Increasing Parental Knowledge About Child Feeding: Evaluation of the Effect of Public Health Policy Communication Media in France

Abstract

BackgroundUnhealthy eating behaviors are risk factors for non-communicable diseases. Parents largely influence the development of eating behaviors during childhood through their feeding practices. Parental feeding practices in line with recommendations are more likely to turn into healthier outcomes in children. From a public health perspective, it should be first ascertained whether providing parents with recommendations about child feeding is a useful approach for increase parental knowledge. Recently, the French health authorities developed a brochure covering updated child feeding recommendations. The present study aims to evaluate the short-term effects of reading this brochure on parental knowledge about child feeding, distinguishing knowledge accuracy and certainty.MethodsA brochure containing updated child feeding recommendations for 0–3 years old was developed by the French public health agency. A representative sample of French parents (n = 400) was targeted to complete an online questionnaire (T0) comprising 30 statements regarding child feeding. For each statement, parents indicated whether it was true/false and how certain they were of their answer (4-point scale). After receiving and reading the brochure, the same parents completed the same questionnaire 3 weeks later (T1). Accuracy (number of correct answers) and certainty (number of mastered answers: correct answers given with the maximal degree of certainty) were compared at T1 vs. T0 using paired t-tests. Knowledge evolution based on parental age, parity and education level was tested with linear models.ResultsA total of 452 parents responded at T0 and T1 and were considered for analysis. Between T0 and T1, the number of correct answers [median 22–25, t(451) = 17.2, p ≤ 0.001] and mastered answers [median 11–17, t(451) = 18.8, p ≤ 0.001] significantly increased. The median of the difference between T1 and T0 was larger for mastered than for correct answers. The observed evolution in knowledge was independent of parental age, parity or education level.ConclusionsA brochure containing child feeding recommendations has the potential to increase the accuracy and, to an even greater degree, the certainty of parental knowledge. This increase was observed even for younger or less educated parents.

Complementary feeding practices are related to the risk of food allergy in the ELFE cohort

“…36 Recent studies underline the need for public health communications to disseminate and explain this change in the guidelines to parents and professionals who work with children. 37,38 The very large sample and the collection of detailed sociodemographic and economic data ensure the presence of more statistical power and a favorable level of control over potential confounders. As in most observational studies, the selection/attrition bias was quite important, but the weighted analyses suggest that this bias had a limited impact on our findings.…”

“…Our findings support the updated guidelines, indicating that the introduction of food allergens should not be delayed and should occur “when CF is initiated any time after 4 months” 8 and “as early as the CF is initiated that is to say between 4 and 6 months” (updated French guidelines from the Public Health France website, September 2021) 36 . Recent studies underline the need for public health communications to disseminate and explain this change in the guidelines to parents and professionals who work with children 37,38 …”

Bringing down barriers to children’s healthy eating: a critical review of opportunities, within a complex food system

“…Nevertheless, it could be hypothesised that an increase in knowledge (as an intermediate outcome) could act as a proxy in changing behaviour. For example, a recent study has shown that providing child-feeding recommendations in paper format to parents can increase their knowledge accuracy and certainty regarding feeding recommendations (248) . As parents who are aware of the recommendations will not automatically align their feeding practices to what is recommended (249,250) , further investigation could clarify whether the knowledge of the recommendations triggers self-efficacy and could predict, ultimately, the adoption of optimal parental feeding practices and/or children's eating behaviours.…”