Providers’ response to child eating behaviors: A direct observation study

Abstract

Child care providers play an important role in feeding young children, yet little is known about children’s influence on providers’ feeding practices. This qualitative study examines provider and child (18 months -4 years) feeding interactions. Trained data collectors observed 200 eating occasions in 48 family childcare homes and recorded providers’ responses to children’s meal and snack time behaviors. Child behaviors initiating provider feeding practices were identified and practices were coded according to higher order constructs identified in a recent feeding practices content map. Analysis examined the most common feeding practices providers used to respond to each child behavior. Providers were predominately female (100%), African-American (75%), and obese (77%) and a third of children were overweight/obese (33%). Commonly observed child behaviors were: verbal and non-verbal refusals, verbal and non-verbal acceptance, being “all done”, attempts for praise/attention, and asking for seconds. Children’s acceptance of food elicited more autonomy supportive practices vs. coercive controlling. Requests for seconds was the most common behavior, resulting in coercive controlling practices (e.g., insisting child eat certain food or clean plate). Future interventions should train providers on responding to children’s behaviors and helping children become more aware of internal satiety and hunger cues.

Examining the Obesogenic Attributes of the Family Child Care Home Environment: A Literature Review

“…There were eleven cross-sectional studies [ 16 , 17 , 19 , 20 , 22 , 23 , 25 , 26 , 29 – 32 ], one observational study [ 27 ], one study used accelerometers [ 21 ], and four studies used qualitative methods [ 18 , 24 , 28 , 33 ]. Eight studies focused solely on FCCHs or FCCH providers, meaning these studies did not include other types of child care facilities [ 16 , 18 , 21 , 24 , 27 – 30 ]. Five studies examined both the nutrition and physical activity environment [ 19 , 20 , 26 , 29 , 30 ].…”

“…Five studies examined both the nutrition and physical activity environment [ 19 , 20 , 26 , 29 , 30 ]. Four studies focused only on the nutrition environment [ 22 , 23 , 27 , 31 ] while two focused solely on the physical activity environment [ 21 , 25 ]. Six studies examined TPB related beliefs [ 16 , 18 , 24 , 28 , 32 , 33 ].…”

Providers perspectives on self-regulation impact their use of responsive feeding practices in child care

“…Future studies are needed to determine the impact of responsive feeding practices on child outcomes across childcare contexts as well as child characteristics that may lead to the use of more responsive feeding practices. For example, children's acceptance of food is related to childcare providers using more responsive feeding practices (Tovar et al, 2016). It is also recommended that future studies focus on determining if training child care providers in nutrition and childhood obesity prevention strategies influences their implementation of responsive feeding practices.…”

The family child care home environment and children's diet quality

“…This same survey also showed that while most providers sat with children during meals, few ate the same foods as children, thus missing out on an important opportunity for role modeling. An observational study of family child care homes in Rhode Island found that providers often offered positive reinforcement in response to children’s acceptance of food; however, providers also responded with controlling practices when children requested second helpings of food (Tovar et al, 2016). The low number of studies conducted with family child care homes highlights the need to conduct both observational and intervention research in this area to help improve foods and beverages served and mealtime feeding practices.…”