Parental Feeding Practices and Children's Healthy Diet Clinical Trial
— SF4KOfficial title:
The SmartFeeding4Kids, a Web-based Food Parenting Intervention to Promote Positive Feeding Practices and Healthy Diet in Preschool Children, Through Self-regulation and Behavior Change Techniques: a Randomized Control Trial
This research aims to develop and study the efficacy of a web-based brief intervention, Smart Feeding4Kids, to promote healthy dietary patterns in young children (2 to 6 years old) through changes in parents' feeding practices. The intervention is grounded on self-regulation and habit-formation models and combines the use of several effective behavioral methodologies. The multidisciplinary team integrates experienced researchers on parenting interventions, child nutrition, and the development of online applications to support personalized nutritional assessment and psychological interventions. The monitoring of the use of the platform and the knowledge about the predictors of efficacy, adherence, and involvement obtained in this project will offer professionals essential information to the development of future online interventions. The project will also contribute with knowledge concerning the most effective methodologies for changing parental feeding practices and collects unique information about the eating habits and practices of parents of Portuguese children. The main hypotheses of the study: 1. parents who enrolled in behavior change and social support interventions will report significantly higher use of effective feeding practices (child's self-regulation intake practices, food availability, and accessibility practices) and significantly lower use of ineffective feeding practices (food control, restriction, and permissiveness feeding practices); 2. children whose parents enrolled in behavior change and social support interventions will have a significantly more frequent intake of vegetables and fruits intake, and significantly less frequent intake of sugar-sweetened foods and beverages; 3. positive changes in parental feeding practices will mediate children's food intake, with increased vegetables and fruits and decreased sugar-sweetened foods and beverages intake.
| Status | Recruiting |
| Enrollment | 260 |
| Est. completion date | December 31, 2024 |
| Est. primary completion date | December 31, 2024 |
| Accepts healthy volunteers | Accepts Healthy Volunteers |
| Gender | All |
| Age group | N/A and older |
| Eligibility | Inclusion Criteria: - Parent/caregiver of a 2 to 6 years old child, at baseline (if the parent has two children in the same age interval, the parent must choose the child that raises more concerns about their health habits, as reference) - Have access to a mobile phone or computer/tablet with internet - Be fluent in Portuguese - Agree to participate in the study to accomplish the intervention in which they are allocated, the evaluation protocols, and the tasks required in each condition Exclusion Criteria: - No exclusion criteria |
| Country | Name | City | State |
|---|---|---|---|
| Portugal | Faculdade de Psicologia, Universidade de Lisboa | Lisboa |
| Lead Sponsor | Collaborator |
|---|---|
| University of Lisbon | Centro de Investigação em Ciência Psicológica, Universidade de Lisboa, Faculdade de Psicologia, Universidade de Lisboa, FCiências.ID, Faculdade de Ciências, Universidade de Lisboa, Fundação para a Ciência e a Tecnologia |
Portugal,
| Type | Measure | Description | Time frame | Safety issue |
|---|---|---|---|---|
| Other | Perception of the child's weight | Parents are asked to subjectively rate their child's current weight, considering the child's age and height (underweight, average weight, overweight) | Baseline | |
| Other | Concerns about the child's weight | Concerns about the child's weight are measured with four questions. The first question is about the parent's current concern about the child's weight. The other three items correspond to the Concern of Child Weight subscale of the Child Feeding Questionnaire - Revised (Birch et al., 2001) in its Portuguese version. The items are answered on a 5-point Likert scale (from No concern to Very concern). Higher values in the first item or in the subscale correspond to a higher degree of concerns about child's weight. | Baseline | |
| Other | Child's BMI and percentile | Children's weight and height measurements are assessed through parent's report. Child's BMI and percentile are calculated according to the World Health Organization Child Growth Standards. | Baseline, immediately after the intervention, 3 months after the intervention, 6 months after the intervention | |
| Other | Child's temperament | Parents are asked to read three sentences that describe the three temperament types and identify which better describe their child | Baseline | |
| Other | Parent's BMI and percentile | Parent's weight and height measurements are assessed through their onw report. Parent's BMI and percentile are calculated according to the World Health Organization Standards. | Baseline | |
| Other | Application usability | To assess usability, we will use the System Usability Scale. It is a commonly used, validated 10-item questionnaire that asks users to rate a system on a 5-point Likert scale from '1= strongly disagree' to '5 = strongly agree'. Questions focus on the ease of use of the system and the integration of various functions within it. | Immediately after the intervention | |
| Primary | Changes from baseline in the child's dietary intake reported by parents | Child's dietary intake reported by parents: Child's dietary intake is evaluated through a 24h food recall, completed during 3 days (two weekdays and one weekend day). Data regarding the mean number of portions of vegetables, fruit, and sugar-sweetened foods and beverages registered on three days will be extracted from the database and analyzed separately as primary outcomes. | Baseline, immediately after the intervention, 3 months after the intervention, 6 months after the intervention | |
| Primary | Changes from baseline in parental feeding practices | Parental feeding practices: Parental feeding practices are evaluated through a self-reported questionnaire, Food Parenting Practices Questionnaire, with three subscales (Child's Intake Self-regulation Practices, Food Availability and Accessibility Practices, and Ineffective Control Practices) developed and adapted to the Portuguese population within this study. Parents answer to 40 items on a 5-point Likert scale (from Totally false to Totally true). Higher values on each subscale indicate a more frequent use of this type of parental feeding practices. The total mean score of each subscale ranged from 1 to 5. | Baseline, immediately after the intervention, 3 months after the intervention, 6 months after the intervention | |
| Secondary | Changes from baseline in parental perceived barriers related to food and feeding | Parental barriers are evaluated through a self-reported instrument, Parental Perception on Children's Healthy Feeding Barriers Questionnaire, developed and adapted to the Portuguese population within this study. The instrument has 30 items divided by 5 subscales (Child-related barriers, Parent-related barriers: vegetables & fruit, Parent-related barriers: added sugars, Context-related barriers, Cost-related barriers), answered on a 5-point Likert scale (from Totally false to Totally true). Higher values on each subscale indicate that a specific kind of parental barriers is more present. The total mean score of each subscale ranged from 1 to 5. | Baseline, immediately after the intervention, 3 months after the intervention, 6 months after the intervention | |
| Secondary | Changes from baseline in food parenting self-efficacy | Parental self-efficacy is measured with a self-reported questionnaire, Parental Self-efficacy for Children's Healthy Diet Scale, previously developed by the team, with 4 items answered in a 5-point Likert scale (from No sure to Absolutely sure). Higher values on the scale correspond to higher parental self-efficacy. Score ranged from 1 to 5. | Baseline, immediately after the intervention, 3 months after the intervention, 6 months after the intervention | |
| Secondary | Changes from baseline in parental motivation to change | Parental motivation to change is measured through a self-reported questionnaire with three items developed within this study. In each item, parents report their degree of importance, confidence and readiness to adhere and promote healthy changes in the child's diet and parental feeding practices, answering in a 10-point numerical scale (e.g., from Not important to Extremely important). Higher mean scores correspond to a higher degree of motivation to change (score ranged between 1 and 10). | Baseline, immediately after the intervention, 3 months after the intervention, 6 months after the intervention |