The effectiveness of interventions on changing caregivers' feeding practices with preschool children: A systematic review and meta‐analysis

Abstract

SummaryCaregivers' feeding practices are critical in shaping preschool children's eating habits and preventing childhood obesity. We conducted a systematic review and meta‐analysis to evaluate the effectiveness of existing interventions targeting caregivers of preschool children, which aimed to promote child healthy eating and/or manage child weight and/or prevent child nutrition‐related problems and included feeding practices as one of the outcomes. Eighteen studies with 18 intervention programs and 3887 respondents that completed baseline evaluations were eligible for data synthesis. Behavior change techniques (BCTs) frequently used included the following: instruction on how to perform the behavior and demonstration of the behavior. The pooled effects of randomized controlled trials (RCTs) on pressure to eat (pooled standardized mean difference [SMD] = 0.61; 95%CI: −1.16, −0.06), use of food as a reward (pooled SMD = −0.31; 95%CI: −0.61, −0.01), and emotional feeding (pooled SMD = −0.36; 95%CI: −0.66, −0.06) were found statistically significant compared with control groups at post‐intervention. However, there were no pooled effects on restrictive feeding and pressure to eat at other follow‐ups or on other feeding practices at post‐intervention. Interventions may have short‐term effects on decreasing the adoption of coercive control. Future interventions should directly and adequately optimize feeding practices, include components of individual support, and contribute to the maintenance of the effects over the long term.

Empowering parents to optimize feeding practices with preschool children (EPO-Feeding): A study protocol for a feasibility randomized controlled trial

“…The development of the EPO-Feeding Program followed the framework outlined by MRC [ 48 ]. It encompassed systematic reviews [ 13 , 16 ] and involved stakeholder engagement through qualitative interviews with parents ( n = 35) and healthcare professionals ( n = 11) and focus groups with kindergarten teachers ( n = 22). We also conducted a cross-sectional study ( n = 1779) in China to determine if PPCW had a close link to PFPs.…”

“…The family, especially primary caregivers (e.g., parents), may influence children’s eating (e.g., food intake) and weight status through feeding practices in the family-based food environment [ 11 , 12 ]. Hence, many researchers have studied feeding practices to identify efficient strategies to promote children’s healthy eating and prevent childhood obesity in this specific context [ 13 ].…”

“…The absence of intervention effects may be attributed to limited studies prioritizing feeding practices as primary outcomes and incorporating explicit content around responsive feeding. Instead, most of the included studies primarily targeted child nutritional-related issues (e.g., child obesity prevention and healthy eating promotion) [ 13 ]. Therefore, there is a need to develop intervention programs which focus on the most effective ways to optimize feeding practices.…”

“…Consequently, they might overfeed their young children or use favourite foods, such as sweets, as rewards to encourage greater food consumption [ 37 ]. However, no published interventions have focused on optimizing feeding practices with preschool children in mainland China [ 13 ].…”

“…The program provides specific information tailored for this population. In accordance with the Medical Research Council (MRC) framework for developing complex interventions [ 48 ], the development of program was informed by findings from systematic reviews [ 13 , 16 ], qualitative interviews with various stakeholders, and a cross-sectional study to explore PFPs and PPCW.…”