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Title:Parental feeding styles and weight status of preschool children in Chile: Perceptions and influential factors
Author(s):Vizcarra Catalan, Marcela C
Director of Research:Schwingel, Andiara
Doctoral Committee Chair(s):Bost, Kelly; Khan, Naiman; Hughes, Sheryl
Doctoral Committee Member(s):Galvez, Patricia
Department / Program:Kinesiology & Community Health
Discipline:Community Health
Degree Granting Institution:University of Illinois at Urbana-Champaign
Degree:Ph.D.
Genre:Dissertation
Subject(s):Chile
feeding styles
feeding practices
parent socialization
child eating behaviors
underestimation of child weight status
perceptions, childhood obesity
Abstract:Chile is currently one of the Latin American countries with the highest prevalence of childhood obesity, where 34% of children under the age of six are categorized as obese or overweight. Parents have an integral role in obesity prevention in preschool children as the parents can create a home food and meal environment through feeding behaviors, and take actions based on their perceptions of their child’s weight status. Parents’ feeding styles, parent feeding practices, and factors influencing them are especially relevant to young children who are developing eating behaviors. Although the Chilean guidelines of healthy eating among young children have included a parenting perspective of feeding to promote healthy growth, there is scarce evidence on the topic, especially from Chile. Therefore, the purpose of this dissertation was to investigate parenting approaches to feeding and misperceptions of child weight status in Chilean families with preschool children, focusing on the following objectives: (1) to examine the moderating effect of parent feeding styles on the relation between underestimation of the child weight status and child BMI z-scores; (2) to assess parent misperceptions of weight status in young children; and the association of sociodemographic, anthropometric, and behavioral factors with parent underestimation of child weight status; and (3) to explore what influences parents’ feeding practices for their three- to five-year-old children. Cross-sectional data was obtained from parents and their three- to five-year-old children (n = 174), recruited from childcare centers located in low-income neighborhoods in Santiago, Chile. Weight and height were measured from parents and children, questionnaires regarding feeding styles and parent perceptions of child weight status were administered. An analysis of variance was used to examine child BMI z-score differences between feeding styles. Multiple linear regressions were conducted to test the moderating effect of parent feeding styles— demandingness and responsiveness—on the relation between underestimation of the child weight status and child BMI z-scores. Frequencies of misperceptions were obtained by comparing the perceived versus the objective child weight status; and multiple logistic regressions were conducted to examine the factors associated with underestimation of child weight status. For objective 3, we conducted photo-elicitation interviews with a purposively selected subset of 25 parents with diverse feeding styles. A thematic analysis with an inductive approach was conducted to identify influences on parents’ feeding practices from parents’ perspectives. Children of parents who had high demanding/low responsive feeding styles (M = .89, SD = .90) had significantly lower BMI z-scores compared to children of parents who have low demanding/low responsive feeding styles (M = 1.65, SD = 1.21). Parent underestimation of child weight status (B = .88, p < .001), and parent demandingness (B = -.53, p < .001) were independently associated with child BMI z-scores. Underestimation of child weight status was 47% in the total sample, and 78% among parents of overweight or obese children. Child BMI z-scores OR = 2.8 (95% CI: 1.91, 4.36), and parents of boys OR = 4.5 (95% CI: 1.33, 15.46), were associated with higher likelihood of parent underestimation of child weight status, while less screen hours exposure in the child OR = .52 (95% CI: .29, .93) was associated with lower likelihood of underestimation of child weight status. We identified three themes affecting parent feeding practices: (1) parent and child characteristics and the feeding dynamics; (2) family complexity and challenges; and (3) parents’ health knowledge. In the first theme, parents’ previous experiences as well as the parents’ reactions to the child’s characteristics generated adjustments in how the parent fed their child. In the second theme, interactions between family members (e.g., mothers, fathers, and grandparents) regarding the feeding of the child were complex. Moreover, family context revealed limited income and time, which determined the availability of necessary food, and the quality of food preparations. In the last theme, parents demonstrated knowledge of food and health, with knowledge sources being from public childcare and healthcare centers as well as from the Internet resources. Our results suggest that childhood obesity prevention programs may improve efficacy by considering parent feeding styles and addressing factors that can help parents to correctly estimate the weight status of their young children. In addition, attention must be paid to the uniqueness of parent-child interactions, the role of family members, and the family relationships with community organizations, such as childcare centers and healthcare centers. These organizations could develop a culturally-sensitive approach to enhance parents’ feeding practices to promote healthy eating and development of Chilean children.
Issue Date:2020-05-07
Type:Thesis
URI:http://hdl.handle.net/2142/108163
Rights Information:Copyright 2020 Marcela Vizcarra Catalan
Date Available in IDEALS:2020-08-26
Date Deposited:2020-05


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