Department of Pediatric and Preventive Dentistry, Centre for Early Childhood Caries Research (CECCRe), Sri Ramachandra Institute of Higher Education and Research, Chennai, India.
Department of Public Health Dentistry, Faculty of Dental Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai, India.
Community Dent Oral Epidemiol. 2020 Dec;48(6):471-479. doi: 10.1111/cdoe.12558. Epub 2020 Jul 16.
Feeding practices adopted by parents play a critical role in the development of children's taste preferences, eating habits, nutrition and eventual weight status. Many scales have been developed to assess feeding practices among children of various age groups. This paper aimed to construct and validate a robust scale for the comprehensive assessment of sleep-time feeding practices for children aged 0-3 years and to establish the risk of developing Early Childhood Caries (ECC).
There were multiple phases to the development of the scale: (a) formation of a conceptual framework, (b) systematic development of an item pool, (c) refinement of the item pool by focus group discussion, cognitive interviewing and pretesting, (d) validity testing and (e) reliability testing. The conceptual framework was built based on four broad constructs: breastfeeding, bottle-feeding, other feeding modes and 'tooth and diet' constructs. Reviews of existing scales in related areas were instrumental in scale development and helped to generate an initial pool of 45 items, which was finally refined to 28 items.
Cognitive interviews by the 'think-aloud protocol' helped to reduce ambiguity and maximize clarity of the questions. Pretesting the scale aided increased comprehension and specificity. Face and content validity were corroborated by 'subject matter experts' who endorsed the suitability and appropriateness of items. Reliability was assessed by test-retest, and a near-perfect agreement was obtained in 96% of the items.
This is the first validated scale currently available for recording sleep-time feeding practices of children less than three years of age. This 28-item scale can be applied as a potential clinical scale to record sleep-time feeding history and the risk of developing ECC as well as a research scale to investigate the association of sleep-time feeding practices with ECC.
父母采用的喂养方式对儿童味觉偏好、饮食习惯、营养摄入和最终体重状况的发展起着至关重要的作用。许多量表已经开发出来，用于评估不同年龄组儿童的喂养方式。本文旨在构建和验证一种用于全面评估 0-3 岁儿童睡眠时喂养行为的可靠量表，并确定其与早期儿童龋（ECC）发生风险的关系。
该量表的开发有多个阶段：（a）形成概念框架，（b）系统地开发项目池，（c）通过焦点小组讨论、认知访谈和预测试对项目池进行精炼，（d）进行有效性测试，（e）进行可靠性测试。概念框架是基于四个广泛的结构构建的：母乳喂养、奶瓶喂养、其他喂养方式和“牙齿与饮食”结构。对相关领域现有量表的回顾在量表开发中发挥了重要作用，并帮助生成了最初的 45 个项目池，最终精炼为 28 个项目。
采用“出声思维法”的认知访谈有助于减少问题的模糊性并最大限度地提高问题的清晰度。对量表进行预测试有助于提高理解能力和针对性。通过“主题专家”的面质和内容有效性验证了项目的适宜性和恰当性。通过测试-重测评估了可靠性，96%的项目得到了近乎完美的一致性。
这是目前可用于记录 3 岁以下儿童睡眠时喂养行为的第一个经过验证的量表。该 28 项量表可作为一种潜在的临床量表，用于记录睡眠时喂养史和发生 ECC 的风险，也可作为研究量表，用于调查睡眠时喂养行为与 ECC 的相关性。
