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Obesity prevention interventions have been designed to promote responsive feeding in early childhood. However, existing interventions primarily target first-time mothers without considering the complexities of feeding multiple children within a family unit. By applying principles of Constructivist Grounded Theory (CGT), this study aimed to explore how mealtimes are enacted in families with more than one child. A mixed- methods study was conducted with parent-sibling triads (n = 18 families) in South East Queensland, Australia. Data included direct mealtime observations, semistructured interviews, field notes, and memos. Data were analysed using open and focused coding, during which constant comparative analysis was applied. The sample comprised of two- parent families with children ranging in age from 12 to 70 months (median sibling age difference = 24 months). A conceptual model was developed to map sibling-related processes integral to the enactment of mealtimes in families. Notably, this model captured feeding practices used by siblings, such as pressure to eat and overt restriction, that previously had only been described in parents. It also documented feeding practices used by parents that may occur only in the presence of a sibling, such as leveraging sibling competitiveness and rewarding a child to vicariously condition their sibling's behaviour. The conceptual model demonstrates complexities in feeding that give shape to the overall family food environment. Findings from this study can inform the design of early feeding interventions that support parents to remain responsive, particularly when their perceptions and expectations of siblings differ. [ABSTRACT FROM AUTHOR]

Research on feeding in early childhood has focused primarily on parent–child dyadic interactions, despite parents enacting these practices within the complex dynamic of the family system. Using a sibling design, this study aimed to assess how parents may adapt their food parenting practices for siblings in response to differences in their eating behaviors. A cross-sectional online survey was conducted between October and December 2022. Data were collected from parents (97.5% women) in Australia with 2 children aged 2 to 5 years (n = 336 parents and n = 672 children). Survey items were completed for each sibling, and included four subscales of the Children's Eating Behaviour Questionnaire and seven subscales of the Feeding Practices and Structure Questionnaire-28. Multiple linear regression models examined associations between within-sibling pair differences in child eating behaviors and food parenting practices, adjusting for differences in child body mass index z score, age, gender, and early feeding method. Within-sibling pair differences in eating behaviors were associated with differences in some food parenting practices. For the fussier sibling, parents reported using more control-based practices, including persuasive feeding, reward for eating, and reward for behavior, and less of the structure-based practice, family meal settings (P values < 0.001). Similar directions of associations were found for persuasive feeding, reward for eating, and family meal settings with siblings who were slower eaters or more satiety responsive (P values < 0.007); however, no significant differences in reward for behavior were observed in relation to sibling differences in these eating behaviors. For the more food responsive sibling, parents reported using more control-based practices, including reward for behavior and overt restriction (P values < 0.002). Within families, parents may adapt certain practices in response to differences in their children's eating behaviors. Interventions promoting responsive feeding should be designed to acknowledge the integral role of siblings in shaping parents' feeding decisions. [ABSTRACT FROM AUTHOR]

This study examines how fathers negotiate the role of feeding with other family members, and how this both impacts and is shaped by the structure of mealtimes. Six separate focus groups. South East Queensland, Australia. Fathers (N = 27) of children aged ≤12 years employed in blue-collar occupations or service industries. Fathers' perceptions of their role in family feeding. Grounded theory. Two major themes were identified: (1) mealtime structure , reflecting various arrangements and management procedures that give ultimate shape to mealtimes; and (2) division of labor , reflecting the work required to bring about such arrangements and how this work is allocated. These themes were interrelated and harmonized to create family mealtimes. Fathers felt that labor was assigned pragmatically; designated roles around feeding within the family facilitated structured mealtimes. Fathers' roles in balancing the labor and structured mealtimes to feed the family require further research attention, particularly across different family structures, to enhance their engagement in and contribution to the family meal environment. Offering cooking programs and meal planning education to fathers may support them in their different roles and enhance efficiency. [ABSTRACT FROM AUTHOR]

Objective: Determine whether feeding practices across mothers and fathers are interpreted and measured with equivalent accuracy (measurement invariance) using the Feeding Practices and Structure Questionnaire-28 (FPSQ-28).Design: Cross-sectional hard-copy and online survey design; Setting: Socioeconomically disadvantaged community in Queensland, Australia.Participants: Mothers (n = 279) and fathers (n = 225) of 2- to 5-year old children.Variables Measured: Parental feeding practices were measured using the 7 multi-item factors from the FPSQ-28.Analysis: Confirmatory factor analysis (CFA) was applied to evaluate the factor structure of the FPSQ-28 among mothers and fathers from a socioeconomically disadvantaged community. Measurement invariance between mothers and fathers was examined using hierarchical multi-group CFAs.Results: The 7-factor FPSQ-28 model showed good fit and was invariant across parent gender.Conclusions and Implications: The FPSQ-28 subscales appear to be interpreted equivalently, and thus to measure the same constructs, irrespective of the gender of the parents. The questionnaire can be used to measure or compare mothers' and fathers' self-reported feeding practices and examine influence on child health outcomes. In the current sample of mothers and fathers recruited from a socioeconomically disadvantaged community, mothers used more 'covert restriction' than fathers. [ABSTRACT FROM AUTHOR]

Over the last decade, there have been repeated calls to expand the operationalisation of food parenting practices. The conceptualisation and measurement of these practices has been based primarily on research with parent-child dyads. One unexplored dimension of food parenting pertains to the evaluation of practices specific to feeding siblings. This study describes the development and validation of the Feeding Siblings Questionnaire (FSQ) – a tool designed to measure practices in which siblings are positioned as mediators in parents' attempts to prompt or persuade a child to eat. Item development was guided by a conceptual model derived from mixed-methods research and refined through expert reviews and cognitive interviews. These interviews were conducted in two phases, where parents responded to the questionnaire primarily to test i) the readability and relevance of each item, and ii) its overall feasibility. The instrument was completed by 330 parents (96.1% mothers) in Australia with two children aged 2–5 years, and repeated by 133 parents (40.3%) two weeks later. Exploratory factor analysis was performed on baseline data. Internal consistency and test re-test reliability of the subsequent subscales were examined. Construct validity was assessed through comparisons with existing measures of food parenting practices and child eating behaviours. The final FSQ scale included 22 items, reflecting five food parenting practices: sibling competitiveness, active sibling influence, threatening unequal division of food, sibling role modelling, and vicarious operant conditioning. Internal consistency and test re-test reliability estimates were high, and there was some evidence of convergent construct validity. While its factor structure should be confirmed in a different sample, the FSQ offers a novel tool for assessing, monitoring, and evaluating feeding interactions beyond those confined to the parent-child dyad. [ABSTRACT FROM AUTHOR]

Fussy eating is a nuanced, mealtime-specific behaviour associated with difficult temperament but has been rarely examined within the context of mealtime structure. The aim of this study was to a) examine associations between child temperament, and mothers' and fathers' structure-related feeding practices and b) explore whether these associations were mediated by child fussy eating. Cohabiting mother-father pairs (N = 205) of children aged between 2- to 5-years residing in a socioeconomically disadvantaged Australian city completed self-reported, validated measures of child temperament, food fussiness and structure-related feeding practices (structured meal timing, structured meal setting and family meal setting). Child temperament was associated with maternal and paternal structure-related feeding practices, such that more difficult temperament was associated with less mealtime structure. Mothers' perception of child food fussiness mediated the relationship between difficult temperament and increased provision of alternative meals to the child from the rest of the family. Additionally, mothers' and fathers' perception of child food fussiness mediated the relationship between difficult child temperament and lower frequency of sitting at a table together for family meals. Therefore, perceptions of child food fussiness may explain why mothers and fathers use less structure at mealtimes with children who have more difficult temperaments. These results suggests that similar intervention approaches can be used for both mothers and fathers from socioeconomically disadvantaged families to target fussy eating and structure the mealtime environment. Promoting mealtime structure to facilitate parents' appropriate responses to food refusal or difficult behaviour at mealtimes is indicated. [ABSTRACT FROM AUTHOR]

Background: Recovery Colleges (RCs) are education-based centres providing information, networking, and skills development for managing mental health, well-being, and daily living. A central principle is co-creation involving people with lived experience of mental health/illness and/or addictions (MHA). Identified gaps are RCs evaluations and information about whether such evaluations are co-created., Aims: We describe a co-created scoping review of how RCs are evaluated in the published and grey literature. Also assessed were: the frameworks, designs, and analyses used; the themes/outcomes reported; the trustworthiness of the evidence; and whether the evaluations are co-created., Methods: We followed Arksey and O'Malley's methodology with one important modification: "Consultation" was re-conceptualised as "co-creator engagement" and was the first, foundational step rather than the last, optional one., Results: Seventy-nine percent of the 43 included evaluations were peer-reviewed, 21% grey literature. These evaluations represented 33 RCs located in the UK (58%), Australia (15%), Canada (9%), Ireland (9%), the USA (6%), and Italy (3%)., Conclusion: Our findings depict a developing field that is exploring a mix of evaluative approaches. However, few evaluations appeared to be co-created. Although most studies referenced co-design/co-production, few described how much or how meaningfully people with lived experience were involved in the evaluation.

Background: Across developed economies, most children attend early childhood education and care (ECEC) programs attending up to 10,000 h prior to school. These programs present significant opportunity for public health nutrition interventions through provision of healthy food. We sought to identify whether this opportunity is being taken through analysis of population data from Queensland, Australia. Specifically, we asked if meal provision occurs in locations where risk of food insecurity is high and how economic functioning of ECEC services is associated with meal provision., Methods: Of ECEC services in Queensland, (N = 1623) administrative data on meal provision (2020) was available for 947 ECEC services (58.4% of cohort). We assessed the association of meal provision in these services with area indices of social disadvantage (geographic location, social disadvantage, proportion of child developmental vulnerability) and ECEC service economic functioning (fee structure, market competition)., Findings: ECEC services in remote and rural communities were less likely to provide meals. A similar but weaker trend was evident in socio-economically disadvantaged metropolitan communities. In these locations market competition increased likelihood of meal provision but without fee increase., Interpretation: The competitive market works contrary to the potential for ECEC services to support child nutrition and promote public health. Children living in disadvantaged communities, where food insecurity is inevitably higher, are less likely to have meals provided by their ECEC service. Market competition increases the likelihood of meal provision, yet in disadvantaged communities, parents' ability to pay constrains fees that can be charged raising concern about food quality and effects on quality of provision more broadly. Systemic public supports to enable high quality food provision without compromising other aspects of quality, particularly in the most disadvantaged communities, should be a public health priority., Competing Interests: Declaration of competing interest None., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Children learn to like a wide variety of healthy foods through exposure in their early feeding environment. While some children may reject foods during this learning process, parents may perceive persistent refusal as 'fussy' or 'picky' eating. Low-income parents may provide fussy children with a narrow range of foods that they will like and accept to avoid food and economic waste; inadvertently limiting children's exposure to a variety of healthy foods. This 'risk aversion' to food rejection may be particularly salient in food insecure households where resources are further constrained. We aimed to examine if food insecurity modifies the relationship between child fussy eating and parents' food provision and feeding with respect to exposure to a variety of healthy foods. Australian mothers residing in a low-income community (N = 260) completed a cross-sectional survey on their preschool-aged child's 'food fussiness', household food insecurity and food exposure practices. Food exposure practices included the home availability of fruit and vegetables, and children's tasting of a variety of fruit and vegetables (food provision); and whether parents prepared alternative meals for their child (feeding). Mothers reporting food insecurity (11%) were less likely to have fruit frequently available in the home compared to mothers reporting food security. Food insecurity moderated the relationship between fussy eating and food exposure practices insofar that food secure mothers were more likely to prepare alternative meals for fussier children. Family resources and child fussy eating behaviours are identified as important contextual factors in food provision and feeding. Findings from the current study suggest that health professionals, researchers and policymakers tailor interventions to consider both the needs of families and child eating characteristics., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Objective: Child fussy eating has been associated with a range of maternal feeding practices; however, whether effects are parent-driven, child-driven, or bidirectional (i.e., both) remains unclear. This study tested for bidirectional relationships between nonresponsive and structure-related maternal feeding practices and child fussy eating at age 2, 3.7, and 5 years using a cross-lagged model approach., Methods: First-time Australian mothers (N = 207) reported four nonresponsive and four structure-related feeding practices and child food fussiness (FF) using validated questionnaires at child age 2, 3.7, and 5 years. Bivariate cross-lagged analyses were conducted for each of the eight feeding practices separately., Results: Both child- and parent-driven associations were observed. Higher FF at 3.7 years predicted higher nonresponsive feeding practices and less structure-related practices at 5 years. Higher structure-related practices at 2 and 3.7 years predicted lower FF at 3.7 and 5 years, respectively. Use of food as a reward for behavior at 3.7 years predicted higher FF at 5 years., Conclusions: Both parent- and child-driven associations explain the relationship between fussy eating and feeding practices. Given that early fussy eating is associated with more nonresponsive feeding, providing parents with anticipatory guidance to manage fussy eating behavior in infants and toddlers may help to avoid the use of these practices. Furthermore, the use of structure-related feeding practices and avoiding the use of food rewards may help to prevent the development of fussy eating.

Background: Against a background of changing family structures and socioeconomic demands in contemporary families, fathers are more actively engaged in meal preparation and feeding of their children, yet in research studies targeting improvement in nutrition and feeding practices fathers are under-represented. Among possible explanations for this bias are acceptability of research projects and accessibility to male research participants. The aims of this study were to identify (i) fathers' preferences for participation in child nutrition research and interventions and (ii) the potential to recruit fathers through their workplaces with the possibility of delivering interventions through those workplaces., Methods: This paper draws on two independent yet linked studies that explored fathers' roles in family feeding, and intervention studies aimed at supporting father's dietary knowledge and feeding practices. For Study 1 (conducted first) secondary data analysis was conducted on survey data (n = 463 fathers of preschool children) to determine preferences related to type of program, delivery mode, and location and timing. For Study 2 six focus groups and one individual interview were conducted with n = 28 fathers to determine acceptability of recruitment of fathers working in traditionally blue-collar occupations and service industries (as defined by the Australian Bureau of Statistics) and potential of intervention delivery through their workplaces., Results: Fathers were engaged in child feeding and indeed sought nutrition-related information. Fathers indicated a preference for family-focused and online delivery of interventions. Whilst potential to recruit through blue-collar workplaces was evident, participants were divided in their views about the acceptability of interventions conducted through the workplace. There was a sense of support for the logic of such interventions but the focus group participants in this study showed only modest enthusiasm for the idea., Conclusions: With limited support for the workplace as an intervention setting, further systematic exploration of technology-based intervention design and engagement is warranted. Based on findings, interventions should target a) content that is focused on the family and how to make changes at the family level, rather than the father individually; and b) online delivery, such as Apps or online video chat sessions, for convenience and to facilitate sharing of information with family members.

Objective: Few studies on child feeding have focused on family dynamics or disadvantaged families, yet feeding occurs in the complex social, economic, and relational context of the family. We examined how the level (high vs low) and concordance (concordant vs discordant) of nonresponsive feeding practices of mothers and fathers are associated with child fussy eating, in a socioeconomically disadvantaged Australian sample., Methods: Mother-father pairs (N = 208) of children aged 2 to 5 years old independently completed validated questionnaires reporting their "persuasive feeding," "reward for eating," "reward for behavior," and child's "food fussiness." The fussiness scores did not differ between mother-father pairs and were averaged to derive a single dependent variable. K-means cluster analyses were used to assign mother-father pairs to clusters for each feeding practice, based on mean scores. Three ANCOVAs, corresponding to each feeding practice, tested differences in child fussiness across clusters while controlling for covariates., Results: Four clusters were identified for each feeding practice-concordant: (1) high (MHi/FHi) for both parents and (2) low (MLo/FLo) for both parents; and discordant: (3) high for mother but low for father (MHi/FLo); and (4) low for mother but high for father (MLo/FHi). For "persuasive feeding," MLo/FLo reported lower levels of fussiness compared with MHi/FLo, MHi/FHi, and MLo/FHi (p values < 0.05). For "reward for eating," MLo/FLo reported lower levels of fussiness than did MHi/FHi (p < 0.05). Child fussiness did not differ across "reward for behavior" clusters., Conclusion: In socioeconomically disadvantaged families, when parents are concordant in avoiding nonresponsive feeding practices, less child "food fussiness" is reported. Findings suggest that feeding interventions should consider inclusion of both parents in 2-parent households.

Objective: To characterise parent presentations of fussy eating and mealtime interactions at a point of crisis, through analyses of real-time recordings of calls to a parenting helpline., Design: Qualitative analysis included an inductive thematic approach to examine clinical parent presentations of fussy eating and derive underlying themes relating to mealtime interactions., Setting: Calls made to the Child Health Line regarding feeding concerns were recorded and transcribed verbatim., Subjects: From a corpus of 723 calls made during a 4-week period in 2009, twelve were from parents of children aged 6-48 months., Results: Parents of infants (≤12 months, n 6) presented feeding concerns as learning challenges in the process of transitioning from a milk-based to a solid-based diet, while parents of toddlers (13-48 months, n 6) presented emotional accounts of feeding as an intractable problem. Parents presented their child's eating behaviour as a battle (conflict), in which their children's agency over limited intake and variety of foods (child control) was constructed as 'bad' or 'wrong'. Escalating parent anxiety (parent concern) had evoked parent non-responsive feeding practices or provision of foods the child preferred., Conclusions: Real-time descriptions of young children's fussy eating at a time of crisis that initiated parents' call for help have captured the highly charged emotional underpinnings of mealtime interactions associated with fussy eating. Importantly, they show the child's emerging assertion of food autonomy can escalate parents' emotional distress that, in the short term, initiates non-responsive feeding practices. The current study identifies the importance of educational and emotional support for parents across the period of introducing solids.