages, parents are considered the
main individuals in charge for food choices of children
and they feed their child using different methods. The
methods used by parents are one of the important ways of
influence on child nutrition. Studies indicated that the
methods of children nutrition by parents relate directly to
child’s ability to regulate food consumption according to
the internal signals of hunger and satiety [2] and his/her
food preferences [6] with the level of energy consumption
and body weight [7].
Parents use a wide range of methods to control their
children nutrition as per the different social, economic
and cultural methods [8, 5-11]. With respect to the extent
of approaches used by parents to feed children, the results
of research carried out on the effect of these activities on
diet and health of children were contradictory. The
majority of studied behaviors in researches included
limiting children’s diet, forcing them to eat food and
controlling them explicitly [7, 8, 10]. Topics such as
modeling for children, training healthy nutrition for
children, using food as a reward, and controlling
children’s emotions by foodstuff have not been discussed
much, while they might be of paramount importance.
Various tools are used to evaluate children’s feeding
methods [7, 8, 10, 12, 13].
Comprehensive Feeding Practices Questionnaire
(CFPQ) is a self-administered test, which is designed to
study the different aspects of children’s feeding methods
and it seems to be more completed than the rest of
available tools. This questionnaire was first designed by
Musher-Eizenman et al. in America in 2007 [12]. This
questionnaire was designed aiming to collect and study all
the information related to the pre-school parents-children
dietary interactions. The main questionnaire had 49
questions, which studied children feeding methods
through 12 different aspects. As there is a rather high risk
of malnutrition among the Iranian children and the rate of
children obesity is increasing, having a tool, which
evaluates the methods used in children nutrition from
different aspects, can help us understand the differences
in children’s nutritional condition. Meanwhile, we have
never had a tool to evaluate feeding methods used by
parents in our country. Therefore, the present research
aims to discuss the validation and reliability of the 49-
question Comprehensive Feeding Practices Questionnaire
(CFPQ) to make possible the use of one of the most
modern and completed tools for evaluation of children
nutrition in the country, in case the results are favorable.
T
Validating of child feeding questionnaire Doaei S et al.
43
Materials and Methods
In this research which is carried out in a cross-sectional
approach, 150 mothers with 3-5 year old children enrolled
in Rasht kindergartens in 2010 were selected through the
second-stage cluster random sampling. First, 15
kindergartens were selected among all the kindergartens
of Rasht and then 10 children were selected randomly
from each kindergarten. To fill out the questionnaires,
written consent forms were taken from mothers. The
questionnaires were handed over to mothers in envelopes
through the kindergarten manager. They were asked to
put the questionnaire in the envelope after filling out and
give it back to kindergarten manager. This research uses a
49-question form of Comprehensive Feeding Practices
Questionnaire (CFPQ).
This questionnaire discusses mothers’ behavior related
to children nutrition from 12 different aspects including
child authority, emotion regulation, encourage balance
and variety, environment, using food as reward,
involvement, modeling, monitoring, pressure, restriction
for health, restriction for weight control and teaching
about nutrition. The questions were answered in a five-
point Likert scoring method. The options for questions 1-
13 are “Never” to “Always” and for questions 14-49 are
“completely agree” to “completely disagree”. The
structural analysis of this questionnaire has been
performed by Musher-Eizenman et al. in 2007. The 49-
question form has been executed on a sample including
33 couples (husband and wife) with 4-6 year old children.
Consequently, 12 factors were obtained, which reflect 12
aspects of the methods used by parents in connection with
children nutrition.
To make the questionnaire applicable in Iran, first, it
was translated into Persian and then, confirmed by two
child nutrition specialists. Subsequently, the translated
form was translated again into English by a bilingual
person. In a meeting held between the researchers and the
translator, it was compared with the original
questionnaire. Comparison of these two English texts
indicated that the translation is correct. After insuring the
validity of translation, the content validity, construct
validity, and questionnaire reliability were examined. To
measure the content validity, the opinions of child
nutrition specialists about the questions of the
questionnaire were collected in writing and measured
using Content Validity Ratio (CVR).
The internal consistency method of each factor with
total scores of the questionnaire was used to study the
construct validity. In the internal consistency method,
high consistencies indicate the convergence of factors
with the total scores of the questionnaire. The validity of
this questionnaire was determined by both test-retest
method and internal consistency. For this purpose, the
interclass Correlation Coefficient and Cronbach's alpha
were used. In order to determine the validity of
questionnaire’s test-retest, the mothers were studied again
three weeks after the first round of completion of the
questionnaire.
Results
The clarity and simplicity of the questions were
examined and challenges were resolved using
consultation with child nutrition specialists.
Questionnaire Validity: To examine the tool validity,
the content validity and construct validity were studied. In
content validity, we obtained the opinions of 5 child
nutrition specialists about the questionnaire. The Content
Validity Ratio (CVR) above 0.6 is considered favorable
[16]. The CVR of all the questions, except for the
questions 2, 16 and 46 were reported as satisfactory. To
be confident about the results of the content validity, the
Content Validity Index (CVI) was also obtained which
confirmed the results of CVR. Therefore, the questions
with low content validity were omitted from the
questionnaire and the next steps of the research were
performed on the remaining 46 questions. Table 1
represents the results of the content validity. The Internal
Consistency Method of each factor with the total scores of
the questionnaire was used to study the construct validity.
In the Internal Consistency Method, the consistencies
above 0.3 indicate micro convergence of tests with the
total score of the questionnaire [17]. Table 2 represents
the results. As table 2 shows, the consistencies at the
confidence level of 0.99 are significant. The validity of
this questionnaire was determined by test-retest Method
as well as Internal Consistency. For this purpose, the
Interclass Correlation Coefficient and Cronbach's alpha
were used, respectively.
Test-retest: In order to determine the test-retest validity
of the questionnaire, 90 mothers with 3-6-year-old
children were selected in a cluster-randomized manner.
They were studied again 3 weeks after the first round of
completion of the questionnaire. The Interclass
Correlation Coefficient (ICC) of the whole questionnaire
and each factor were calculated separately. The
coefficients above 0.7 are interpreted as significant [18]
and they were at a high level of significance for all the
questions.
Internal Consistency: Cronbach's alpha was used to
measure the internal consistency of the questionnaire. The
coefficients above 0.7 are interpreted as significant [19]
and the obtained results were completely satisfactory at a
high level of significance (Table 4).
Discussion
In general, the results of the present study indicate that
the Comprehensive Feeding Practices Questionnaire
(CFPQ) enjoys favorable validity. In this study, the
validity coefficient of test-retest of the questionnaire and
Cronbach's alpha were obtained as 0.88 and 0.88,
respectively. On the measurement of the validity of
questionnaire, the content validity and construct validity
were evaluated. The content validity of the questions of
questionnaire, except for 3 questions, was reported at a
high level (0.6-1) and the questions with low level of
content validity were omitted.
Zahedan J Res Med Sci 2013 Mar; 15(3): 42-45
44
Table 1. Content Validity Ratio (CVR) of the questions of comprehensive questionnaire on children feeding methods
Table 2. Internal consistency of each factor with the total score of the questionnaire
Factors
p-Value
Factors
Internal consistency
p-Value
1
0.01
7
0.366
0.01
2
0.01
8
0.296
0.01
3
0.01
9
0.671
0.01
4
0.01
10
0.722
0.01
5
0.01
11
0.580
0.01
6
0.01
12
0.356
0.01
Table 3. Interaclass Correlation Coefficient (ICC)
Factors
ICC
Monitoring
0.84
Pressure to eat
0.83
Restriction for health
0.83
Restriction for weight control
0.91
Modeling 0.85
Teaching about nutrition
0.84
Total score of the questionnaire
0.88
Child authority
0.85
Emotion regulation
0.87
Encourage balance and variety
0.81
Environment
0.85
Using food as reward
0.85
Involvement
0.83
Table 4. Total internal consistency of questionnaire and factors
Factors
Cronbach's alpha
Modeling
0.85
Monitoring
0.84
Pressure to eat
0.83
Restriction for health
0.83
Restriction for weight control
0.90
Teaching about nutrition
0.80
Total score of the questionnaire
0.88
Child authority
0.85
Emotion regulation
0.87
Encourage balance and variety
0.81
Environment
0.83
Using food as reward
0.85
Involvement
0.83
The psychometric experts believe that the correlation
between subtests of one test with the total scores of the
questionnaire indicates the internal integrity and content
validity of a test [17]. To study the content validity of the
present study, the correlation of subtests of the
questionnaire with the total scores of the questionnaire
were studied. The correlations between them were
reported 0.296-0.722, which were significant.
This questionnaire has recently been designed to
remove the shortcomings of the earlier questionnaires.
Due to having several characteristics including execution
simplicity, objectivity and measuring different aspects
related to children nutrition, it can help us understand the
personal differences between children nutritional
condition and the reasons of these differences. As the
present questionnaire discusses feeding methods from 12
different aspects, it seems to be more complete than other
questionnaires such as Child Feeding Questionnaire [13],
which evaluates children feeding methods only through 3
aspects (direct control, indirect control, and forcing to
eat).
In general, these evidences confirm the validity and
reliability of the 46-question Comprehensive Feeding
Practices Questionnaire (CFPQ). Therefore, nutrition
experts and other related sub-disciplines can use this
questionnaire to identify the parents-children nutritional
interactions. As the validity measurement of the
questionnaire is not limited to the methods used in the
research, it is recommended to consider other validity
measurement methods including “Concurrent Validity”
and “Predicative Validityin complementary studies.
Acknowledgements
The present research is part of a research project titled
“Study of the Relationship between Social Factors and
Children Feeding Methods with Dietary and BMI of 3-6
year Old Children in Rasht in 2010” (No.040398) for
which the National Nutrition and Food Technology
Research Institute has allocated its budget. We thank the
Welfare Organization of Gilan Province for the necessary
cooperation with us on implementing this project.
Authors’ Contributions
Doaee S. participated in the project carried out most of
the experimental work. Dr. S. Jafari Shoorijeh and Dr.
Tabatabai-Naini as project leaders, designed the study,
and coordinated all manuscript preparation. Dr. A
CVR
Questions
CVR
Questions
CVR
Questions
CVR
Questions
CVR
Questions
0.6
41
0.6
31
0.6
21
0.6
11
0.6
1
0.6
42
1
32
0.6
22
1
12
-0.2
2
0.6
43
1
33
1
23
0.6
13
1
3
0.6
44
0.6
34
0.6
24
0.6
14
1
4
1
45
0.6
35
0.6
25
0.6
15
0.6
5
-0.2
46
0.6
36
0.6
26
-0.2
16
1
6
0.6
47
0.6
37
0.6
27
1
17
1
7
0.6
48
1
38
0.6
28
0.6
18
0.6
8
0.6
49
1
39
1
29
1
19
1
9
0.6
40
1
30
0.6
20
0.6
10
Validating of child feeding questionnaire Doaei S et al.
45
Tamadon drafted the first version of the manuscript and
performed the statistical analysis.
Conflict of Interest
The authors declare no conflict of interest.
Funding/Support
National Nutrition and Food Technology Research
Institute, Shahid Beheshti University of Medical
Sciences,Tehran,Iran.
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Please cite this article as: Doaei S, Naser Kalantari N, Gholamalizadeh M, Rashidkhani B. Validating and investigating reliability of
comprehensive feeding practices questionnaire. Zahedan J Res Med Sci (ZJRMS) 2013; 15(3): 42-45.
... Thirty-four items and a 5-factor structure consisting of monitoring, restriction for weight, promotion of overconsumption, healthy eating guidance, and healthy eating variety were found to be supported (32) . In studies in other countries such as France (21) , Norway (33) , Brazil (34) , Iran (35), and New Zealand (18) , the original CFPQ structure was not supported. The reason for the presence of different constructs in these studies was associated with ethnicity, differences in socio-economic status, and the examination of different age groups. ...
... Similar to other studies, the Cronbach's alpha value of involvement was found to be below 0.60 (15,20) . Similar to the original CFPQ, the Crohnbach alpha value of monitoring is consistent with studies conducted both in Turkish culture and in other countries (17)(18)(19)(20)35) . This suggests that the monitoring and related items are understood well by different cultures and that it is a valid construct. ...
Article
Full-text available
Objective The Comprehensive Feeding Practices Questionnaire (CFPQ) measures parental attitudes toward feeding practices that directly influence children’s eating habits. This study aims to determine the reliability and validity of the Turkish adaptation of the CFPQ developed by Musher-Eizenman et al. Design Validity and reliability analyses were conducted for the T-CFPQ. In addition to reliability analyses and partial correlations between scale dimensions, correlations between scale dimensions according to mothers’ BMI and children’s BMI z-scores were also examined. Setting Parents with children aged 18 months to 8 years living in the community. Participants The study sample consisted of 274 parents with children aged 18 months to 8 years who agreed to participate in the online survey. Results In this study, 47 items and 12-factor structure describing feeding practices were supported by CFA. Although most of the dimensions of the T-CFPQ showed significant correlations with each other, the highest correlation was found between the encourage balance/variety and the dimension of modeling and teaching nutrition (r=0.53; 0.50) (p<0.05). There was a negative correlation between the child’s BMI z-score and the pressure to eat dimension (r=-0.173; p<0.01) and a positive correlation between the restriction for weight dimension (r =0.339; p<0.01). Maternal BMI was negatively associated with the involvement dimension (r=-0.121; p<0.05) and positively associated with the restriction for weight dimension (r=0.154; p<0.01). Conclusions The findings revealed that the T-CFPQ is a valid and reliable measurement tool that can be applied to obtain the necessary information for evaluating nutritional interactions between parent and child.
... Consistent with our hypothesis, a modified version of the CFPQ with five factors and 34 items was found to better assess maternal feeding practices in this sample than the original 12-factor, 49-item CFPQ (Musher-Eizenman & Holub, 2007). The lack of fit to the original model is consistent with other studies examining the appropriateness of using the CFPQ among other ethnicities outside the United States (Al-Qerem et al., 2017;Doaei, Kalantari, Gholamalizadeh, & Rashidkhani, 2013;Haszard et al., 2013;Mais et al., 2015;Melbye, Ogaard, & Overby, 2011;Shohaimi et al., 2014;Warkentin et al., 2016). As with the present study, many of these studies also required an EFA with substantial modification to achieve an acceptable fit. ...
... Monitoring was the only factor in the present study that was identical to that of the original CFPQ. This is consistent with studies examining the psychometric properties of the CFPQ in countries besides the United States, which have consistently included all monitoring items from the original CFPQ (Al-Qerem et al., 2017;Doaei et al., 2013;Haszard et al., 2013;Mais et al., 2015;Melbye et al., 2011;Shohaimi et al., 2014). This indicates that these items are well understood and that monitoring is likely a relevant construct across varying cultures and ethnicities. ...
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The Comprehensive Feeding Practices Questionnaire (CFPQ)is an important measure to assess parent feeding practices as it encompasses a broad range of feeding behaviors, not just behaviors negatively associated with child weight outcomes. However, parent feeding practices have been shown to differ across ethnicities and the CFPQ has not been tested among low-income, Hispanic-American parents with preschool-aged children, a group at elevated risk for developing obesity. A confirmatory factor analysis was performed with the present Hispanic-American sample of Head Start mothers with preschoolers to confirm the original 12-factor, 49-item structure of the CFPQ. Because the original factor structure was not confirmed in the present Hispanic-American sample, an exploratory factor analysis was conducted to examine the psychometric properties of the CFPQ in this sample (n = 187). Among this sample, a five-factor model with 34 items was found to more appropriately assess parent feeding practices than the original 12-factor, 49-item CFPQ. This study provides preliminary validation of the CFPQ for use among low income, Hispanic-American families. Although future research is needed to replicate findings among a larger sample, this study takes an important first step toward more accurately assessing parent feeding practices among this high-risk population to inform tailored interventions that aim to reduce economic and ethnic disparities in child obesity.
... The total scores were computed for each subscale, and higher scores indicated greater engagement in those feeding practices [24]. Studies have shown that the CFPQ subscales have evidence of internal consistency with Cronbach's alpha coefficients ranging between 0.52 and 0.85 [24][25][26][27]. ...
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Background/Objectives: Diet quality during early childhood significantly influences long-term health outcomes, including obesity and chronic disease risks. Parental feeding practices, dietary beliefs, and demographic factors have been shown to impact children’s diet quality. This study aimed to determine the extent to which the demographic characteristics and the factors of primary caregivers (dietary beliefs, intention to provide a healthy diet, feeding practices) can explain the variance in the diet quality of preschoolers in the US Methods: This descriptive correlational cross-sectional study was guided by the Theory of Planned Behavior (TPB). A total of 146 primary caregivers of preschool children (aged 3–5) were recruited through convenience and snowball sampling. Data were collected using a self-reported questionnaire and a structured telephone interview. Diet quality was assessed using the Dietary Approaches to Stop Hypertension (DASH) score. Hierarchical multiple regression analyses were conducted to determine the factors associated with preschoolers’ diet quality. Results: The mean DASH score was 40.5 (SD = 10.1), reflecting moderate to low diet quality. The results showed that 16% of the variance in diet quality was significantly explained by race (non-White) and three caregiver feeding practices (food as a reward, restriction food for health, and restriction for weight control). Of these, race (non-White) and restriction food for health were significant predictors and associated with lower diet quality in preschoolers. Conclusions: These findings align with previous studies and suggest that the conceptual framework of this study might be further refined and tested in future studies.
... El CIPA se ha utilizado para medir las PMAI y se ha validado en varios grupos de edad y en diferentes países (7)(8)(9)(10)(11)(12), mostrando diferencias en las cargas factoriales de las dimensiones del CIPA y diferentes puntuaciones de confiabilidad en términos del coeficiente alfa de Cronbach (13). Dado lo anterior, y debido al interes de contar con cuestionarios culturalmente apropiados para identificar factores relacionados con el SP-OB infantil, surgió la necesidad de desarrollar una versión en español del CIPA con el objetivo de examinar y confirmar su validez una vez traducido y adaptado a la población mexicana. ...
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Introduction: the emotional state influences the selection of foods that an individual consumes. In Colombia, no tool allows to detect the people most susceptible to develop emotional intake. Objective: to validate the Emotional Intake Questionnaire-Garaulet in a student population of the National University of Colombia. Methods: a cross-sectional descriptive observational study was conducted with a convenience sample of students in all the University's campuses in two stages employing the Spanish and the Colombian questionnaires through e-mail. Two questions were included in the survey, to assess the emotions of sadness and anxiety; a linearity relationship was established with the cut-off scores to maintain proportionality and preserve the dimensions of the study phenomenon. Results: in phase 1, 1177 subjects participated, and in phase 2, 831 subjects participated. Of these, 63.6 % and 52.8 % were emotional and very emotional eaters in the Colombian and Spanish versions, respectively. Taking the total amount of people, 22.3 % were emotional and very emotional eaters with body mass index > 25 kg/m². In addition, 4.7 % had an eating disorder and 14.2 % had a psychiatric disorder. Finally, sensitivity, specificity, and positive and negative predictive values were 99.0 %, 49.3 %, 89.9 % and 91.2 %, respectively. Conclusions: the Colombian version of the Emotional Eating Questionnaire demonstrates acceptable validity and reliability compared to the Spanish version. A high prevalence of emotional eaters was observed in the university population, which could be detected early through the use of this questionnaire. Suffering from this disorder is a risk factor for developing obesity and other metabolic diseases in the future.
... Questions number 16, 37, and 42 were reversely coded [15]. The intra-class correlation coefficient (ICC) was in the range of 0.80 to 0.91 and the Cronbach α was obtained in the range of 0.80 to 0.90 [16]. ...
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Background and Objective: This study compared children's eating behaviors, body mass index, and parents' feeding practices between typically developing (TD) children and children with attention-deficit/hyperactivity disorder (ADHD). Materials & Methods: In this descriptive study, 95 children with ADHD and 95 TD children aged 6 to 11 years were studied. The Conner's parents rating scale, the comprehensive feeding practice questionnaire, and the child eating behavior questionnaire were completed for both groups. In addition, both groups' weight and body mass index were measured and calculated. Clinical interviews and the Kiddie Schedule were held for both groups. The obtained data were analyzed by the independent t test and the Chi-square test in SPSS software, version 19.0, at a significance level of less than 0.05. Results: The two groups showed no significant differences in demographic characteristics and feeding practices. The parents in the two groups were similar in all study variables except for emotional control and monitoring over feeding practice. The correlation between body mass index and child eating behavior scores showed significant relationships with food disorder (r=-0.281, P=0.006), enjoyment of food (r=0.295, P=0.004), and food responsiveness/emotional binge (r=0.288, P=0.005).According to the stepwise regression, the predictors of body mass index were weight restraints and food disorder in the ADHD group and health restraints in the control group. Conclusion: This study found no significant differences between TD children and ADHD children regarding weight, body mass index, eating behavior, or parental feeding practice. Further research is needed to evaluate related variables, such as physical activity and birth weight.
... El CIPA se ha utilizado para medir las PMAI y se ha validado en varios grupos de edad y en diferentes países (7)(8)(9)(10)(11)(12), mostrando diferencias en las cargas factoriales de las dimensiones del CIPA y diferentes puntuaciones de confiabilidad en términos del coeficiente alfa de Cronbach (13). Dado lo anterior, y debido al interes de contar con cuestionarios culturalmente apropiados para identificar factores relacionados con el SP-OB infantil, surgió la necesidad de desarrollar una versión en español del CIPA con el objetivo de examinar y confirmar su validez una vez traducido y adaptado a la población mexicana. ...
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Introduction: identifying maternal attitudes and behaviors related to child feeding could be difficult since the underlying constructs are abstract and complex. Different questionnaires have been used to identify these constructs: one of the most widely used is the Comprehensive Feeding Practices Questionnaire (CFPQ), which had been validated in different populations. However, no previous study ever validated the CFPQ in Mexican mothers. Material and methods: a process of cultural adaptation was done to adapt the CFPQ to Mexican mothers, and subsequently a confirmatory factor analysis was done. A total of 300 mother-preschooler pairs participated. Weight and height were measured and the nutritional status was obtained. Results: the CFPQ is a useful questionnaire to identify child feeding practices, since the model's goodness of fit indices were acceptable (CFI = 0.943, TLI = 0.937, NFI = 0.874 and RMSEA = 0.042), as was the internal consistency of the CFPQ. Conclusion: the CFPQ version that was translated into Spanish and adapted to Mexican mothers demonstrated significant internal reliability, and therefore is useful to identify and describe maternal child-feeding practices.
... Translation and content validity of the CFPQ was done in a previous study in Iran, so we used the translated CFPQ in our study. [6] The study was conducted in rural and urban areas of Birjand city, capital city of the South Khorasan province in Iran. An acceptable sample size for doing factor analysis (300 mothers with 2-5-year-old children) was selected with simple systematic random sampling. ...
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Background: Overweight, obesity, and underweight are common child health problems in Iran. Child-feeding practices are one of the major factors affecting children's weight through eating behavior and dietary intake. The Comprehensive Feeding Practices Questionnaire (CFPQ), a 49-item measure comprising 12 subscales, assesses parental child-feeding practices. It is used to determine factors that may affect the development of overweight, obesity, and underweight and therefore, helps us plan appropriate preventive action. The aim of this study was to revise and adapt CFPQ to be used for 2-5-year-old children. Methods: This study including, 300 mothers selected by simple systematic random sampling, was conducted in the rural and urban areas of Birjand city, Iran. Health workers interviewed the mothers and completed questionnaire according to the standard protocol. Exploratory factor analysis (EFA), tests for internal consistency, and test-retest reliability were conducted. Results: EFA resulted in a final questionnaire with 39 items distributed over seven factors, including Healthy Eating Guidance, Modeling, Parent Pressure, Monitoring, Emotion Regulation, Child Control, and Restriction. The internal consistency reliability for the proposal scales was acceptable for five out of the seven factors and all of the seven factors demonstrated excellent test-retest reliability. Conclusions: The revised CFPQ is a valid tool for determining the various aspects of parental feeding practices aiming to prevent overweight, obesity, and underweight among 2-5-year-old children.
... The validity value of the CFPQ (Comprehensive Feeding Practice Questionnaire) questionnaire was 0.80-0.91 and the reliability value of the CFPQ questionnaire was 0.80-0.90 (Doaei, Kalantari, Gholamalizadeh, & Rashidkhanip, 2013). The feeding practice instrument used in this study was analyzed using a 75 percent value of the total score of the questionnaire. ...
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Improper feeding practice in children is one of the causes of nutritional problems in developing countries. This case causes 1.5 million children to die. Feeding practice is a behavior to control the types and the amount of food for children. This study aimed to identify the mother feeding practice to children in the provision of nutrition in a PAUD at Jatinangor sub-district. This study used a descriptive quantitative approach. The population in this study were mothers who had children aged 3-6 years, respondents were chosen using total sampling technique. There were 55 respondents in this study. Data collection used a CFPQ questionnaire (Comprehensive Feeding Practice Questionnaire) to identify the mother's feeding practice. Data were analyzed using the 75 percentile value of the total score of the questionnaire. Data is presented using frequency distribution. The result showed that 39 (70.9%) mothers had poor feeding practice and 16 (29.1%) mother had good feeding practice. These results illustrate that mother feeding practice is still not appropriate in fulfilling nutrition for children. Nurses as a health worker are expected to improve mothers’ knowledge regarding how to apply good and balanced food that appropriate with children's need.Keywords: Children, feeding practice, nutritional status of children.
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The Comprehensive Feeding Practices Questionnaire (CFPQ) has been evaluated in international studies, but the evaluation of its psychometric properties in Spanish, and in particular for parents of adolescents is still limited, and the invariance of measurement according to gender has not been evaluated. Therefore, the objectives of this study were: (1) To adapt the five-factor model of the CFPQ instrument to Spanish; (2) To examine the psychometric properties of this adaptation; and (3) To evaluate the measurement invariance of the model to verify the equivalence of measurement of the perceptions of food parenting practices between mothers and fathers belonging to nuclear, dual-earner families with adolescent children. Participants were 946 mothers and fathers from Southern Chile. Results showed that the conceptual equivalence for the CFPQ was achieved. An exploratory factor analysis was performed for a five-factor model: Monitoring, Child control, Restriction for weight control, Modeling and Environment. Horn’s parallel analysis identified four factors, while factor loading analysis determined the removal of the environment factor. Confirmatory factor analysis presented good reliability values. Convergent and discriminant validity was confirmed, and medium-to-high levels of goodness of fit were obtained, eliminating two items. Results supported a final model of four factors and 19 items. Multigroup analysis of the measurement model verified the configural and metric invariance between fathers and mothers, while the scalar and strict partial invariance was verified. These findings are a relevant guide to measure factorial scores in the four-factor model of the CFPQ, establishing a characterization of feeding practices of parents and adolescents.
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Background and purpose: Nutritional behavior of children depends largely on the behavior of their parents, especially their mothers. Therefore, this study was conducted to determine and compare the nutritional behaviors of mothers of overweight and obese children with those of normal weight children. Materials and methods: This descriptive-analytical case-control study was performed in elementary school students and their mothers in Sari, Iran 2017. Hundred and sixty five students were selected through multistage random sampling, including overweight and obese students (n=82) and normal weight students (n=83). Students' heights and weights were recorded and anthropometric indices were calculated by WHO AnthroPlus 4 software. Then, the nutritional behavior of the mothers was assessed by Comprehensive Feeding Practices Questionnaire. Data analysis was performed in SPSS V20. Results: Nutritional behaviors in mothers of children with normal weight, and overweight and obese children were not significantly different (61.25±9.36 and 62.17±7.91, respectively, P=0.20). Compared to the mothers of normal-weight students, the mothers of overweight and obese students had more restrictions to control children’s weight (P=0.009) but less encouraged balance and variety of food (P=0.020). Fast-eating was more prevalent in overweight and obese students (P=0.026). Conclusion: There were similar nutritional behaviors in the mothers studied, but there were some differences in feeding practices which could be among the causes of differences in students' weights.
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This article examines the definition, importance, conceptual basis, and functional nature of content validity, with an emphasis on psychological assessment in clinical situations. The conditional and dynamic nature of content validity is discussed, and multiple elements of content validity along with quantitative and qualitative methods of content validation are reviewed. Finally, several recommendations for reporting and interpreting content validation evidence are offered. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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The reliability and validity of Russian translations of two psychiatric screening questionnaires: the General Health Questionniare, 12-item version (GHQ-12), and the Brief Scale for Anxiety and Depression (BSAD) were assessed in the region of Tver, northwest of Moscow. For the BSAD a comparison was made between an inverview and selfreport version. The internal reliability of the GHQ-12 was found to be congruent with the literature, but the testretest reliability and validity were lower. The BSAD had a good reliability and proved to be a good predictor of DSM-III-R anxiety and depressive disorders. The BSAD administered as a self-report questionnaire had almost the same qualities as the clinical interview, making a choice on practical considerations possible. The figures for reliability and validity of GHQ-12 and BSAD did not differ much from those found in an earlier study in a region near Chernobyl in Belarus (Havenaar et al., 1995).
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Children are assuming larger roles in household consumer decisions and have also emerged as independent consumers, thus forming an increasingly powerful market segment. Children can be seen as forming, first, a primary market; second, as influencers on their parents’ decision making; and third, as potential future adult consumers. The second role is the main focus of this paper, centring on supermarket purchases. Using focus groups and in-depth interviews, this study explores the influence of children on supermarket shopping. Participants included parents and children of families in Midlothian, Scotland. The results showed that children have a significant influence on supermarket product purchases. The factors which influence children's product preferences are analysed, and their ability to relay their choices to their parents is considered.
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Aim: The present study assessed the relationship between maternal attitudes, beliefs and child feeding practices. It was hypothesised that: (i) maternal control over feeding would increase when mothers perceived their children as over- or underweight and were concerned about the weight status of their children; and (ii) mothers would express more concern about their daughters' weight, and report higher levels of control over feeding as a result. Methods: Participants included 112 mothers and their children aged 2–6 years who were attending swim lessons at a Central Coast swim school. Mothers completed the Child Feeding Questionnaire to assess maternal attitudes, beliefs and control over child feeding. Child and maternal body mass indexes were measured. Correlational analyses, t-tests and multiple regression analyses were performed. Results: Mothers reported a high overall level of control in child feeding, and a low level of concern for child weight. Child overweight and obesity were marginally lower than reported in previous studies. Mothers reported more concern for their daughters' weight, but did not report increased control over feeding based on child gender. Pressure to eat was negatively associated with maternal education, suggesting a link between socioeconomic status and child feeding practices. Mothers displayed higher levels of parental control over obese than normal-weight children, suggesting that they accurately assessed the weight status at the obese level. Conclusion: Mothers may be able to detect obesity in their children, but not overweight. Mothers may also be unconcerned about their sons' weight, and this discrepancy should be investigated in clinical and educational settings. Nutrition education and child obesity prevention and treatment programs should take maternal attitudes, perceptions and child feeding practices into account when planning interventions.
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Psychological influences on the childhood diet are addressed. The focus is on factors that influence the formation of children's food preferences. Evidence for links among food preferences, dietary intake and children's adiposity is presented, with an emphasis on dietary fat. Few food and flavor preferences are innate; most are learned via experience with food and eating and involve associative conditioning of food cues to aspects of the child's eating environment, especially the social contexts and physiological consequences of eating. Parents' child-feeding practices are central in this early feeding environment and affect children's food preferences and their regulation of energy intake. An understanding of how children's food preferences are acquired is essential in developing strategies to improve the quality of children's dietary intake.
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Childhood overweight has increased dramatically, particularly among young girls. Genetic and environmental factors produce the overweight phenotype. Nonshared environments appear to account for a substantial proportion of the population variance in overweight but remain largely unspecified and unmeasured. Our goal was to evaluate the influence of maternal control in feeding, an aspect of nonshared family environment, on daughters' eating and relative weight. Structural equation modeling was used to test models that describe maternal influences on daughters' eating and relative weight. The participants were 197 white, non-Hispanic families with 5-y-old daughters. The mothers' own dietary restraint and their perceptions of their daughters' risk of overweight were used to predict maternal control in feeding, which was used to predict the daughters' eating and weight outcomes. Maternal body mass index was a modest predictor of daughters' relative weight. The addition of the family-environment pathway provided a good fit and showed additional, independent prediction of daughters' relative weight. Mothers' dietary restraint and perceptions of their daughters' risk of overweight predicted maternal child-feeding practices, which in turn predicted daughters' eating and relative weight. Child-specific aspects of the family environment, including mothers' child-feeding practices and perceptions of their daughters' risk of overweight, may represent important, nonshared, environmental influences on daughters' eating and relative weight. The environmental effects noted were modest but comparable in magnitude to the direct association between maternal and child weight, which indicates that measuring family environmental factors can enhance our understanding of the etiology of childhood overweight.
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Certain mother-child feeding patterns (MCFPs) may promote childhood obesity and/or disordered eating. To assess the demographic correlates of MCFPs and to test whether differences in MCFPs are associated with child body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters) z scores in a population-based study. A secondary analysis of the National Longitudinal Survey of Youth main and child cohorts was conducted on more than 1000 Hispanic, African American, and non-Hispanic/non-African American children, aged 3 to 6 years. The MCFPs were measured by means of 3 interview questions probing mother-allotted child food choice, child compliance during meals, and child obedience during meals. Mothers of non-Hispanic/non-African American children allotted greater food choice than mothers of African American or Hispanic children. Maternal BMI and other demographic measures were unrelated to MCFPs. The lowest levels of mother-allotted child food choice and child eating compliance were associated with reduced child BMI, with mean BMI z scores of -0.36 and -0.41, respectively. Effect sizes were small, however, and MCFPs did not discriminate children who were overweight or at risk for being overweight from children who were not (P>.05). Feeding strategies providing the least child food choice were associated with reduced child BMI. However, MCFPs did not relate to child overweight status.
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To replicate the finding of a negative association between parental control and fruit and vegetable consumption in girls. To extend the investigation to boys and examine sex differences. To test the hypothesis that children's food neophobia explains this association. Cross-sectional questionnaire survey. The questionnaire included items assessing parents' and children's fruit and vegetable intake, the Parental Control Index, and the Child Food Neophobia Scale. Parents of 564 2- to 6-year-old children, recruited from 22 London nursery schools. Relationships between continuous variables were examined with Pearson product moment correlation coefficients. Sex differences were tested using independent sample t tests, and sex differences in correlations were assessed from their 95% confidence intervals. Parental control and children's food neophobia were entered into a hierarchical multiple regression to test the hypothesis that neophobia explains the association between parental control and children's fruit and vegetable intake. We replicated the finding that parental control was correlated with children's fruit and vegetable consumption and found no significant sex differences. Parental fruit and vegetable consumption and children's food neophobia were also strong predictors of children's fruit and vegetable consumption, and both were associated with parental control, suggesting that they might explain the association between control and intake. Controlling for children's food neophobia and parental intake reduced the association of parental control with children's fruit and vegetable intake to nonsignificance. These findings emphasize the importance of systematic research about associations between parental feeding styles and children's dietary habits so that dietetics professionals can give parents sound advice.