Center for Childhood Obesity Research, 129 Noll Laboratory, The Pennsylvania State University, University Park, PA, 16802, USA; Nutritional Sciences, 110 C Chandlee Laboratory, The Pennsylvania State University, University Park, PA, 16802, USA.
Center for Childhood Obesity Research, 129 Noll Laboratory, The Pennsylvania State University, University Park, PA, 16802, USA.
Appetite. 2021 Apr 1;159:105060. doi: 10.1016/j.appet.2020.105060. Epub 2020 Dec 1.
Expert guidance encourages interventions promoting structure-based practices to establish predictable eating environments in order to foster children's self-regulatory skills. However, few studies have examined whether and how child characteristics may moderate effects of interventions on maternal feeding practices. This analysis aimed to examine the effect of the INSIGHT Responsive Parenting (RP) intervention delivered largely during infancy, on child appetitive traits at 2.5 years and maternal feeding practices at 3 years. Primiparous mother-newborn dyads were randomized to a RP intervention designed for obesity prevention or a safety control intervention. Mothers completed the Child Eating Behavior Questionnaire at 2.5 years and the Structure and Control in Parent Feeding Questionnaire at 3 years. T-tests assessed study group differences on child appetitive traits at 2.5 years and maternal feeding practices at age 3. ANCOVA models assessed the effect of study group on parent feeding practices and tested appetitive traits as a moderator. Two hundred thirty-two mother-child dyads completed the trial. Mothers were predominantly white, non-Hispanic, college educated, and married. RP group mothers used more consistent meal routines, and less pressure, food to soothe, and food as reward compared to controls. Child satiety responsiveness moderated the RP intervention effect on maternal use of limiting exposure to unhealthy foods such that the RP intervention was most effective for children at higher levels of satiety responsiveness. Food responsiveness moderated RP intervention effects on maternal use of pressure, such that at lower levels of food responsiveness, control group mothers used more pressure than RP mothers. The INSIGHT RP intervention demonstrated sustained effects on maternal feeding practices through age 3 years, with some intervention effects showing moderation by child appetitive traits.
专家指导鼓励采取基于结构的干预措施，以建立可预测的饮食环境，从而培养儿童的自我调节技能。然而，很少有研究探讨儿童特征是否以及如何调节干预措施对母亲喂养行为的影响。本分析旨在研究 INSIGHT 响应式育儿（RP）干预措施对 2.5 岁儿童食欲特征和 3 岁时母亲喂养行为的影响。初产妇母婴对子被随机分配到 RP 干预组（旨在预防肥胖）或安全对照组。母亲在 2.5 岁时完成儿童饮食行为问卷，在 3 岁时完成父母喂养问卷的结构和控制部分。t 检验评估了 2.5 岁时研究组儿童食欲特征和 3 岁时母亲喂养行为的差异。ANCOVA 模型评估了研究组对父母喂养行为的影响，并测试了食欲特征作为调节因素。232 对母婴完成了试验。母亲主要是白人、非西班牙裔、大学学历、已婚。RP 组的母亲比对照组更常采用一致的进餐常规，较少采用施压、食物安抚和食物奖励的方式。饱腹感反应性调节了 RP 干预对母亲限制不健康食物摄入的影响，使得 RP 干预对饱腹感反应性较高的儿童效果最佳。食物反应性调节了 RP 干预对母亲使用施压的影响，即食物反应性较低时，对照组母亲比 RP 母亲使用更多的施压方式。INSIGHT RP 干预通过 3 岁时持续对母亲喂养行为产生影响，其中一些干预效果受到儿童食欲特征的调节。
