Modifying the Environment and Policy Assessment and Observation (EPAO) to better capture feeding practices of family childcare home providers.
Modifying the Environment and Policy Assessment and Observation (EPAO) to better capture feeding practices of family childcare home providers.
复制标题
修改环境与政策评估和观察 (EPAO)，以更好地了解家庭托儿所提供者的喂养做法。
DOI：
10.1017/s1368980018002665
复制
发表时间：
2019
影响因子：
3.2
通讯作者：
Ward,DianneS
中科院分区：
文献类型：
--
作者：
Tovar,Alison;Vaughn,AmberE;Fisher,JenniferOrlet;BenjaminNeelon,SaraE;Burney,Regan;Webster,Kathleen;Liu,Tao;Ostbye,Truls;Ward,DianneS
目的描述的修改和验证现有的工具，环境和政策评估和观察（EPAO），以更好地捕捉供应商喂养practices.DesignModifications的EPAO进行了，有效性评估，通过专家评审，试点测试，然后用于收集随访数据，在为期两天的家访正在进行的随机分组试验。探索性因素分析探讨了饲养方式的潜在因素结构。为了测试这些因素的预测有效性，多水平混合模型研究了健康饮食指数-2010中的因素与儿童饮食质量之间的关联（HEI-2010）评分（通过儿童保育饮食观察协议测量）。设置家庭儿童保育院（FCCH）在罗得岛和北卡罗来纳州，用改进的EPAO对53个FCCH进行了初步测试，然后用133个FCCH收集数据。（“强制控制和放纵喂养的做法”，“自主支持的做法”，“负面的角色塑造”）捕获了总方差的43%。在调整协变量的多层次混合模型中，“自主支持实践”与儿童的饮食质量呈正相关。使用“自主支持实践”增加1个单位与儿童HEI-2010得分增加9.4个单位相关（P= 0.001）。鉴于美国学龄前儿童的饮食仍然不理想，向儿童保育提供者传授支持性喂养方法可能有助于改善儿童的饮食质量。
ObjectiveTo describe the modification and validation of an existing instrument, the Environment and Policy Assessment and Observation (EPAO), to better capture provider feeding practices.DesignModifications to the EPAO were made, validity assessed through expert review, pilot tested and then used to collect follow-up data during a two-day home visit from an ongoing cluster-randomized trial. Exploratory factor analysis investigated the underlying factor structure of the feeding practices. To test predictive validity of the factors, multilevel mixed models examined associations between factors and child’s diet quality as captured by the Healthy Eating Index-2010 (HEI-2010) score (measured via the Dietary Observation in Childcare Protocol).SettingFamily childcare homes (FCCH) in Rhode Island and North Carolina, USA.ParticipantsThe modified EPAO was pilot tested with fifty-three FCCH and then used to collect data in 133 FCCH.ResultsThe final three-factor solution (‘coercive control and indulgent feeding practices’, ‘autonomy support practices’, ‘negative role modelling’) captured 43 % of total variance. In multilevel mixed models adjusted for covariates, ‘autonomy support practices’ was positively associated with children’s diet quality. A 1-unit increase in the use of ‘autonomy support practices’ was associated with a 9·4-unit increase in child HEI-2010 score (P=0·001).ConclusionsSimilar to the parenting literature, constructs which describe coercive controlling practices and those which describe autonomy-supportive practices emerged. Given that diets of pre-schoolers in the USA remain suboptimal, teaching childcare providers about supportive feeding practices may help improve children’s diet quality.