Chilman Laine B, Meredith Pamela J, Southon Nicole, Kennedy-Behr Ann, Frakking Thuy, Swanepoel Libby, Verdonck Michèle
School of Health, University of the Sunshine Coast, Sunshine Coast, Australia.
School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
Aust Occup Ther J. 2024 Oct;71(5):644-660. doi: 10.1111/1440-1630.12947. Epub 2024 Mar 27.
BACKGROUND/AIM: Picky eating is a common childhood phenomenon that impacts many families' occupations surrounding mealtimes. Evidence of the effectiveness of Occupational Performance Coaching (OPC) for caregivers of children suggests it may represent a useful occupation-focused intervention for parents of picky eaters. Using an OPC-targeted intervention, this study aims to report preliminary effectiveness, explore the experience of parents' participation, and investigate factors that influence the OPC intervention.
This study used an explanatory mixed-method design. Parent participants (n = 8) were recruited via purposive sampling and engaged in three sessions of OPC delivered via an online platform between October and December 2022. Standardised assessments were completed before and after OPC and a qualitative semi-structured interview two weeks after the final OPC session. Variables were analysed descriptively, and independent t tests were performed to compare scores on each standardised assessment pre- and post-intervention. Pearson's correlation analyses were conducted to consider associations between resistance to change and the extent of change in each outcome measure. Reflexive thematic analysis was conducted on postintervention interview transcripts.
Consumer invovlement was limited to parents feedback on their experiences of the intervention.
Improvements in occupational performance as measured by the COPM change score were statistically significant (p = <0.001). Child eating behaviours, as measured by the CEBQ Food Fussiness subscale change score (p = 0.01) and BPFAS change score (p = 0.02), demonstrated significant improvements. The extent to which parents viewed these behaviours as problematic as measured by the BPFAS problem change score, showed a significant reduction (p = <0.001). Three themes emerged from interviews with parents: small changes beyond nutrition, parents supported as the experts, and what parents value within an intervention.
Targeted OPC intervention delivered online by an occupational therapist may be an effective intervention for parents of picky eaters. Future studies using randomised controls are required before OPC can be routinely recommended in a clinical setting for the management of picky eating in children.
背景/目的：挑食是一种常见的儿童现象，会影响许多家庭围绕用餐时间的日常活动。有证据表明，职业表现指导（OPC）对儿童照顾者有效，这表明它可能是针对挑食儿童家长的一种有用的以日常活动为重点的干预措施。本研究采用以OPC为目标的干预措施，旨在报告初步效果，探索家长参与的体验，并调查影响OPC干预的因素。
本研究采用解释性混合方法设计。通过目的抽样招募了家长参与者（n = 8），他们于2022年10月至12月期间通过在线平台参加了三次OPC课程。在OPC前后完成标准化评估，并在最后一次OPC课程两周后进行定性半结构化访谈。对变量进行描述性分析，并进行独立t检验以比较干预前后各标准化评估的分数。进行Pearson相关分析以考虑变革阻力与各结果指标变化程度之间的关联。对干预后访谈记录进行反思性主题分析。
消费者参与仅限于家长对干预体验的反馈。
以COPM变化分数衡量的职业表现有显著改善（p = <0.001）。以CEBQ食物挑剔子量表变化分数（p = 0.01）和BPFAS变化分数（p = 0.02）衡量的儿童饮食行为有显著改善。以BPFAS问题变化分数衡量的家长认为这些行为有问题的程度显著降低（p = <0.001）。对家长的访谈产生了三个主题：营养之外的小变化、家长作为专家得到支持以及家长在干预中看重的东西。
职业治疗师通过在线方式提供的针对性OPC干预可能是针对挑食儿童家长的有效干预措施。在OPC能够在临床环境中常规推荐用于管理儿童挑食之前，需要进行使用随机对照的未来研究。
