The content of Food, Feeding, and Your Family (FFYF) primarily came from a previously developed parenting education program, Strategies for Effective Eating Development (SEEDS). The research informing the development of SEEDS, as well as publications reporting the results of the SEEDS evaluation can be found in the Research section of the SEEDS website. Design of the SEEDS program was informed by over 30 years of research on food parenting and childhood obesity, including numerous studies by the program developers of FFYF. Food, Feeding, and your Family was validated in a randomized controlled trial of 540 parents of 2- to 8-year-olds who received Eating Smart – Being Active through the Expanded Food and Nutrition Education Program (EFNEP) in Colorado and Washington state (see publications below).
Hughes, S. O., Power, T. G., Baker, S. S., Barale, K. V., Lanigan, J. D., Parker, L., Silva Garcia, K., Aragon, M. C., Micheli, N. (2020). Pairing feeding content with a nutrition education curriculum: A comparison of online and in-class delivery. Journal of Nutrition Education and Behavior, 52, 314-325.
Objective: To develop a childhood obesity prevention program, Food, Feeding and Your Family (FFYF), which encourages eating self-regulation in young children. This article describes the research methods for FFYF. Activities that will be used to guide the development of the program are illustrated in a logic model.
Design: A randomized control trial will be conducted with participant groups randomized into 1 of 3 conditions: (1) in-class delivery of feeding content and nutrition education, (2) online delivery of feeding content and in-class delivery of nutrition education, and (3) nutrition education only. Assessments will be collected at baseline, program completion, and 6 and 12 months after completion of the program.
Participants: Parents with 2- to 8-year-old children will be recruited from affiliated community agencies, 540 participants across both states. Interventions: FFYF derives content from an empirically validated parental feeding program, Strategies for Effective Eating Development, and will be administered with Eating Smart-Being Active, an evidence based, nutrition education curriculum.
Main Outcome Measures: Parents will report on feeding practices, child eating behaviors, feeding styles, and acculturation.
Analysis: Because of the nested nature of the data, multilevel analyses will be used: time points within parents within groups.
Aragón, M. C., Auld, G., Baker, S. S., Barale, K. V., Garcia, K. S., Micheli, N., Parker, L., Lanigan, J. D., Power, T. G., & Hughes, S. O. (2021). Implementation science strategies promote fidelity in the Food, Feeding, and Your Family Study. Journal of Nutrition Education and Behavior, 53, 1028–1037.
Objective: Use of implementation science strategies to promote fidelity in the Food, Feeding, and Your Family study.
Design: Cluster randomized controlled trial with 3 conditions: control, in-class, or online, delivered in English or Spanish. Observations of 20% of classes. Setting: Expanded Food and Nutrition Education Program (EFNEP) in 2 states.
Participants: EFNEP peer educators (n = 11). Intervention: Parental feeding content incorporated into EFNEP lessons (in-class) or through text with links to videos/activities (online). Extensive educator training, scripted curriculum, frequent feedback.
Analysis: Assessment of fidelity compliance. Qualitative analysis of verbatim educator interviews and classroom observer comments.
Results: During 128 class observations (40−45 per condition), peer educators followed scripted lesson plan 78% to 89% of the time. There was no evidence of cross-contamination of parental feeding content in control and only minor sharing in online conditions. Variations with fidelity were primarily tied to the EFNEP curriculum, not the parent feeding content. Educators (n = 7) expressed favorable opinions about the Food, Feeding, and Your Family study, thought it provided valuable information, and appreciated support from EFNEP leadership.
Conclusions and Implications: Incorporating implementation science strategies can help ensure successful adherence to research protocols. With proper training and support, EFNEP peer educators can deliver an evidence-based curriculum as part of a complex research study.
Hughes, S. O., Power, T. G., Baker, S. S., Barale, K. V., Aragon, M. C., Lanigan, J. D., Parker, L., Silva Garcia, K., Auld, G., Johnston, C. A., & Micheli, N. (2023). Short-term efficacy of a childhood obesity prevention program designed to pair feeding content with nutrition education. Childhood Obesity, 19, 239-248.
Background: Family-based programs show considerable promise in preventing overweight and obesity in young children. However, dissemination is difficult because significant participant and staff involvement is required. This study examined the short-term efficacy of adding parental feeding content to a widely-used nutrition education curriculum for families in low-resourced communities comparing the influence of two delivery methods (in-class and online) on parents’ feeding knowledge, practices, and styles.
Methods: In this cluster randomized controlled trial, parents of 2- to 8-year-old children enrolled in the EFNEP (Expanded Food and Nutrition Education Program) in Colorado and Washington were randomly assigned to: in-class nutrition education only, in class nutrition education with in-class feeding content, or in-class nutrition education with online feeding content. Data from the 382 participants who completed both pretest and posttest assessments are reported in this study.
Results: Multilevel analyses showed empirical support for the influence of the program on parents’ feeding knowledge, practices, and styles. Online and in-class methods were equally effective in delivering feeding content in low-resourced communities. Consistent effects were seen across the two delivery methods for encouraging children to try new foods (p < 0.05), use of child centered feeding practices (i.e., greater responsiveness, p < 0.05), child involvement in food preparation (p < 0.05), and understanding the number of presentations often necessary for child acceptance of a new food (p < 0.001). Location and language differences were seen across some constructs.
Conclusions: This study demonstrates the efficacy of in-class and online approaches to feeding highlighting the program’s positive effects on promoting healthy feeding behaviors for parents of children in low-resourced families.
Pierce, T. B., Aragon, M. C., Auld, G., Barale, K. V., Hughes, S. O., Power, T. G., Lanigan, J. D., Parker, L., & Baker, S. S. (in press). Parents report positive changes in parental feeding practices 12 months after intervention. Journal of Nutrition Education and Behavior.
Objective: Determine self-reported parental feeding behavior changes and perspectives on parental feeding intervention at 12-month follow-up.
Methods: Telephone focus groups using a 2 x 2 design (English/Spanish x in-class or online) with Expanded Food and Nutrition Education Program participants (n = 37) with children 2-8 years and high exposure to the Food, Feeding, and Your Family intervention (7 lessons). Researchers (n = 3) independently identified themes.
Results: Parent behavior changes that (1) positively influenced children’s diets, (2) involved children in food-related activities, (3) eased stressful situations around food, (4) led to healthier food choices, and (5) saved money when food shopping. Commonly implemented practices included establishing structured mealtime routines, introducing new foods multiple times, and encouraging children’s eating competence. Online participants noted materials were easily accessible via text messages.
Conclusions and Implications: Incorporating parental feeding content (in-class or online) into nutrition education interventions, such as the Expanded Food and Nutrition Education Program, supports developing positive parental feeding behaviors in families with low income.