Adolescent vegetable consumption: the role of socioemotional family characteristics.

OBJECTIVE: To describe associations between adolescents' frequency of vegetable consumption, food parenting practices and socioemotional family characteristics, and to explore potential mediated relationships that may contribute to an understanding of the family processes involved. DESIGN: Cross-sectional survey among adolescents aged 13-15 years. SETTING: A survey questionnaire including self-report measures on adolescents' frequency of vegetable consumption, perceived food parenting practices (i.e. family dinner frequency, maternal/paternal healthy eating guidance (HEG), maternal/paternal social support for vegetable consumption) and socioemotional family characteristics (i.e. general family functioning and level of cohesion and conflict within the family) was distributed in a convenience sample of secondary school students. PARTICIPANTS: Four hundred forty students from five secondary schools in eastern Norway completed the questionnaire. RESULTS: Results from multiple linear regression analysis revealed positive and statistically significant associations between adolescents' frequency of vegetable consumption, maternal HEG and family cohesion. A partial indirect (mediated) association between family cohesion and adolescents' frequency of vegetable consumption, working through maternal HEG, was also found. CONCLUSIONS: Results from the present study suggest that perceived family cohesion may influence adolescents' frequency of vegetable consumption both directly and indirectly. However, there is a need for continued investigation of family-related factors influencing adolescent eating. In particular, the role of socioemotional family characteristics should be further scrutinised in future studies.

The reliability of the general functioning scale in Norwegian 13-15-year-old adolescents and association with family dinner frequency.

BACKGROUND: Family environment is crucial to the development of health behaviors into adolescence and adulthood. The aims of this study were (1) to explore the reliability of the General Functioning Scale (GFS) among Norwegian 13-15-year-olds, and (2) to assess whether family functioning reported by adolescents was associated with family dinner frequency. METHODS: In total 440 secondary-school students were invited to participate in this cross-sectional web-based questionnaire survey, with 54 participating in the test-retest study. Test-retest and internal consistency were assessed for the 12-item GFS-scale. Associations between family functioning and family dinner frequency were tested using multiple logistic regression. RESULTS: The GFS had high internal consistency (corrected item-total correlations ranging from 0.40 to 0.65, Cronbach's α = 0.85), and excellent test-retest reliability (intra-class correlation coefficient = 0.83). In the logistic regression model, a higher score on GFS (poorer family functioning) was associated with a reduced likelihood of having dinner together on a daily basis (i.e., 6-7 times per week, OR = 0.36, CI = 0.20-0-64) after adjusting for age, gender, ethnicity, living situation and parental education level. CONCLUSIONS: The GFS had high reliability. As poorer family functioning was associated with less frequent family dinners, the family environment may be an important (contextual) target to influence adolescent health behaviors. It would be of interest to further explore the role of family functioning in relation to adolescents' dietary habits, besides shared family meals, and to reveal the mechanisms underlying such relationships.

Perceived rules and accessibility: measurement and mediating role in the association between parental education and vegetable and soft drink intake.

BACKGROUND: The existence of socioeconomic differences in dietary behaviors is well documented. However, studies exploring the mechanisms behind these differences among adolescents using comprehensive and reliable measures of mediators are lacking. The aims of this study were (a) to assess the psychometric properties of new scales assessing the perceived rules and accessibility related to the consumption of vegetables and soft drinks and (b) to explore their mediating role in the association between parental education and the corresponding dietary behaviors. METHODS: A cross-sectional survey including 440 adolescents from three counties in Norway (mean age 14.3 years (SD = 0.6)) was conducted using a web-based questionnaire. Principal component analysis, test-retest and internal reliability analysis were conducted. The mediating role of perceived accessibility and perceived rules in the association between parental education and the dietary behaviors was explored using linear regression analyses. RESULTS: Factor analyses confirmed two separate subscales, named "accessibility" and "rules", both for vegetables and soft drinks (factor loadings >0.60). The scales had good internal consistency reliability (0.70-0.87). The test-retest reliability of the scales was moderate to good (0.44-0.62). Parental education was inversely related to the consumption of soft drinks and positively related to the consumption of vegetables. Perceived accessibility and perceived rules related to soft drink consumption were found to mediate the association between parental education and soft drink consumption (47.5 and 8.5 % of total effect mediated). Accessibility of vegetables was found to mediate the association between parental education and the consumption of vegetables (51 % of total effect mediated). CONCLUSION: The new scales developed in this study are comprehensive and have adequate validity and reliability; they are therefore considered appropriate for use among 13-15 year-olds. Parents, in particular those with a low educational background, should be encouraged to increase the accessibility of vegetables and to decrease the accessibility of soft drinks, in particular during dinner. Enforcing parental rules limiting soft drink intake in families with low parental education also appears relevant.

Adolescent impulsivity and soft drink consumption: The role of parental regulation.

The present study aimed to explore the process in which impulsivity might influence soft drink consumption in adolescents, addressing potential mediating effects of perceived parental regulation regarding unhealthy eating. A cross-sectional survey was performed among 440 13-15-year-olds in Eastern Norway. The survey questionnaire included measures of impulsivity, six types of maternal and paternal regulation (as perceived by the adolescents), and consumption of sugar-sweetened beverages (SSB). Parallel multiple-mediator analyses were performed to reveal potential mediating effects of perceived parental regulatory behaviors on the association between adolescent impulsivity and SSB consumption. Separate models were run for maternal and paternal regulation. Results from our model analyses (both maternal and paternal models) indicated that all the six measured parental regulatory behaviors jointly acted as mediators on the association between adolescent impulsivity and SSB consumption. However, only perceived maternal and paternal legitimacy of regulation showed a unique contribution to the mediated effect. This finding suggests that adolescents' perception of parental legitimate authority is of particular importance in explaining the relationship between impulsivity and unhealthy eating behaviors in adolescents. Future nutrition interventions targeting adolescents and their parents should take personal factors such as adolescents' level of impulsivity into account. Ultimately; what may be an appropriate approach to impulsive individuals and their parents may diverge from what may be an appropriate approach to less impulsive individuals and their parents.

Development of family and dietary habits questionnaires: the assessment of family processes, dietary habits and adolescents' impulsiveness in Norwegian adolescents and their parents.

BACKGROUND: There is a need for valid and comprehensive measures of parental influence on children's energy balance-related behaviours (EBRB). Such measures should be based on a theoretical framework, acknowledging the dynamic and complex nature of interactions occurring within a family. The aim of the Family & Dietary habits (F&D) project was to develop a conceptual framework identifying important and changeable family processes influencing dietary behaviours of 13-15 year olds. A second aim was to develop valid and reliable questionnaires for adolescents and their parents (both mothers and fathers) measuring these processes. METHODS: A stepwise approach was used; (1) preparation of scope and structure, (2) development of the F&D questionnaires, (3) the conducting of pilot studies and (4) the conducting of validation studies (assessing internal reliability, test-retest reliability and confirmatory factor analysis) using data from a cross-sectional study. RESULTS: The conceptual framework includes psychosocial concepts such as family functioning, cohesion, conflicts, communication, work-family stress, parental practices and parental style. The physical characteristics of the home environment include accessibility and availability of different food items, while family meals are the sociocultural setting included. Individual characteristics measured are dietary intake (vegetables and sugar-sweetened beverages) and adolescents' impulsivity. The F&D questionnaires developed were tested in a test-retest (54 adolescents and 44 of their parents) and in a cross-sectional survey including 440 adolescents (13-15 year olds), 242 mothers and 155 fathers. The samples appear to be relatively representative for Norwegian adolescents and parents. For adolescents, mothers and fathers, the test-retest reliability of the dietary intake, frequencies of (family) meals, work-family stress and communication variables was satisfactory (ICC: 0.53-0.99). Barratt Impulsiveness Scale-Brief (BIS-Brief) was included, assessing adolescent's impulsivity. The internal reliability (Cronbach's alphas: 0.77/0.82) and test-retest reliability values (ICC: 0.74/0.77) of BIS-Brief were good. CONCLUSIONS: The conceptual framework developed may be a useful tool in guiding measurement and assessment of the home food environment and family processes related to adolescents' dietary habits, in particular and for EBRBs more generally. The results support the use of the F&D questionnaires as psychometrically sound tools to assess family characteristics and adolescent's impulsivity.

Parental food-related behaviors and family meal frequencies: associations in Norwegian dyads of parents and preadolescent children.

BACKGROUND: Frequent family meals are associated with healthy dietary behaviors and other desirable outcomes in children and adolescents. Therefore, increased knowledge about factors that may increase the occurrence of family meals is warranted. The present study has its focus on the home food environment, and aims to explore potential associations between parent-reported feeding behaviors and child-reported family meal frequencies. METHODS: Cross-sectional surveys were performed among 10-12-year-olds and their parents recruited from eighteen schools in southwest Norway. The child questionnaire included measures of family meal frequencies (breakfast, dinner and supper). The parent questionnaire included measures of parental feeding behaviors adapted from the Comprehensive Feeding Practices Questionnaire. A series of multiple linear regression analyses were conducted to examine the relationships between parental feeding behaviors and the frequency of family meals. RESULTS: The frequency of family breakfasts was associated with three parental feeding variables; home environment (ß=.11, p<.05), pressure to eat (ß=.11, p<.01), and monitoring (ß=.10, p<.05). The frequency of family dinners and suppers was associated with one parental feeding variable; home environment (ß=.11, p<.01 and ß=.12, p<.01 for dinners and suppers respectively). CONCLUSIONS: The home environment variable was the most important correlate of child-reported family meal frequencies in this study. Although further research is needed, our findings support the evident influence of parents and the home food environment on child and adolescent eating behavior, which in the present study was measured as the frequency of shared family meals.

Associations between parental feeding practices and child vegetable consumption. Mediation by child cognitions?

The present study aimed to explore the process in which parental food-related behaviors might influence preadolescent children's vegetable consumption, addressing potential mediating effects of child cognitions. Cross-sectional surveys were performed among 10-12-year-olds and their parents. The child questionnaire included measures of vegetable consumption and child cognitions related to vegetable consumption (i.e. attitudes, social influence, self-efficacy and intention). The parent questionnaire included measures of parental feeding practices adapted from the Comprehensive Feeding Practices Questionnaire. Stepwise regressions were performed to reveal potential mediating effects of child cognitions on the associations between parental feeding practices and child vegetable consumption. Our results suggested a mediating effect of child self-efficacy on the association between parental restrictive behavior and child vegetable consumption. Other potential mediating effects were not supported in this study.

Child consumption of fruit and vegetables: the roles of child cognitions and parental feeding practices.

OBJECTIVE: To examine the roles of child cognitions and parental feeding practices in explaining child intentions and behaviour regarding fruit and vegetable consumption. DESIGN: Cross-sectional surveys among pre-adolescent children and their parents. SETTING: The child questionnaire included measures of fruit and vegetable consumption and cognitions regarding fruit and vegetable consumption as postulated by the Attitude-Social Influence-Self-Efficacy (ASE) model. The parent questionnaire included measures of parental feeding practices derived from the Comprehensive Feeding Practices Questionnaire (CFPQ). SUBJECTS: In total, 963 parents and 796 students in grades 5 and 6 from eighteen schools in the south-western part of Norway participated. RESULTS: A large portion of child intention to eat fruit and child fruit consumption was explained by child cognitions (29 % and 25 %, respectively). This also applied to child intention to eat vegetables and child vegetable consumption (42 % and 27 %, respectively). Parent-reported feeding practices added another 3 % to the variance explained for child intention to eat fruit and 4 % to the variance explained for child vegetable consumption. CONCLUSIONS: The results from the present study supported the application of the ASE model for explaining the variance in child intentions to eat fruit and vegetables and in child consumption of fruit and vegetables. Furthermore, our findings indicated that some parental feeding practices do have an influence on child intentions and behaviour regarding fruit and vegetable consumption. However, the role of parental feeding practices, and the pathways between feeding practices and child eating intentions and behaviour, needs to be further investigated.

Validation of the Comprehensive Feeding Practices Questionnaire with parents of 10-to-12-year-olds.

BACKGROUND: There is a lack of validated instruments for quantifying feeding behavior among parents of older children and adolescents. The Comprehensive Feeding Practices Questionnaire (CFPQ) is a self-report measure to assess multiple parental feeding practices. The CFPQ is originally designed for use with parents of children ranging in age from about 2 to 8 years. It is previously validated with American and French parents of children within this age range. The aim of the present study was to adapt and test the validity of this measure with parents of older children (10-to-12-year-olds) in a Norwegian setting. METHODS: A sample of 963 parents of 10-to-12-year-olds completed a Norwegian, slightly adapted version of the CFPQ. Scale analyses were performed to test the validity of the instrument in our sample. RESULTS: Although a few problematic items and scales were revealed, scale analyses showed that the psychometric properties of the slightly adapted, Norwegian version of the CFPQ were surprisingly similar to those of the original CFPQ. CONCLUSIONS: Our results indicated that the CFPQ, with some small modifications, is a valid tool for measuring multiple parental feeding practices with parents of 10-to 12-year-olds.

Promotion and Prevention Focused Feeding Strategies: Exploring the Effects on Healthy and Unhealthy Child Eating.

There is a general lack of research addressing the motivations behind parental use of various feeding practices. Therefore, the present work aims to extend the current literature on parent-child feeding interactions by integrating the traditional developmental psychological perspective on feeding practices with elements of Regulatory Focus Theory (RFT) derived from the field of motivational psychology. In this paper, we seek to explain associations between parental feeding practices and child (un)healthy eating behaviors by categorizing parental feeding practices into promotion and prevention focused strategies, thus exploring parent-child feeding interactions within the framework of RFT. Our analyses partly supported the idea that (1) child healthy eating is positively associated with feeding practices characterized as promotion focused, and (2) child unhealthy eating is negatively associated with feeding practices characterized as prevention focused. However, a general observation following from our results suggests that parents' major driving forces behind reducing children's consumption of unhealthy food items and increasing their consumption of healthy food items are strategies that motivate rather than restrict. In particular, parents' provision of a healthy home food environment seems to be essential for child eating.