SmartFeeding4Kids, an online self-guided parenting intervention to promote positive feeding practices and healthy diet in young children: study protocol for a randomized controlled trial

Ana Isabel Gomes, Ana Isabel Pereira, Tiago Guerreiro, Diogo Branco, Magda Sofia Roberto, Ana Pires, Joana Sousa, Tom Baranowski, Luísa Barros, Ana Isabel Gomes, Ana Isabel Pereira, Tiago Guerreiro, Diogo Branco, Magda Sofia Roberto, Ana Pires, Joana Sousa, Tom Baranowski, Luísa Barros

Abstract

Background: Caregivers' influence on young children's eating behaviors is widely recognized. Nutritional interventions that focus on the promotion of children's healthy diet should actively involve parents, focusing on their feeding behaviors and practices.

Methods: This work aims to describe the development and study protocol of the SmartFeeding4Kids (SF4K) program, an online self-guided 7-session intervention for parents of young (2-6 years old) children. The program is informed by social cognitive, self-regulation, and habit formation theoretical models and uses self-regulatory techniques as self-monitoring, goal setting, and feedback to promote behavior change. We propose to examine the intervention efficacy on children's intake of fruit, vegetables, and added sugars, and parental feeding practices with a two-arm randomized controlled with four times repeated measures design (baseline, immediately, 3 and 6 months after intervention). Parental perceived barriers about food and feeding, food parenting self-efficacy, and motivation to change will be analyzed as secondary outcomes. The study of the predictors of parents' dropout rates and the trajectories of parents' and children's outcomes are also objectives of this work.

Discussion: The SmartFeeding4Kids program relies on technological resources to deliver parents' self-regulation techniques that proved effective in promoting health behaviors. The study design can enhance the knowledge about the most effective methodologies to change parental feeding practices and children's food intake. As a self-guided online program, SmartFeeding4Kids might overcome parents' attrition more effectively, besides being easy to disseminate and cost-effective.

Trial registration: The study was registered in ClinicalTrials.gov ( NCT04591496 ) on October 19, 2020.

Keywords: Dietary intake; Feeding practices; Intervention; Online; Parents; Preschool children; Randomized controlled trial.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2021. The Author(s).

Figures

Fig. 1
Fig. 1
Flow diagram of the SmartFeeding4Kids RCT study
Fig. 2
Fig. 2
SmartFeeding4Kids RCT study schedule of enrolment, interventions, and assessments (according to SPIRIT guidelines)
Fig. 3
Fig. 3
SmartFeeding4Kidsapp features (from the upper left edge to the lower right edge of the figure). (1) General view of the program: sessions’ sequence. (2) Child’s 24-h food intake: selection of the number of portions eaten by the child in that day, regarding a specific food/beverage. (3) Nutritional information content (session 1). (4) Aba’s intervention: examples of verbalizations regarding ineffective feeding practices (e.g., pressure to eat). (5) Evaluative feedback: information about the number of portions of sugar-sweetened foods/beverages and vegetables eaten by the child in the day(s) recorded. (6) Goal setting: list of theme-related goals proposed to parents at the end of session 1

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