School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK.
Centre for Behaviour Change, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK; Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Polhill Avenue, Bedford, MK41 9EA, UK.
Appetite. 2023 Oct 1;189:106764. doi: 10.1016/j.appet.2023.106764. Epub 2023 Jul 12.
Children's vegetable intake is low, despite benefits for immediate and long-term health. Repeatedly reoffering vegetables, role-modelling consumption, and offering non-food rewards effectively increase children's vegetable acceptance and intake. However, a number of barriers prevent families from reoffering previously-rejected vegetables. This study used the Theoretical Domains Framework (TDF) and the COM-B model of behaviour to explore barriers and enablers to reoffering, role-modelling and offering non-food rewards among parents of 2-4-year-old children. Twenty-five semi-structured interviews were conducted, from which eleven core inductive themes were generated: 'Child factors', 'Eating beliefs', 'Effectiveness beliefs', 'Past experience', 'Current family behaviours', 'Harms', 'Knowledge', 'Need for change', 'Parent effort', 'Parent values' and 'Practical issues'. The codes underpinning these themes were inductively mapped to 11 of the 14 TDF domains, and five of the six COM-B components. Previously-reported influences on families' vegetable feeding practices were confirmed, including concerns about child rejection of foods/meals, cost of vegetables, and food waste. Novel findings included some parents' perceptions that these practices are pressurising, and that certain beliefs/knowledge about children's eating behaviour can provide a "protective mindset" that supports families' perseverance with reoffering over time. Future interventions should be tailored to better reflect the diversity of needs and previous experiences of feeding that families have, with some families likely to find that troubleshooting and further signposting is appropriate for their needs while others might benefit from more persuasive and educational approaches. The mapping of codes to the TDF and COM-B will facilitate the identification of appropriate intervention functions and behaviour change techniques when designing new interventions to support families with increasing their children's vegetable intake.
尽管儿童摄入蔬菜对其近期和长期健康都有好处，但实际上他们的蔬菜摄入量仍然较低。反复提供蔬菜、树立榜样并提供非食物奖励可以有效地增加儿童对蔬菜的接受度和摄入量。然而，许多因素阻止了家庭重复提供之前被拒绝的蔬菜。本研究使用理论领域框架（TDF）和行为的 COM-B 模型，探索了 2-4 岁儿童父母重新提供、树立榜样和提供非食物奖励的障碍和促成因素。进行了 25 次半结构化访谈，从中生成了 11 个核心归纳主题：“儿童因素”、“饮食信念”、“有效性信念”、“过往经验”、“当前家庭行为”、“危害”、“知识”、“改变需求”、“父母努力”、“父母价值观”和“实际问题”。这些主题所依据的代码被归纳映射到 TDF 的 14 个领域和 COM-B 的 6 个组成部分中的 11 个。之前报道的影响家庭蔬菜喂养实践的因素得到了证实，包括对儿童拒绝食物/餐点、蔬菜成本和食物浪费的担忧。新的发现包括一些父母认为这些做法具有压力，而关于儿童饮食行为的某些信念/知识可以提供一种“保护心态”，支持家庭随着时间的推移坚持重新提供食物。未来的干预措施应根据家庭喂养需求和以往经验的多样性进行调整，一些家庭可能需要解决问题和进一步提供指导，而另一些家庭可能需要更有说服力和教育性的方法。将代码映射到 TDF 和 COM-B 将有助于在设计新的干预措施以支持家庭增加儿童蔬菜摄入量时，确定适当的干预功能和行为改变技术。
