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. 2018 Nov 20;15(1):113.
doi: 10.1186/s12966-018-0736-7.

Validation of a measurement instrument for parental child feeding in a low and middle-income country

Digna Niken Purwaningrum  1   2 , Helda Yessy Maria Sibagariang  3 , Jayashree Arcot  4 , Hamam Hadi  5 , Rasita Amelia Hasnawati  6 , Risma Saski Rahmita  6 , Rohan Jayasuriya  7
Affiliations

Validation of a measurement instrument for parental child feeding in a low and middle-income country

Digna Niken Purwaningrum et al. Int J Behav Nutr Phys Act. .

Abstract

Background: Parental child feeding practices (PCFP) are a key factor influencing children's dietary intake, especially in the preschool years when eating behavior is being established. Instruments to measure PCFP have been developed and validated in high-income countries with a high prevalence of childhood obesity. The aim of this study was to test the appropriateness, content, and construct validity of selected measures of PCFP in a low and middle-income country (LMIC) in which there is both undernutrition and obesity in children.

Methods: An expert panel selected subscales and items from measures of PCFP that have been well-tested in high-income countries to measure both "coercive" and "structural" behaviors. Two sequential cross-sectional studies (Study 1, n = 154; Study 2, n = 238) were conducted in two provinces in Indonesia. Findings of the first study were used to refine subscales used in Study 2. An additional qualitative study tested content validity from the perspective of mothers (the intended respondents). Factorial validation and reliability were also tested. Convergent validity was tested with child nutritional status.

Results: In Study 1, a confirmatory factor analysis (CFA) model with 11 factors provided good fit (RMSEA = 0.045; CFI = 0.95 and TLI = 0.95) after two subscales were removed. Reliability was good among seven of the subscales. Following a decision to take out an additional subscale, the instrument was tested for factorial validity (Study 2). A CFA model with 10 subscales provided good fit (RMSEA = 0.03; CFI = 0.92 and TLI = 0.90). The reliability of subscales was lower than in Study 1. Convergent validity with nutrition status was found with two subscales.

Conclusions: The two studies provide evidence of acceptable psychometric properties for 10 subscales from tested instruments to measure PCFP in Indonesia. This provides the first evidence of the validity of these measures in a LMIC setting. Some shortcomings, such in the reliability of some subscales and further tests of predictive validity, require further investigation.

Keywords: Child feeding practices; Indonesia; Parental child feeding; Validation.

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Conflict of interest statement

Ethics approval and consent to participate

Ethics approvals for Study 1 were obtained from the Human Research Ethic Committee, University of New South Wales, Australia, and the Human Ethics Committee, Faculty of Medicine (HC15303), University of Lampung (No. 1740/UN26/8/DT/2015). Ethics approvals for Study 2 were obtained from the Human Research Ethics Committee, University of New South Wales, Australia (HC15826), and the Medical and Health Research Ethics Committee, Universitas Gadjah Mada, Indonesia (KE/FK/196/EC/2016). All research activities in Lampung and Yogyakarta provinces were approved by local governments (Research and Development Department and the District Health Offices). Informed consent was obtained in writing from all participants before data collection in all phases.

Consent for publication

Not applicable (this manuscript does not contain any individual details, images or videos. Only aggregate data were used in this publication).

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
The Parental Child Feeding Practices Model in Study One. The PCFP model with standardized estimates fitted in a sample of Study 1, factor correlations and reliabilities (n = 154)
Fig. 2
Fig. 2
The Parental Child Feeding Practices Model in Study Two. The PCFP model with standardized estimates fitted in a sample of Study 2, factor correlations and reliabilities (n = 238)
See this image and copyright information in PMC

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