Development and Preliminary Evaluation of Chinese Preschoolers’ Caregivers’ Feeding Behavior Scale

Abstract

BackgroundCaregivers’ feeding behavior plays a crucial role in the development of overweight and obesity in preschoolers. However, to date, there is no broadly accepted scale or questionnaire for assessing preschoolers’ caregivers’ feeding behavior in China. ObjectiveTo develop a scale that can be used to assess preschoolers’ caregivers’ feeding behavior in China and to conduct a preliminary evaluation of the scale’s reliability, validity, and discriminative ability. DesignThe scale was created through a literature review and qualitative interviews with the target population. Items were reviewed by 50 caregivers of preschoolers and 10 experienced pediatricians, and 95 items were selected to form a draft scale. The draft scale underwent three rounds of investigation, and the results from these evaluations were used to select items that formed the final scale. Participants/settingThree groups of caregivers (n=175, 400, and 912) were sampled and stratified from urban and suburban kindergartens in the cities of Jinan and Xi’an between March 2016 and October 2017 to participate in evaluations of the draft scale. From these caregiver groups, 146, 362, and 768 participants completed valid questionnaires, respectively, which were used in the scale’s evaluation. Primary outcome measuresThe general demographic data of the participants and scores of each item in the scale were the primary outcome measures. Statistical analyses performedExploratory factor analysis and variability analysis were used to evaluate the draft scale, based on data from two rounds of investigation. The structure of the scale was explored through confirmatory factor analysis, and its reliability, construct validity, and discriminative ability were evaluated based on data from a third round of investigation. ResultsThe Chinese Preschoolers’ Caregivers’ Feeding Behavior Scale (CPCFBS) consisted of 35 items and seven dimensions; the total cumulative variance contribution rate was 58.6%; the Cronbach’s α coefficient was .91; the split-half reliability coefficient was 0.89; and the test–retest reliability coefficient was 0.85. The age and weight status of the children and the caregivers’ age and education levels, as well as family incomes and child-caregiver relationships, were correlated with feeding behavior. ConclusionsThe CPCFBS appeared to have good reliability and construct validity in specific Chinese populations. Future studies are needed to confirm existing findings in different Chinese populations with larger sample sizes.