A measurement scale to assess responsive feeding among Cambodian young children

Ndèye S Sall, France Bégin, Jérémie B Dupuis, Jimmy Bourque, Lylia Menasria, Barbara Main, Lenin Vong, Vannary Hun, David Raminashvili, Chhorvann Chea, Lucie Chiasson, Sonia Blaney, Ndèye S Sall, France Bégin, Jérémie B Dupuis, Jimmy Bourque, Lylia Menasria, Barbara Main, Lenin Vong, Vannary Hun, David Raminashvili, Chhorvann Chea, Lucie Chiasson, Sonia Blaney

Abstract

The caregiver-child interaction during mealtime, which refers to responsive feeding (RF), influences child's dietary intake. In Cambodia, given the level of malnutrition, getting better knowledge of RF among young children is essential, but to do so, using an appropriate assessment tool is necessary. We aim to develop and to validate a measurement tool to assess RF in two different situations (before and after an intervention) among children 6-23 months old. This research is part of a larger trial assessing the impact of nutrition education combined or not with the provision of complementary foods on child nutritional status. The "Opportunistic Observation Form" from the Process for the Promotion of Child Feeding package was used to collect data on RF through direct observations of child's meal episodes. Data were used to define an initial scale composed of four constructs and 15 indicators. Confirmatory factor analyses (CFA) and Hancock and Mueller's H reliability indices were computed to assess the validity and reliability of the scale. The final tool was applied to baseline and endline data. At baseline, the sample included 243 pairs and, at endline, 248 pairs. The final scale included two latent constructs (RF and active feeding) that comprise three indicators for active feeding and five for RF. Criteria for fit indices of CFA were met for both constructs though better at baseline. Reliability coefficients were above 0.80 for each construct at baseline and endline. This research proposes a scale that could be used to assess active feeding and RF. Further validation is warranted in different contexts.

Keywords: Cambodia; active feeding; measurement scale; responsive feeding; young children.

Conflict of interest statement

The authors declare that they have no conflicts of interest.

© 2020 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.

Figures

Figure 1
Figure 1
Flow chart describing study population at baseline and endline

References

    1. Abebe, Z. , Haki, G. D. , & Baye, K. (2017). Child feeding style is associated with food intake and linear growth in rural Ethiopia. Appetite, 116, 132–138. 10.1016/j.appet.2017.04.033
    1. Aboud, F. E. , Moore, A. C. , & Akhter, S. (2008). Effectiveness of a community‐based responsive feeding programme in rural Bangladesh: A cluster randomized field trial. Maternal & Child Nutrition, 4, 275–286. 10.1111/j.1740-8709.2008.00146.x
    1. Aboud, F. E. , Shafique, S. , & Akhter, S. (2009). A responsive feeding intervention increases children's self‐feeding and maternal responsiveness but not weight gain. The Journal of Nutrition, 139, 1738–1743. 10.3945/jn.109.104885
    1. Alvarez, M. L. , Wurgaft, F. , & Wilder, H. (1982). Non‐verbal language in mothers with malnourished infants. A pilot study. Social Science & Medicine, 16, 1365–1369. 10.1016/0277-9536(82)90033-8
    1. Bentley, M. E. , Stallings, R. , Fukumoto, M. , & Elder, M. (1991). Maternal feeding behavior and child acceptance of food during diarrhea episodes, convalescence and health in the Central Northern Sierra of Peru. American Journal of Public Health, 83, 1–5.
    1. Bentley, M. E. , Wasser, H. M. , & Creed‐Kanashiro, H. M. (2011). Responsive feeding and child undernutrition in low‐ and middle‐income countries. The Journal of Nutrition, 141(3), 502–507. 10.3945/jn.110.130005
    1. Birch, L. L. (1998). Development of food acceptance patterns in the first years of life. Proceedings of the Nutrition Society, 57, 617–624.
    1. Black, M. M. , & Aboud, F. E. (2011). Responsive feeding is embedded in a theoretical framework of responsive parenting. The Journal of Nutrition, 141(3), 490–494. 10.3945/jn.110.129973
    1. Black, N. M. , & Hurley, K. M. (2017). Complementary feeding: Building the foundation for a healthy life. Nestlé Nutrition Institute Series, 87, 153–165.
    1. Caron, P. O. (2018). Modélisation par équations structurelles avec Mplus. Québec: Presses de l'Université du Québec.
    1. Conway, J. M. , & Huffcutt, A. I. (2003). A review and evaluation of exploratory factor analysis practices in organizational research. Organizational Research Methods, 6(2), 147–168.
    1. Dearden, K. A. , Hilton, S. , Bentley, M. E. , Caulfield, L. E. , Wilde, C. , Ha, P. B. , & Marsh, D. (2009). Caregiver verbal encouragement increases food acceptance among Vietnamese toddlers. The Journal of Nutrition, 139, 1387–1392. 10.3945/jn.108.102780
    1. Dettwyler, K. A. (1986). Infant feeding in Mali, West Africa: Variations in belief and practice. Social Science & Medicine, 23, 651–664. 10.1016/0277-9536(86)90112-7
    1. Development Initiatives (2017). Global Nutrition Report 2017: Nourishing the SDGs. Development Initiatives: Brustol, United Kingdom.
    1. Engle, P. L. , Bentley, M. , & Pelto, G. (2000). The role of care in nutrition programmes: Current research and a research agenda. Proceedings of the Nutrition Society, 59, 25–35.
    1. Engle, P. L. , & Pelto, G. H. (2011). Responsive feeding: Implications for policy and program implementation. The Journal of Nutrition, 141(3), 508–511. 10.3945/jn.110.130039
    1. Floyd, F. , & Widaman, K. (1995). Factor analysis in the development and refinement of clinical assessment instruments. Psychological Assessment, 7(3), 286–299.
    1. Food and Agriculture Organization (2015). Improving complementary feeding in North‐Western Cambodia: Lessons learned from a process review of a food security and nutrition project. FAO: Phnom Penh.
    1. Gana, K. , & Broc, G. (2018). Introduction à la modélisation par équations structurales: Manuel pratique avec Lavaan. Londres, Royaume‐Uni: ISTE éditions.
    1. Gittelsohn, J. , Shankar, A. V. , West, K. P. Jr. , Faruque, F. , Gnywali, T. , & Pradhan, E. K. (1998). Child feeding and care behaviors are associated with xerophthalmia in rural Nepalese households. Social Science & Medicine, 47, 477–486. 10.1016/s0277-9536(98)00131-2
    1. Gorsuch, R. L. (1983). Factor analysis (2nd ed.). Erlbaum: Hillsdale, NJ.
    1. Ha, P. B. , Bentley, M. E. , Pachón, H. , Sripaipan, T. , Caulfield, L. E. , Marsh, D. R. , & Schroeder, D. G. (2002). Caregiver styles of feeding and child acceptance of food in rural Viet Nam. Food and Nutrition Bulletin, 23(4), 95–100.
    1. Hancock, G. R. , & Mueller, R. O. (2001). Rethinking construct reliability within latent variable systems. Structural equation modeling: Present and future. A Festschrift in honor of Karl Jöreskog. Lincolnwood, IL: Scientific Software International, Inc.
    1. Heller, R. L. , & Mobley, A. R. (2019). Instruments assessing parental responsive feeding in children ages birth to 5 years: A systematic review. Appetite, 138, 23–51. 10.1016/j.appet.2019.03.006
    1. Jansen, E. , Mallan, K. M. , Nicholson, J. M. , & Daniels, L. A. (2014). The feeding practices and structure questionnaire: Construction and initial validation in a sample of Australian first‐time mothers and their 2‐year olds. International Journal of Behavioral Nutrition and Physical Activity, 11, 72 10.1186/1479-5868-11-72
    1. Jansen, E. , Williams, K. E. , Mallan, K. M. , & Nicholson, J. M. (2016). The feeding practices and structure questionnaire (FRSQ‐28): A parsimonious version validated for longitudinal use from 2 to 5 years. Appetite, 100, 172–180. 10.1016/j.appet.2016.02.031
    1. Lewis, T. F. (2017). Evidence regarding the internal structure: Confirmatory factor analysis. Measurement and Evaluation in Counseling and Development, 50(4), 239–247. 10.1080/07481756.2017.1336929
    1. McCambridge, J. , Witton, J. , & Elbourne, D. R. (2014). Systematic review of the Hawthorne effect: New concepts are needed to study research participation effects. Journal of Clinical Epidemiology, 67(3), 267–277. 10.1016/j.jclinepi.2013.08.015
    1. Menasria, L. , Blaney, S. , Main, B. , Vong, L. , Hun, V. , Raminashvili, D. , … Leblanc, C. P. (2018). Mitigated impact of provision of local foods combined with nutrition education and counseling on young child nutritional status in Cambodia. Nutrients, 10, 1450 10.3390/nu10101450
    1. Moore, A. C. , Akhter, S. , & Aboud, F. E. (2006). Responsive complementary feeding in rural Bangladesh. Social Science & Medicine, 62(8), 1917–1930. 10.1016/j.socscimed.2005.08.058
    1. Mwase, I. , Mutoro, A. , Owino, V. , Garcia, A. L. , & Wright, C. M. (2016). Poor infant feeding practices and high prevalence of malnutrition in urban slum child care centres in Nairobi: A pilot Study. Journal of Tropical Pediatrics, 62(1), 46–54. 10.1093/tropej/fmv071
    1. National Institute of Statistics, Directorate General for Health & ICF International (2015). Cambodia Demographic and Health Survey 2014. Phnom Penh (Cambodia) and Rockville (Maryland, USA).
    1. Oni, G. A. , Brown, K. H. , Bentley, M. E. , Dickin, K. L. , Kayode, D. , & Alade, I. (1991). Feeding practices and prevalence of hand‐feeding of infants and young‐children in Kwara State, Nigeria. Ecology of Food and Nutrition, 25, 209–219.
    1. PAHO & WHO (2003). Guiding principles for complementary feeding of the breastfed child. Washington, DC: Pan American Health Organization.
    1. PAHO, WHO and UNICEF (2013). ProPAN 2.0 (Process for the Promotion of Child Feeding) (2rd ed.). Washington, DC: Pan American Health Organization.
    1. Pelto, G. H. , Levitt, E. , & Thairu, L. (2003). Improving feeding practices: Current patterns, common constraints, and the design of interventions. Food and Nutrition Bulletin, 24, 45–82. 10.1177/156482650302400104
    1. Pérez‐Escamilla, R. , Segura‐Pérez, S. , & Hall Moran, V. (2019). Dietary guidelines for children under 2 years of age in the context of nurturing care. Maternal & Child Nutrition, 15, e12855.
    1. Robert Wood Johnson Foundation (RWJF) (2017). Feeding infants and young toddlers: Using the latest evidence in child‐care settings. Health Eating Research Program. RWJF.
    1. Ruel, M. T. , Levin, C. E. , Armar‐Klemesu, M. , Maxwell, D. , & Morris, S. S. (1999). Good care practices can mitigate the negative effects of poverty and low maternal schooling on children's nutritional status: Evidence from Accra. World Development, 27(11), 1993–2009.
    1. Spill, M. K. , Callahan, E. H. , Shapiro, M. J. , Spahn, J. M. , Wong, Y. P. , Benjamin‐Nellon, S. E. , … Cassavale, O. K. (2019). Caregiver feeding practices and child weight outcomes: A systematic review. American Journal of Clinical Nutrition, 109(Supp_7), 990s–1002s. 10.1093/ajcn/nqy276
    1. Tabachnick, B. G. , & Fidell, L. S. (2013). Using multivariate statistics (6th ed.). Pearson: Boston, MA.
    1. UNICEF (1990). Strategy for improved nutrition of children and women in developing countries. UNICEF: New York, NY.
    1. UNICEF (2006). Responsive feeding: Supporting close and loving relationship. London (UK): United Kingdom Baby Friendly Initiative info sheet. UNICEF.
    1. Vazir, S. , Engle, P. , Blakrishna, N. , Griggiths, P. L. , Johnson, S. L. , Creed‐Kanashiro, H. , & Bentley, M. E. (2013). Cluster‐randomized trial on complementary and responsive feeding education to caregivers found improved dietary intake, growth and development among rural Indian toddlers. Maternal & Child Nutrition, 9(1), 99–117. 10.1111/j.1740-8709.2012.00413.x
    1. WHO (2005). Guiding principles for feeding non‐breastfed children 6‐24 months of age. Geneva: World Health Organization.
    1. WHO & UNICEF (2003). Global strategy for infant and young child feeding. Geneva: World Health Organization.
    1. Wondafrash, M. , Amsalu, T. , & Woldie, M. (2012). Feeding styles of caregivers of children 6‐23 months of age in Derashe special district, Southern Ethiopia. BMC Public Health, 12, 235 10.1186/1471-2458-12-235

Source: PubMed

Sponsors en medewerkers

Medische omstandigheden

Geneesmiddelinterventies

3
Abonneren