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Mediators of improved child diet quality following a health promotion intervention: the Melbourne InFANT Program.

Spence AC, Campbell KJ, Crawford DA, McNaughton SA, Hesketh KD - Int J Behav Nutr Phys Act (2014)

Bottom Line: Post- intervention, higher maternal feeding knowledge and lower use of foods as rewards was found to mediate the direct intervention effect on child diet quality.While other aspects of maternal feeding practices, self-efficacy and dietary intakes did not act as mediators, they were associated with child diet quality.This evidence of intervention efficacy and mediation provides important insights for planning future interventions.

View Article: PubMed Central - PubMed

Affiliation: Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Hwy, Burwood, Victoria, 3125, Australia. a.spence@deakin.edu.au.

ABSTRACT

Background: Young children's diets are currently suboptimal. Given that mothers have a critical influence on children' diets, they are typically a target of interventions to improve early childhood nutrition. Understanding the maternal factors which mediate an intervention's effect on young children's diets is important, but has not been well investigated. This research aimed to test whether maternal feeding knowledge, maternal feeding practices, maternal self-efficacy, and maternal dietary intakes acted as mediators of the effect of an intervention to improve child diet quality.

Methods: The Melbourne Infant Feeding Activity and Nutrition Trial (InFANT) Program was a cluster-randomized controlled trial, conducted from 2008-2010. This novel, low-dose, health promotion intervention was delivered quarterly over 15 months and involved educational activities, promotion of peer discussion, a DVD and written materials. Post-intervention, when children were approximately 18 months of age, child diets were assessed using multiple 24-hour recalls and a purpose-developed index of diet quality, the Obesity Protective Dietary Index. Maternal mediators were assessed using a combination of previously validated and purpose-deigned tools. Mediation analysis was conducted using the test of joint significance and difference of coefficients methods.

Results: Across 62 parents' groups in Melbourne, Australia, 542 parents were recruited. Post- intervention, higher maternal feeding knowledge and lower use of foods as rewards was found to mediate the direct intervention effect on child diet quality. While other aspects of maternal feeding practices, self-efficacy and dietary intakes did not act as mediators, they were associated with child diet quality.

Conclusions: Mediation analysis of this novel health promotion intervention showed the importance of maternal feeding knowledge and use of foods as rewards in impacting child diet quality. The other maternal factors assessed were appropriate targets but further research on how to impact these in an intervention is important. This evidence of intervention efficacy and mediation provides important insights for planning future interventions.

Trial registration: Current Controlled Trials ISRCTN81847050, registered 23 November 2007.

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Theoretical model showing proposed mediators of the intervention effect on child diet quality, informed by MacKinnon 2008[21].
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Fig1: Theoretical model showing proposed mediators of the intervention effect on child diet quality, informed by MacKinnon 2008[21].

Mentions: The Melbourne Infant Feeding Activity and Nutrition Trial (InFANT) Program was a health promotion intervention which significantly improved diet quality of children at 18 months of age [27]. The intervention aimed to achieve this via improving mothers’ knowledge of child feeding and nutrition, child feeding practices, self-efficacy for promoting healthy eating and modeling. Therefore the hypothesis tested in this study is that these maternal correlates would act as mediators of the intervention effect on children’s diet quality, as outlined in Figure 1. This study aims to assess which components of maternal behavior were impacted by the intervention and acted as mediators of the intervention effect on child diet quality.Figure 1


Mediators of improved child diet quality following a health promotion intervention: the Melbourne InFANT Program.

Spence AC, Campbell KJ, Crawford DA, McNaughton SA, Hesketh KD - Int J Behav Nutr Phys Act (2014)

Theoretical model showing proposed mediators of the intervention effect on child diet quality, informed by MacKinnon 2008[21].
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4230360&req=5

Fig1: Theoretical model showing proposed mediators of the intervention effect on child diet quality, informed by MacKinnon 2008[21].
Mentions: The Melbourne Infant Feeding Activity and Nutrition Trial (InFANT) Program was a health promotion intervention which significantly improved diet quality of children at 18 months of age [27]. The intervention aimed to achieve this via improving mothers’ knowledge of child feeding and nutrition, child feeding practices, self-efficacy for promoting healthy eating and modeling. Therefore the hypothesis tested in this study is that these maternal correlates would act as mediators of the intervention effect on children’s diet quality, as outlined in Figure 1. This study aims to assess which components of maternal behavior were impacted by the intervention and acted as mediators of the intervention effect on child diet quality.Figure 1

Bottom Line: Post- intervention, higher maternal feeding knowledge and lower use of foods as rewards was found to mediate the direct intervention effect on child diet quality.While other aspects of maternal feeding practices, self-efficacy and dietary intakes did not act as mediators, they were associated with child diet quality.This evidence of intervention efficacy and mediation provides important insights for planning future interventions.

View Article: PubMed Central - PubMed

Affiliation: Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Hwy, Burwood, Victoria, 3125, Australia. a.spence@deakin.edu.au.

ABSTRACT

Background: Young children's diets are currently suboptimal. Given that mothers have a critical influence on children' diets, they are typically a target of interventions to improve early childhood nutrition. Understanding the maternal factors which mediate an intervention's effect on young children's diets is important, but has not been well investigated. This research aimed to test whether maternal feeding knowledge, maternal feeding practices, maternal self-efficacy, and maternal dietary intakes acted as mediators of the effect of an intervention to improve child diet quality.

Methods: The Melbourne Infant Feeding Activity and Nutrition Trial (InFANT) Program was a cluster-randomized controlled trial, conducted from 2008-2010. This novel, low-dose, health promotion intervention was delivered quarterly over 15 months and involved educational activities, promotion of peer discussion, a DVD and written materials. Post-intervention, when children were approximately 18 months of age, child diets were assessed using multiple 24-hour recalls and a purpose-developed index of diet quality, the Obesity Protective Dietary Index. Maternal mediators were assessed using a combination of previously validated and purpose-deigned tools. Mediation analysis was conducted using the test of joint significance and difference of coefficients methods.

Results: Across 62 parents' groups in Melbourne, Australia, 542 parents were recruited. Post- intervention, higher maternal feeding knowledge and lower use of foods as rewards was found to mediate the direct intervention effect on child diet quality. While other aspects of maternal feeding practices, self-efficacy and dietary intakes did not act as mediators, they were associated with child diet quality.

Conclusions: Mediation analysis of this novel health promotion intervention showed the importance of maternal feeding knowledge and use of foods as rewards in impacting child diet quality. The other maternal factors assessed were appropriate targets but further research on how to impact these in an intervention is important. This evidence of intervention efficacy and mediation provides important insights for planning future interventions.

Trial registration: Current Controlled Trials ISRCTN81847050, registered 23 November 2007.

Show MeSH
Related in: MedlinePlus