Few child-care providers meet the national recommendations for healthful feeding practices. Effective strategies are needed to address this disparity, but research examining influences on child-care providers' feeding practices is limited. The purpose of this study was to identify determinants of child-care providers' healthful and controlling feeding practices for children aged 2 to 5 years. In this cross-sectional study, child-care providers (n=118) from 24 center-based programs (six Head Start [HS], 11 Child and Adult Care Food Program [CACFP] funded, and seven non-CACFP) completed self-administered surveys during 2011-2012. Multilevel multivariate linear regression models were used to predict seven feeding practices. Working in an HS center predicted teaching children about nutrition and modeling healthy eating; that may be attributed to the HS performance standards that require HS providers to practice healthful feeding. Providers who reported being concerned about children's weight, being responsible for feeding children, and had an authoritarian feeding style were more likely to pressure children to eat, restrict intake, and control food intake to decrease or maintain children's weight. Providers with nonwhite race, who were trying to lose weight, who perceived nutrition as important in their own diet, and who had a greater number of nutrition training opportunities were more likely to use restrictive feeding practices. These findings suggest that individual- and child-care-level factors, particularly provider race, education, training, feeding attitudes and styles, and the child-care context may influence providers' feeding practices with young children. Considering these factors when developing interventions for providers to meet feeding practice recommendations may add to the efficacy of childhood obesity prevention programs.

The purpose of this study was to explore the relationship between health literacy and nutrition behaviors using a low-income sample. Face-to-face surveys at 11 social services offices generated a convenience sample of 154 Supplemental Nutrition Assistance Program (SNAP)-eligible adults. We assessed health literacy, fruit and vegetable intake, food label use, consumption of healthy foods, and demographic characteristics. Thirty seven percent of the sample had adequate health literacy as measured by the Newest Vital Sign (NVS). Race and parenthood were significantly related to health literacy scores. Adequate health literacy, as measured by the NVS, was associated with frying chicken less often and eating the peels of fresh fruit more often. The findings suggest that health practitioners should ensure nutrition-related messages are accessible to all of their clients, especially those with the lowest health literacy levels.

A social-ecological framework suggests that nutrition education programs designed to increase young children's fruit and vegetable consumption should address the influence of immediate and extended family. However, very few nutrition education programs recognize the importance of grandmothers in shaping preschoolaged children's consumption patterns. This study explored the impact of grandmothers on their grandchildren's fruit and vegetable consumption. Specifically, the authors addressed 3 research questions: (1) Are grandmothers involved in purchasing food for or feeding their preschool-aged grandchildren? (2) What resources do mothers and grandmothers have to purchase fruits and vegetables, and do these resources allow them to purchase a healthy amount of fruits and vegetables? (3) Do mothers and grandmothers consume fruits and vegetables and understand their importance? Using a sample of 62 low-income mothers and grandmothers from ruralMaryland, the authors found evidence that grandmothers shaped their grandchildren's fruit and vegetable consumption by purchasing and providing food for their daughters and grandchildren. However, grandmothers also reported consuming less than the recommended daily amount of fruits and vegetables, which suggests they may negatively affect their grandchildren's fruit and vegetable consumption. Implications for future research and programming are discussed.

Despite greater risk for poor nutrition, inactivity, and overweight, some low-income children are able to maintain a healthy weight. We explore if a strong family sense of coherence (FSOC) acts as a protective factor against childhood obesity for low-income preschool children. Families with a strong FSOC view challenges as predictable, understandable, worthy of engaging, and surmountable. Data were collected from 321 low-income mothers and their preschool children in five states between March 2011 and May 2013. FSOC was assessed using the Family Sense of Coherence Scale. A 16-item checklist was used to assess practicing healthy child behaviors (fruit and vegetable consumption and availability, physical activity, and family meals) and limiting unhealthy child behaviors (sweetened beverage and fast food consumption, energy dense snack availability, and screen time). Child body mass index (BMI) z-scores were calculated from measured height and weight. FSOC was significantly associated with practicing healthy child behaviors (β = 0.32, p < .001). We did not find a statistically significant association between FSOC and limiting unhealthy child behaviors or child BMI z-scores in fully adjusted models. Our results suggest the importance of family functioning in predicting health behaviors around food consumption and availability, physical activity, and family meals.

care providers' motivators, barriers and facilitators to practicing family-style meal service" (2014). Faculty Publications, Department of Child, Youth, and Family Studies. 108. AbstractThis paper presents a qualitative investigation of the motivators, barriers, and facilitators for practicing family-style meal service (FSMS) from the perspective of 18 child care providers serving preschool children in Head Start (HS), Child and Adult Care Food Program (CACFP) funded, and non-CACFP child-care centers. Providers were selected based on maximum variation purposive sampling and semi-structured interviews were conducted until saturation was reached. Provider responses were systematically coded using thematic analysis. HS and CACFP providers reported being motivated to practice FSMS because it created pleasant mealtimes, opportunities to role model healthy eating, and healthful child development. CACFP and non-CACFP providers reported not using FSMS because it was resource intensive, messy, and seemed to violate CACFP policy. HS and CACFP providers offered suggestions to overcome these barriers. They suggested that FSMS eventually becomes easier with practice, children can self-regulate their energy intake, and teaching children self-help skills during play time can avoid messes during mealtimes. Findings from this study have implications for programming, policy, and research.