Validation of the comprehensive feeding practices questionnaire in parents of preschool children in Brazil

Abstract

Background: Recent national surveys in Brazil have demonstrated a decrease in the consumption of traditional food and a parallel increase in the consumption of ultra-processed food, which has contributed to a rise in obesity prevalence in all age groups. Environmental factors, especially familial factors, have a strong influence on the food intake of preschool children, and this has led to the development of psychometric scales to measure parents' feeding practices. The aim of this study was to test the validity of a translated and adapted Comprehensive Feeding Practices Questionnaire in a sample of Brazilian preschool-aged children enrolled in private schools.

Methods: A transcultural adaptation process was performed in order to develop a modified questionnaire (43 items). After piloting, the questionnaire was sent to parents, along with additional questions about family characteristics. Test-retest reliability was assessed in one of the schools. Factor analysis with oblique rotation was performed. Internal reliability was tested using Cronbach's alpha and correlations between factors, discriminant validity using marker variables of child's food intake, and convergent validity via correlations with parental perceptions of perceived responsibility for feeding and concern about the child's weight were also performed.

Results: The final sample consisted of 402 preschool children. Factor analysis resulted in a final questionnaire of 43 items distributed over 6 factors. Cronbach alpha values were adequate (0.74 to 0.88), between-factor correlations were low, and discriminant validity and convergent validity were acceptable.

Conclusions: The modified CFPQ demonstrated significant internal reliability in this urban Brazilian sample. Scale validation within different cultures is essential for a more comprehensive understanding of parental feeding practices for preschoolers.

Keywords: Child nutrition; Feeding behavior; Food consumption; Parent-child relations; Preschool child; Validation studies.

Fig. 1

Participant flowchart of losses and exclusions

Fig. 2

Spearman’s correlations between factors, Cronbach’s alpha for each sub-scale, and factor loadings for each item. Note. Values on the left side of the figure are correlations (Spearman’s rho), with significant correlations (p < 0.05) in bold. Values in ovals are Cronbach’s alpha (α) for each derived sub-scale (all over 0.70). Values in boxes give factor loadings from EFA (all over 0.30)