Food Resource Management Skills Modify the Associations Between Household Food Insecurity and Child Feeding Practices in SNAP-Ed Eligible Head Start Families

Abstract

Abstract Objectives To explore how food security (FS) and food resource management (FRM), strategies to stretch limited food resource dollars, are associated with child feeding practices in low-income preschoolers. Methods In a cross-sectional sample of 364 Head Start households, caregivers completed the 18-item FS module, 6-item FRM behavior subscale, Comprehensive Feeding Practices Questionnaire (e.g., monitoring, restriction, food as reward), and Perceived Stress scale. Households were categorized into four food environment subgroups: FS/good FRM, FS/poor FRM, food insecure/good FRM, and food insecure/poor FRM. Multivariable linear regressions were applied to examine if feeding practices differed across FS-FRM categories, adjusting for demographic and socio-economic covariates that differed significantly by FS-FRM subgroups (race, SNAP participation, parent BMI status). For all models, FS/good FRM was the referent. Lastly, we explored the effect of adding perceived stress to the model. on feeding practices. Results 37% of households were food insecure. The use of parent monitoring, modeling, involvement, and food as reward were significantly different by FS-FRM subgroups (all p-values <0.02). After adjusting for covariates, the FS/poor FRM group used less monitoring (–0.48, 95% CI: –0.71, –0.24), modeling (–0.42, 95CI: –0.66, –0.18), and involvement in feeding (–0.56, 95% CI: –0.80, –0.31). A similar pattern emerged for the food insecure/poor FRM group compared to referent. The use of food as reward was higher in the FS/poor FRM (0.29, 95CI: 0.03, 0.55), food insecure/good FRM (0.39, 95CI: 0.09, 0.70) and food insecure/poor FRM groups (0.33, 95% CI: 0.03, 0.64). These differences observed in feeding practices became insignificant in all but one food insecure subgroup once perceived stress was added to the model. Conclusions Suboptimal child feeding is evident in low-income caregivers with poor FRM skills with or without food insecurity. Promoting FRM skills in addition to addressing FI and stress could potentially synergistically improve child feeding practices in low-income households. Funding Sources This study was funded by USDA's Supplemental Nutrition Assistance Program (SNAP) through the PA Department of Human Services (DHS). This institution is an equal opportunity provider.