Self-Efficacy for Healthy Eating Moderates the Impact of Stress on Diet Quality Among Family Child Care Home Providers

Abstract

ObjectiveTo examine associations of stress and sleep with diet quality of family child care home (FCCH) providers, and whether self-efficacy for healthy eating influences these associations. DesignA cross-sectional analysis was performed using baseline data (2013–2015) from a randomized control trial with FCCH providers. ParticipantsThe study included 166 licensed FCCH providers, aged >18 years, from central North Carolina. Main Outcome Measure(s)Diet quality was assessed with a food frequency questionnaire, used to calculate a modified 2010-Healthy Eating Index score. Stress, sleep quality, and diet self-efficacy were measured via self-administered questionnaires. AnalysisUsing observations from 158 participants with complete data, multiple linear regression models were created to assess whether stress, sleep quality, and diet self-efficacy were associated with diet quality and whether diet self-efficacy moderated these associations (significance set at P < 0.05). ResultsIn the initial model, only diet self-efficacy was significantly associated with diet quality (β = 0.32; P < 0.001). Moderation analyses showed that higher stress was associated with lower diet quality, but only when diet self-efficacy was low. ConclusionsBuilding FCCH providers’ self-efficacy for healthy eating is an important component of health promotion and can buffer the impact of stress on their diet quality.