Sheryl Hughes | Baylor College of Medicine (original) (raw)
Papers by Sheryl Hughes
Childhood obesity (Print), Jan 23, 2016
Maternal depressive symptoms and perceptions of child difficulty are associated with negative eff... more Maternal depressive symptoms and perceptions of child difficulty are associated with negative effects on general development and cognitive functioning in children. The study examined associations between maternal depressive symptoms, perceptions of child difficulty, and maternal feeding behaviors in a population at elevated risk for childhood obesity. Participants were 138 low-income black and Hispanic mothers and their children (ages 3-5) participating in an observational study of mealtimes among Head Start families. Three dinnertime observations were conducted over 2 weeks on each family and audio/videotaped for coding. Coding included eating influence attempts and other food- and nonfood-related interactions exhibited by the mother during dinner. Mothers completed questionnaires on depressive symptoms and perceptions of child difficulty. Linear regressions were conducted, examining associations between maternal depressive symptoms, perceptions of child difficulty, and coded paren...
Appetite, Dec 9, 2016
The current study examined the relationships between the specific strategies that preschool child... more The current study examined the relationships between the specific strategies that preschool children use to regulate their emotions and childhood weight status to see if emotion regulation strategies would predict childhood weight status over and above measures of eating self-regulation. 185 4- to 5-year-old Latino children were recruited through Head Start centers in a large city in the southeastern U.S. Children completed both a delay of gratification task (emotion regulation) and an eating in the absence of hunger task (eating regulation). Eating regulation also was assessed by maternal reports. Four emotion regulation strategies were examined in the delay of gratification task: shut out stimuli, prevent movement, distraction, and attention to reward. Hierarchical linear regressions predicting children's weight status showed that both measures of eating regulation negatively predicted child obesity, and the use of prevent movement negatively predicted child obesity. Total wai...
Maternal and child health journal, Jan 21, 2016
Introduction Parents play a key role in the development of eating habits in preschool children, a... more Introduction Parents play a key role in the development of eating habits in preschool children, as they are the food "gatekeepers." Repeated exposure to new foods can improve child food preferences and consumption. The objective of this study was to determine parent feeding strategies used to influence child acceptance of previously rejected foods (PRF). Methods We conducted eighteen focus groups (total participants = 111) with low-income African American and Hispanic parents of preschool children (3- to 5-year-olds) in Texas, Colorado, and Washington. Through thematic analysis, we coded transcripts and analyzed coded quotes to develop dominant emergent themes related to strategies used to overcome children's food refusal. Results We found three major themes in the data: parents most often do not serve PRF; parents value their child eating over liking a food; and parents rarely use the same feeding strategy more than once for a PRF. Desiring to reduce waste and save ti...
BMC public health, Jul 7, 2016
Little is known about patterns in the transition from healthy weight to overweight or obesity dur... more Little is known about patterns in the transition from healthy weight to overweight or obesity during the elementary school years. This study examined whether there were distinct body mass index (BMI) trajectory groups among elementary school children, and predictors of trajectory group membership. This is a secondary analysis of 1651 elementary school children with complete biannual longitudinal data from kindergarten to the beginning of 5(th) grade. Heights and weights were measured by trained school nurses using standard procedures at the beginning and end of each school year for 11 consecutive assessments. Group-based trajectory clustering and multinomial logit modeling were conducted. When using BMIz score, six trajectory groups were identified revealing substantial consistency in BMIz score across time. When using a categorical variable separating overweight/obese children (BMI ≥ 85%ile) from the rest, five developmental trajectories (persistently non-overweight/obese weight: 5...
Appetite, Jan 12, 2016
Parents influence child weight through interactions that shape the development of child eating be... more Parents influence child weight through interactions that shape the development of child eating behaviors. In this study we examined the association between maternal autonomy promoting serving practices and child appetite regulation. We predicted that maternal autonomy promoting serving practices would be positively associated with child appetite regulation. Participants were low-income Latino children-a group at high risk for the development of childhood obesity. A total of 186 low-income Latina mothers and their 4-5 year old children came to a laboratory on two separate days. On the first day, mothers and children chose foods for a meal from a buffet and were audio/videotaped so that maternal autonomy promoting serving practices could be later coded. On the second day, children completed the Eating in the Absence of Hunger (EAH) task to measure child appetite regulation. Mothers also completed the Child Eating Behavior Questionnaire (CEBQ) to measure other aspects of child appetite...
Games for Health Journal, 2016
Background: Player feedback is an important part of serious games, although there is no consensus... more Background: Player feedback is an important part of serious games, although there is no consensus regarding its delivery or optimal content. ''Mommio'' is a serious game designed to help mothers motivate their preschoolers to eat vegetables. The purpose of this study was to assess optimal format and content of player feedback for use in ''Mommio.'' Materials and Methods: The current study posed 36 potential ''Mommio'' gameplay feedback statements to 20 mothers using a Web survey and interview. Mothers were asked about the meaning and helpfulness of each feedback statement. Results: Several themes emerged upon thematic analysis, including identifying an effective alternative in the case of corrective feedback, avoiding vague wording, using succinct and correct grammar, avoiding provocation of guilt, and clearly identifying why players' game choice was correct or incorrect. Conclusions: Guidelines are proposed for future feedback statements.
Nutrition Reviews, 2016
Although research shows that "food parenting practices" can impact children's diet and eating hab... more Although research shows that "food parenting practices" can impact children's diet and eating habits, current understanding of the impact of specific practices has been limited by inconsistencies in terminology and definitions. This article represents a critical appraisal of food parenting practices, including clear terminology and definitions, by a working group of content experts. The result of this effort was the development of a content map for future research that presents 3 overarching, higher-order food parenting constructs-coercive control, structure, and autonomy support-as well as specific practice subconstructs. Coercive control includes restriction, pressure to eat, threats and bribes, and using food to control negative emotions. Structure includes rules and limits, limited/guided choices, monitoring, meal-and snacktime routines, modeling, food availability and accessibility, food preparation, and unstructured practices. Autonomy support includes nutrition education, child involvement, encouragement, praise, reasoning, and negotiation. Literature on each construct is reviewed, and directions for future research are offered. Clear terminology and definitions should facilitate cross-study comparisons and minimize conflicting findings resulting from previous discrepancies in construct operationalization.
Public health nutrition, Aug 4, 2015
Habit has been defined as the automatic performance of a usual behaviour. The present paper repor... more Habit has been defined as the automatic performance of a usual behaviour. The present paper reports the relationships of variables from a Model of Goal Directed Behavior to four scales in regard to parents' habits when feeding their children: habit of (i) actively involving child in selection of vegetables; (ii) maintaining a positive vegetable environment; (iii) positive communications about vegetables; and (iv) controlling vegetable practices. We tested the hypothesis that the primary predictor of each habit variable would be the measure of the corresponding parenting practice. Internet survey data from a mostly female sample. Primary analyses employed regression modelling with backward deletion, controlling for demographics and parenting practices behaviour. Houston, Texas, USA. Parents of 307 pre-school (3-5-year-old) children. Three of the four models accounted for about 50 % of the variance in the parenting practices habit scales. Each habit scale was primarily predicted b...
Appetite, 2015
Assessing parent affect is important because studies examining the parent-child dyad have shown t... more Assessing parent affect is important because studies examining the parent-child dyad have shown that parent affect has a profound impact on parent-child interactions and related outcomes. Although some measures that assess general affect during daily lives exist, to date there are only few tools that assess parent affect in the context of feeding. The aim of this study was to develop an instrument to measure parent affect specific to the feeding context and determine its validity and reliability. A brief instrument consisting of 20 items was developed that specifically asks how parents feel during the feeding process. This brief instrument draws on the structure of a well-validated general affect measure. A total of 296 Hispanic and Black Head Start parents of preschoolers completed the Feeding Emotions Scale along with other parent-report measures as part of a larger study designed to better understand feeding interactions during the dinner meal. Confirmatory factor analysis supported a two-factor model with independent subscales of positive affect and negative affect (Cronbach's alphas of 0.85 and 0.84, respectively). Concurrent and convergent construct validity was evaluated by correlating the subscales of the Feeding Emotions Scale with positive emotionality and negative emotionality from the Differential Emotions Scale-a measure of general adult emotions. Concurrent and convergent criterion validity was evaluated by testing mean differences in affect across parent feeding styles using ANOVA. A significant difference was found across maternal weight status for positive feeding affect. The resulting validated measure can be used to assess parent affect in studies of feeding to better understand how interactions during feeding may impact the development of child eating behaviors and possibly weight status.
Appetite, 2015
We explored the influence of immigrant mothers feeding style on their children's fruit, vegetable... more We explored the influence of immigrant mothers feeding style on their children's fruit, vegetable and whole grain intake and how this relationship differed by mother's time in the U.S. Baseline data were collected on mother-child (3-12 yrs.) dyads enrolled in Live Well (n=313), a community-based, participatory, randomized controlled lifestyle intervention (2008-2013). Sociodemographics, years of residence in the U.S., behavioral data, and responses to the Caregiver's Feeding Styles Questionnaire (CFSQ) were obtained from the mother. Measured heights and weights were obtained for both mother and child. Child dietary intake was assessed using the Block Food Screener. Separate multiple linear regression models were run, adjusting for child and
Games for Health Journal, 2015
Objective: The purpose of this research is to explore the capacity of story to connect to a healt... more Objective: The purpose of this research is to explore the capacity of story to connect to a health-related videogame, as well as the qualities that may increase efficacy by making the story compelling. Parents of 3-5year-old children often report difficulty getting their children to eat vegetables, which are protective against chronic illnesses. Videogames may be vehicles for training parenting practices for successful vegetable consumption outcomes but often rely on stories to provide context and details. Unfortunately, storytelling may interrupt immersion and player agency. Delivering stories outside of gameplay may provide an understanding of game situations while maintaining immersion. Materials and Methods: Two companion storylines (one a romantic adventure and the other a suspenseful fantasy) were generated for a vegetable parenting game, ''Mommio,'' targeting mothers of preschool children. Mothers of 3-5-year-old children (n = 18) read both storylines and completed semistructured interviews. Results: Mothers preferred the romantic adventure, which featured strong characters, relatable issues, and an engaging plot. Most mothers were interested in playing the ''Mommio'' videogame after reading the stories. Conclusions: Results suggest that it is possible for prose literature to both motivate gameplay and be an immersive narrative companion to, but separate from, games for health. This literature should include engaging, realistic stories and relatable strong characters.
Pediatric Obesity, 2015
The objective of this study was to assess overweight and obesity status transition probabilities ... more The objective of this study was to assess overweight and obesity status transition probabilities using first-order Markov transition models applied to elementary school children. Complete longitudinal data across 11 assessments were available from 1494 elementary school children (from 7599 students in 41 out of 45 schools in a Southeast Texas school district) from kindergarten to the beginning of the fifth grade. Heights and weights were measured by trained school nurses using standard procedures at the beginning and end of each school year for the 11 consecutive assessments. To estimate the transition probabilities, first-order three-state (healthy weight, overweight and obese) Markov transition models were fit to the longitudinal weight status data of all assessment periods. While there was a gradual shift to more children in the overweight or obese category over 5 years, children were most likely to stay in the same weight category as the previous assessment. A consistent seasonal difference in the probability of changing weight status category was seen, with a greater probability of becoming overweight and obese during the summer compared with the school year. The transition probabilities to obesity were higher among boys, Hispanic and non-Hispanic Black, and lower socioeconomic status children. This study provides the first application of a Markov transition model to child weight status data. The transitions into the overweight and obese categories were small, but persistent, with smaller percentages transitioning out of overweight or obese. Early monitoring and summer intervention strategies are needed to prevent the slow, but relentless, transition into the overweight and obese categories.
Childhood obesity (Print), 2013
Childhood obesity is a growing problem. As more researchers become involved in the study of paren... more Childhood obesity is a growing problem. As more researchers become involved in the study of parenting influences on childhood obesity, there appears to be a lack of agreement regarding the most important parenting constructs of interest, definitions of those constructs, and measurement of those constructs in a consistent manner across studies. This article aims to summarize findings from a working group that convened specifically to discuss measurement issues related to parental influences on childhood obesity. Six subgroups were formed to address key measurement issues. The conceptualization subgroup proposed to define and distinguish constructs of general parenting styles, feeding styles, and food parenting practices with the goal of understanding interrelating levels of parental influence on child eating behaviors. The observational subgroup identified the need to map constructs for use in coding direct observations and create observational measures that can capture the bidirecti...
International journal of obesity (2005), 2013
Large portions promote intake among children, but little is known about the external influences o... more Large portions promote intake among children, but little is known about the external influences of the eating environment on children's self-selected portion sizes. This research experimentally tested effects of the amount of entree available and serving spoon size on children's self-served entree portions and intakes at dinner meals. A secondary objective was to identify child and family predictors of self-served entree portion sizes. A 2 × 2 within-subjects design was used, in which the amount of a pasta entree available for self-serving (275 vs 550 g) and the serving spoon size (teaspoon vs tablespoon) were systematically varied. The serving bowl size and portion sizes of all other foods offered were held constant across conditions. Conditions were spaced 1 week apart and randomly assigned. Weighed self-served entree portions and food intakes as well as demographics, maternal feeding styles and child/maternal anthropometrics were measured. Participants were 60 ethnically ...
Journal of Nutrition Education and Behavior, 2014
high fidelity; and the school program with moderate reach, dose, and fidelity. Preliminary findin... more high fidelity; and the school program with moderate reach, dose, and fidelity. Preliminary findings demonstrate significant impacts on psychosocial factors and food-related behaviors. Conclusions and Implications: These findings are being used to disseminate the OPREVENT program to other communities.
International Journal of Behavioral Nutrition and Physical Activity, 2015
Background: Despite a growing consensus on the feeding practices associated with healthy eating p... more Background: Despite a growing consensus on the feeding practices associated with healthy eating patterns, few observational studies of maternal feeding practices with young children have been conducted, especially in low-income populations. The aim of this study was to provide such data on a low income sample to determine the degree to which observed maternal feeding practices compare with current recommendations. Methods: Eighty low-income mothers and their preschool children were videotaped at dinner in their homes. Mothers were chosen from a larger study to create a 2 X 2 X 2 design: maternal ethnicity (African American vs. Latina) by child gender by child weight status (healthy weight vs. overweight/obese). Observers coded videotapes for a range of maternal feeding strategies and other behaviors. Results: Many mothers spent considerable time encouraging eating-often in spite of the child's insistence that he or she was finished. Mothers talked little about food characteristics, rarely referred to feelings of hunger and fullness, and made more attempts to enforce table manners than to teach eating skills. Latina mothers showed higher levels of teaching eating skills and encouraging their children to eat; African American mothers showed higher levels of enforcing table manners and getting children to clear their plates. Mothers of boys used more unelaborated commands and less questions/suggestions than mothers of girls. Finally, compared to mothers of overweight/obese children, mothers of healthy weight children showed higher levels of encouraging eating and lower levels of discouraging eating. Conclusions: Most of the mothers in this study did not engage in feeding practices that are consistent with current recommendations. They did this, despite the fact that they knew they were being observed. These results should be used to inform future research about the motivations behind mothers' feeding practices and the development of interventions by helping identify areas in greatest need of change.
Friend's activity participant-aggregated minutes spent on all trips and vehicle-based trips were ... more Friend's activity participant-aggregated minutes spent on all trips and vehicle-based trips were moderate to strong. However, those related to walking trips and total trips were weak (<.38) and not statistically significant. The average observation-by-observation correspondence between GPS-and diary-based estimates of travel-mode ranged from 87.4% to 97.3% agreement and Kappa statistics ranged from 0.31 to 0.52. Children were significantly more active in parks and less active in restaurants compared with at home, when estimating locations by diaries as well as GPS monitors. Conclusions It is feasible to simultaneously measure and process GPS and accelerometer data on Hispanic-American preschool children. Good between-method correspondence was found for location and moderate correspondence was observed for mode of travel. Location was associated with different activity levels even in this small sample. The simultaneous use of GPS and accelerometers will be used by this team in larger studies to investigate where Hispanic-American preschool children are active. Support/Funding This project was funded by a R21 grant from NIH-NICHD (5R21HD060925).
Journal of Food Research, 2013
This study reports the modeling of three categories of ineffective vegetable parenting practices ... more This study reports the modeling of three categories of ineffective vegetable parenting practices (IVPP) separately (responsive, structure, and control vegetable parenting practices). An internet survey was employed for a cross sectional assessment of parenting practices and cognitive-emotional variables. Parents (n = 307) of preschool children (3-5 years old) were recruited through announcements and postings. Models were analyzed with block regression and backward deletion procedures using IVPP scales as the dependent variables. The independent variables included validated scales from a Model of Goal Directed Vegetable Parenting Practices (MGDVPP), including: intention, habit, perceived barriers, desire, competence, autonomy, relatedness, attitudes, norms, perceived behavioral control, and anticipated emotions. The available scales accounted for 26.5%, 16.7% and 44.6% of the variance in the IVPP responsive, structure and control subscales, respectively. Different sets of diverse variables predicted the three IVPP constructs. Intentions, Habits and Perceived Behavioral Control variables were strong predictors for each of the IVPP constructs, but the subscales were specific to each IVPP construct. Parent emotional responses, an infrequently investigated variable, was an important predictor of ineffective responsive vegetable parenting practices and ineffective structure vegetable parenting practices, but not ineffective control vegetable parenting practices. An Attitude subscale and a Norms subscale predicted ineffective responsive vegetable parenting practices alone. This was the first report of psychometrically tested scales to predict use of IVPP subscales. Further research is needed to verify these findings in larger longitudinal cohorts. Interventions to increase child vegetable intake may have to reduce IVPP. Keywords: ineffective vegetable parenting practices, model of goal directed behavior, vegetable, responsive parenting practices, structure parenting practices, control parenting practices Research suggests parents are important influences on child dietary intake especially in the preschool years (O'Connor et al., 2010). Three categories of food related parenting practices (i.e. parent behaviors intended to influence child food intake) have been broadly conceptualized: structure, demandingness (control), and warmth (responsiveness), and as effective or ineffective practices across those categories (Hughes, O'Connor, & Power, 2008). Effective and ineffective practices loaded independently on separate structures; a three dimensional second level (structure, control and responsiveness) with single dimension first level structure were best fit for www.ccsenet.org/jfr
Journal of the Academy of Nutrition and Dietetics, 2012
Background Evidence-based strategies for promoting vegetable consumption among children are limit... more Background Evidence-based strategies for promoting vegetable consumption among children are limited. Objective To determine the effects of providing a palatable "dip" along with repeated exposure to a raw vegetable on preschoolers' liking and intake. Participants One hundred fifty-two predominately Hispanic preschool-aged children studied in Head Start classrooms in 2008. Design A between-subjects, quasiexperimental design was used. A moderately-liked raw vegetable (broccoli) was offered twice weekly at afternoon snacks for 7 weeks. Classrooms were randomized to receive broccoli in one of four conditions differing in the provision of dip. Bitter taste sensitivity was assessed using 6-n-propylthiouracil. Intervention Broccoli was provided in four conditions: with regular salad dressing as a dip, with a light (reduced energy/fat) version of the dressing as a dip, mixed with the regular dressing as a sauce, or plain (without dressing). Main outcome measures Mean broccoli intake during 7 weeks of exposure and broccoli liking following exposure. Statistical analyses Descriptive statistics were generated. Multilevel models for repeated measures tested effects of condition and bitter sensitivity on mean broccoli intake during exposure and on pre-and post-exposure liking while adjusting for classroom effects and potential covariates. Results The majority of Hispanic preschoolers (70%) showed sensitivity to the bitter taste of 6-n-propylthiouracil. Children's broccoli liking increased following exposure but did not vary by dip condition or bitter sensitivity. Bitter-sensitive children, however, ate 80% more broccoli with dressing than when served plain (PϽ0.001); effects did vary based on whether regular or light dressing was provided as a dip or sauce. Dip did not promote broccoli intake among bitter-insensitive children. Conclusions Providing dip-regular, light, or as a sauceincreased raw broccoli intake among bitter-sensitive Hispanic preschoolers. Findings suggest that offering low-fat dips can promote vegetable intake among some children who are sensitive to bitter tastes.
Childhood obesity (Print), Jan 23, 2016
Maternal depressive symptoms and perceptions of child difficulty are associated with negative eff... more Maternal depressive symptoms and perceptions of child difficulty are associated with negative effects on general development and cognitive functioning in children. The study examined associations between maternal depressive symptoms, perceptions of child difficulty, and maternal feeding behaviors in a population at elevated risk for childhood obesity. Participants were 138 low-income black and Hispanic mothers and their children (ages 3-5) participating in an observational study of mealtimes among Head Start families. Three dinnertime observations were conducted over 2 weeks on each family and audio/videotaped for coding. Coding included eating influence attempts and other food- and nonfood-related interactions exhibited by the mother during dinner. Mothers completed questionnaires on depressive symptoms and perceptions of child difficulty. Linear regressions were conducted, examining associations between maternal depressive symptoms, perceptions of child difficulty, and coded paren...
Appetite, Dec 9, 2016
The current study examined the relationships between the specific strategies that preschool child... more The current study examined the relationships between the specific strategies that preschool children use to regulate their emotions and childhood weight status to see if emotion regulation strategies would predict childhood weight status over and above measures of eating self-regulation. 185 4- to 5-year-old Latino children were recruited through Head Start centers in a large city in the southeastern U.S. Children completed both a delay of gratification task (emotion regulation) and an eating in the absence of hunger task (eating regulation). Eating regulation also was assessed by maternal reports. Four emotion regulation strategies were examined in the delay of gratification task: shut out stimuli, prevent movement, distraction, and attention to reward. Hierarchical linear regressions predicting children's weight status showed that both measures of eating regulation negatively predicted child obesity, and the use of prevent movement negatively predicted child obesity. Total wai...
Maternal and child health journal, Jan 21, 2016
Introduction Parents play a key role in the development of eating habits in preschool children, a... more Introduction Parents play a key role in the development of eating habits in preschool children, as they are the food "gatekeepers." Repeated exposure to new foods can improve child food preferences and consumption. The objective of this study was to determine parent feeding strategies used to influence child acceptance of previously rejected foods (PRF). Methods We conducted eighteen focus groups (total participants = 111) with low-income African American and Hispanic parents of preschool children (3- to 5-year-olds) in Texas, Colorado, and Washington. Through thematic analysis, we coded transcripts and analyzed coded quotes to develop dominant emergent themes related to strategies used to overcome children's food refusal. Results We found three major themes in the data: parents most often do not serve PRF; parents value their child eating over liking a food; and parents rarely use the same feeding strategy more than once for a PRF. Desiring to reduce waste and save ti...
BMC public health, Jul 7, 2016
Little is known about patterns in the transition from healthy weight to overweight or obesity dur... more Little is known about patterns in the transition from healthy weight to overweight or obesity during the elementary school years. This study examined whether there were distinct body mass index (BMI) trajectory groups among elementary school children, and predictors of trajectory group membership. This is a secondary analysis of 1651 elementary school children with complete biannual longitudinal data from kindergarten to the beginning of 5(th) grade. Heights and weights were measured by trained school nurses using standard procedures at the beginning and end of each school year for 11 consecutive assessments. Group-based trajectory clustering and multinomial logit modeling were conducted. When using BMIz score, six trajectory groups were identified revealing substantial consistency in BMIz score across time. When using a categorical variable separating overweight/obese children (BMI ≥ 85%ile) from the rest, five developmental trajectories (persistently non-overweight/obese weight: 5...
Appetite, Jan 12, 2016
Parents influence child weight through interactions that shape the development of child eating be... more Parents influence child weight through interactions that shape the development of child eating behaviors. In this study we examined the association between maternal autonomy promoting serving practices and child appetite regulation. We predicted that maternal autonomy promoting serving practices would be positively associated with child appetite regulation. Participants were low-income Latino children-a group at high risk for the development of childhood obesity. A total of 186 low-income Latina mothers and their 4-5 year old children came to a laboratory on two separate days. On the first day, mothers and children chose foods for a meal from a buffet and were audio/videotaped so that maternal autonomy promoting serving practices could be later coded. On the second day, children completed the Eating in the Absence of Hunger (EAH) task to measure child appetite regulation. Mothers also completed the Child Eating Behavior Questionnaire (CEBQ) to measure other aspects of child appetite...
Games for Health Journal, 2016
Background: Player feedback is an important part of serious games, although there is no consensus... more Background: Player feedback is an important part of serious games, although there is no consensus regarding its delivery or optimal content. ''Mommio'' is a serious game designed to help mothers motivate their preschoolers to eat vegetables. The purpose of this study was to assess optimal format and content of player feedback for use in ''Mommio.'' Materials and Methods: The current study posed 36 potential ''Mommio'' gameplay feedback statements to 20 mothers using a Web survey and interview. Mothers were asked about the meaning and helpfulness of each feedback statement. Results: Several themes emerged upon thematic analysis, including identifying an effective alternative in the case of corrective feedback, avoiding vague wording, using succinct and correct grammar, avoiding provocation of guilt, and clearly identifying why players' game choice was correct or incorrect. Conclusions: Guidelines are proposed for future feedback statements.
Nutrition Reviews, 2016
Although research shows that "food parenting practices" can impact children's diet and eating hab... more Although research shows that "food parenting practices" can impact children's diet and eating habits, current understanding of the impact of specific practices has been limited by inconsistencies in terminology and definitions. This article represents a critical appraisal of food parenting practices, including clear terminology and definitions, by a working group of content experts. The result of this effort was the development of a content map for future research that presents 3 overarching, higher-order food parenting constructs-coercive control, structure, and autonomy support-as well as specific practice subconstructs. Coercive control includes restriction, pressure to eat, threats and bribes, and using food to control negative emotions. Structure includes rules and limits, limited/guided choices, monitoring, meal-and snacktime routines, modeling, food availability and accessibility, food preparation, and unstructured practices. Autonomy support includes nutrition education, child involvement, encouragement, praise, reasoning, and negotiation. Literature on each construct is reviewed, and directions for future research are offered. Clear terminology and definitions should facilitate cross-study comparisons and minimize conflicting findings resulting from previous discrepancies in construct operationalization.
Public health nutrition, Aug 4, 2015
Habit has been defined as the automatic performance of a usual behaviour. The present paper repor... more Habit has been defined as the automatic performance of a usual behaviour. The present paper reports the relationships of variables from a Model of Goal Directed Behavior to four scales in regard to parents' habits when feeding their children: habit of (i) actively involving child in selection of vegetables; (ii) maintaining a positive vegetable environment; (iii) positive communications about vegetables; and (iv) controlling vegetable practices. We tested the hypothesis that the primary predictor of each habit variable would be the measure of the corresponding parenting practice. Internet survey data from a mostly female sample. Primary analyses employed regression modelling with backward deletion, controlling for demographics and parenting practices behaviour. Houston, Texas, USA. Parents of 307 pre-school (3-5-year-old) children. Three of the four models accounted for about 50 % of the variance in the parenting practices habit scales. Each habit scale was primarily predicted b...
Appetite, 2015
Assessing parent affect is important because studies examining the parent-child dyad have shown t... more Assessing parent affect is important because studies examining the parent-child dyad have shown that parent affect has a profound impact on parent-child interactions and related outcomes. Although some measures that assess general affect during daily lives exist, to date there are only few tools that assess parent affect in the context of feeding. The aim of this study was to develop an instrument to measure parent affect specific to the feeding context and determine its validity and reliability. A brief instrument consisting of 20 items was developed that specifically asks how parents feel during the feeding process. This brief instrument draws on the structure of a well-validated general affect measure. A total of 296 Hispanic and Black Head Start parents of preschoolers completed the Feeding Emotions Scale along with other parent-report measures as part of a larger study designed to better understand feeding interactions during the dinner meal. Confirmatory factor analysis supported a two-factor model with independent subscales of positive affect and negative affect (Cronbach's alphas of 0.85 and 0.84, respectively). Concurrent and convergent construct validity was evaluated by correlating the subscales of the Feeding Emotions Scale with positive emotionality and negative emotionality from the Differential Emotions Scale-a measure of general adult emotions. Concurrent and convergent criterion validity was evaluated by testing mean differences in affect across parent feeding styles using ANOVA. A significant difference was found across maternal weight status for positive feeding affect. The resulting validated measure can be used to assess parent affect in studies of feeding to better understand how interactions during feeding may impact the development of child eating behaviors and possibly weight status.
Appetite, 2015
We explored the influence of immigrant mothers feeding style on their children's fruit, vegetable... more We explored the influence of immigrant mothers feeding style on their children's fruit, vegetable and whole grain intake and how this relationship differed by mother's time in the U.S. Baseline data were collected on mother-child (3-12 yrs.) dyads enrolled in Live Well (n=313), a community-based, participatory, randomized controlled lifestyle intervention (2008-2013). Sociodemographics, years of residence in the U.S., behavioral data, and responses to the Caregiver's Feeding Styles Questionnaire (CFSQ) were obtained from the mother. Measured heights and weights were obtained for both mother and child. Child dietary intake was assessed using the Block Food Screener. Separate multiple linear regression models were run, adjusting for child and
Games for Health Journal, 2015
Objective: The purpose of this research is to explore the capacity of story to connect to a healt... more Objective: The purpose of this research is to explore the capacity of story to connect to a health-related videogame, as well as the qualities that may increase efficacy by making the story compelling. Parents of 3-5year-old children often report difficulty getting their children to eat vegetables, which are protective against chronic illnesses. Videogames may be vehicles for training parenting practices for successful vegetable consumption outcomes but often rely on stories to provide context and details. Unfortunately, storytelling may interrupt immersion and player agency. Delivering stories outside of gameplay may provide an understanding of game situations while maintaining immersion. Materials and Methods: Two companion storylines (one a romantic adventure and the other a suspenseful fantasy) were generated for a vegetable parenting game, ''Mommio,'' targeting mothers of preschool children. Mothers of 3-5-year-old children (n = 18) read both storylines and completed semistructured interviews. Results: Mothers preferred the romantic adventure, which featured strong characters, relatable issues, and an engaging plot. Most mothers were interested in playing the ''Mommio'' videogame after reading the stories. Conclusions: Results suggest that it is possible for prose literature to both motivate gameplay and be an immersive narrative companion to, but separate from, games for health. This literature should include engaging, realistic stories and relatable strong characters.
Pediatric Obesity, 2015
The objective of this study was to assess overweight and obesity status transition probabilities ... more The objective of this study was to assess overweight and obesity status transition probabilities using first-order Markov transition models applied to elementary school children. Complete longitudinal data across 11 assessments were available from 1494 elementary school children (from 7599 students in 41 out of 45 schools in a Southeast Texas school district) from kindergarten to the beginning of the fifth grade. Heights and weights were measured by trained school nurses using standard procedures at the beginning and end of each school year for the 11 consecutive assessments. To estimate the transition probabilities, first-order three-state (healthy weight, overweight and obese) Markov transition models were fit to the longitudinal weight status data of all assessment periods. While there was a gradual shift to more children in the overweight or obese category over 5 years, children were most likely to stay in the same weight category as the previous assessment. A consistent seasonal difference in the probability of changing weight status category was seen, with a greater probability of becoming overweight and obese during the summer compared with the school year. The transition probabilities to obesity were higher among boys, Hispanic and non-Hispanic Black, and lower socioeconomic status children. This study provides the first application of a Markov transition model to child weight status data. The transitions into the overweight and obese categories were small, but persistent, with smaller percentages transitioning out of overweight or obese. Early monitoring and summer intervention strategies are needed to prevent the slow, but relentless, transition into the overweight and obese categories.
Childhood obesity (Print), 2013
Childhood obesity is a growing problem. As more researchers become involved in the study of paren... more Childhood obesity is a growing problem. As more researchers become involved in the study of parenting influences on childhood obesity, there appears to be a lack of agreement regarding the most important parenting constructs of interest, definitions of those constructs, and measurement of those constructs in a consistent manner across studies. This article aims to summarize findings from a working group that convened specifically to discuss measurement issues related to parental influences on childhood obesity. Six subgroups were formed to address key measurement issues. The conceptualization subgroup proposed to define and distinguish constructs of general parenting styles, feeding styles, and food parenting practices with the goal of understanding interrelating levels of parental influence on child eating behaviors. The observational subgroup identified the need to map constructs for use in coding direct observations and create observational measures that can capture the bidirecti...
International journal of obesity (2005), 2013
Large portions promote intake among children, but little is known about the external influences o... more Large portions promote intake among children, but little is known about the external influences of the eating environment on children's self-selected portion sizes. This research experimentally tested effects of the amount of entree available and serving spoon size on children's self-served entree portions and intakes at dinner meals. A secondary objective was to identify child and family predictors of self-served entree portion sizes. A 2 × 2 within-subjects design was used, in which the amount of a pasta entree available for self-serving (275 vs 550 g) and the serving spoon size (teaspoon vs tablespoon) were systematically varied. The serving bowl size and portion sizes of all other foods offered were held constant across conditions. Conditions were spaced 1 week apart and randomly assigned. Weighed self-served entree portions and food intakes as well as demographics, maternal feeding styles and child/maternal anthropometrics were measured. Participants were 60 ethnically ...
Journal of Nutrition Education and Behavior, 2014
high fidelity; and the school program with moderate reach, dose, and fidelity. Preliminary findin... more high fidelity; and the school program with moderate reach, dose, and fidelity. Preliminary findings demonstrate significant impacts on psychosocial factors and food-related behaviors. Conclusions and Implications: These findings are being used to disseminate the OPREVENT program to other communities.
International Journal of Behavioral Nutrition and Physical Activity, 2015
Background: Despite a growing consensus on the feeding practices associated with healthy eating p... more Background: Despite a growing consensus on the feeding practices associated with healthy eating patterns, few observational studies of maternal feeding practices with young children have been conducted, especially in low-income populations. The aim of this study was to provide such data on a low income sample to determine the degree to which observed maternal feeding practices compare with current recommendations. Methods: Eighty low-income mothers and their preschool children were videotaped at dinner in their homes. Mothers were chosen from a larger study to create a 2 X 2 X 2 design: maternal ethnicity (African American vs. Latina) by child gender by child weight status (healthy weight vs. overweight/obese). Observers coded videotapes for a range of maternal feeding strategies and other behaviors. Results: Many mothers spent considerable time encouraging eating-often in spite of the child's insistence that he or she was finished. Mothers talked little about food characteristics, rarely referred to feelings of hunger and fullness, and made more attempts to enforce table manners than to teach eating skills. Latina mothers showed higher levels of teaching eating skills and encouraging their children to eat; African American mothers showed higher levels of enforcing table manners and getting children to clear their plates. Mothers of boys used more unelaborated commands and less questions/suggestions than mothers of girls. Finally, compared to mothers of overweight/obese children, mothers of healthy weight children showed higher levels of encouraging eating and lower levels of discouraging eating. Conclusions: Most of the mothers in this study did not engage in feeding practices that are consistent with current recommendations. They did this, despite the fact that they knew they were being observed. These results should be used to inform future research about the motivations behind mothers' feeding practices and the development of interventions by helping identify areas in greatest need of change.
Friend's activity participant-aggregated minutes spent on all trips and vehicle-based trips were ... more Friend's activity participant-aggregated minutes spent on all trips and vehicle-based trips were moderate to strong. However, those related to walking trips and total trips were weak (<.38) and not statistically significant. The average observation-by-observation correspondence between GPS-and diary-based estimates of travel-mode ranged from 87.4% to 97.3% agreement and Kappa statistics ranged from 0.31 to 0.52. Children were significantly more active in parks and less active in restaurants compared with at home, when estimating locations by diaries as well as GPS monitors. Conclusions It is feasible to simultaneously measure and process GPS and accelerometer data on Hispanic-American preschool children. Good between-method correspondence was found for location and moderate correspondence was observed for mode of travel. Location was associated with different activity levels even in this small sample. The simultaneous use of GPS and accelerometers will be used by this team in larger studies to investigate where Hispanic-American preschool children are active. Support/Funding This project was funded by a R21 grant from NIH-NICHD (5R21HD060925).
Journal of Food Research, 2013
This study reports the modeling of three categories of ineffective vegetable parenting practices ... more This study reports the modeling of three categories of ineffective vegetable parenting practices (IVPP) separately (responsive, structure, and control vegetable parenting practices). An internet survey was employed for a cross sectional assessment of parenting practices and cognitive-emotional variables. Parents (n = 307) of preschool children (3-5 years old) were recruited through announcements and postings. Models were analyzed with block regression and backward deletion procedures using IVPP scales as the dependent variables. The independent variables included validated scales from a Model of Goal Directed Vegetable Parenting Practices (MGDVPP), including: intention, habit, perceived barriers, desire, competence, autonomy, relatedness, attitudes, norms, perceived behavioral control, and anticipated emotions. The available scales accounted for 26.5%, 16.7% and 44.6% of the variance in the IVPP responsive, structure and control subscales, respectively. Different sets of diverse variables predicted the three IVPP constructs. Intentions, Habits and Perceived Behavioral Control variables were strong predictors for each of the IVPP constructs, but the subscales were specific to each IVPP construct. Parent emotional responses, an infrequently investigated variable, was an important predictor of ineffective responsive vegetable parenting practices and ineffective structure vegetable parenting practices, but not ineffective control vegetable parenting practices. An Attitude subscale and a Norms subscale predicted ineffective responsive vegetable parenting practices alone. This was the first report of psychometrically tested scales to predict use of IVPP subscales. Further research is needed to verify these findings in larger longitudinal cohorts. Interventions to increase child vegetable intake may have to reduce IVPP. Keywords: ineffective vegetable parenting practices, model of goal directed behavior, vegetable, responsive parenting practices, structure parenting practices, control parenting practices Research suggests parents are important influences on child dietary intake especially in the preschool years (O'Connor et al., 2010). Three categories of food related parenting practices (i.e. parent behaviors intended to influence child food intake) have been broadly conceptualized: structure, demandingness (control), and warmth (responsiveness), and as effective or ineffective practices across those categories (Hughes, O'Connor, & Power, 2008). Effective and ineffective practices loaded independently on separate structures; a three dimensional second level (structure, control and responsiveness) with single dimension first level structure were best fit for www.ccsenet.org/jfr
Journal of the Academy of Nutrition and Dietetics, 2012
Background Evidence-based strategies for promoting vegetable consumption among children are limit... more Background Evidence-based strategies for promoting vegetable consumption among children are limited. Objective To determine the effects of providing a palatable "dip" along with repeated exposure to a raw vegetable on preschoolers' liking and intake. Participants One hundred fifty-two predominately Hispanic preschool-aged children studied in Head Start classrooms in 2008. Design A between-subjects, quasiexperimental design was used. A moderately-liked raw vegetable (broccoli) was offered twice weekly at afternoon snacks for 7 weeks. Classrooms were randomized to receive broccoli in one of four conditions differing in the provision of dip. Bitter taste sensitivity was assessed using 6-n-propylthiouracil. Intervention Broccoli was provided in four conditions: with regular salad dressing as a dip, with a light (reduced energy/fat) version of the dressing as a dip, mixed with the regular dressing as a sauce, or plain (without dressing). Main outcome measures Mean broccoli intake during 7 weeks of exposure and broccoli liking following exposure. Statistical analyses Descriptive statistics were generated. Multilevel models for repeated measures tested effects of condition and bitter sensitivity on mean broccoli intake during exposure and on pre-and post-exposure liking while adjusting for classroom effects and potential covariates. Results The majority of Hispanic preschoolers (70%) showed sensitivity to the bitter taste of 6-n-propylthiouracil. Children's broccoli liking increased following exposure but did not vary by dip condition or bitter sensitivity. Bitter-sensitive children, however, ate 80% more broccoli with dressing than when served plain (PϽ0.001); effects did vary based on whether regular or light dressing was provided as a dip or sauce. Dip did not promote broccoli intake among bitter-insensitive children. Conclusions Providing dip-regular, light, or as a sauceincreased raw broccoli intake among bitter-sensitive Hispanic preschoolers. Findings suggest that offering low-fat dips can promote vegetable intake among some children who are sensitive to bitter tastes.