Poster #65 - Development and Psychometric Testing of the Infant Food Choice Questionnaire

• In Event: Poster Session 09

Abstract

Purpose: Complementary feeding practices (CFPs), the ways solid foods are introduced to infants, are associated with health outcomes, such as obesity and food allergies (Gingras et al., 2019; Du Toit et al., 2015). Both conditions are increasing in prevalence and can have lifelong impacts (Tang & Mullins, 2017; Gupta, et al, 2019; Fryar et al., 2020). Parents make the majority of complementary feeding decisions during infancy. Yet understanding is limited about how parents select foods for their infant. This study’s purpose was to develop a measure of food selection priorities for parents of infants.

Methods: Phase 1 was a qualitative study of maternal beliefs and priorities surrounding complementary feeding and their influence on mothers’ selected CFPs. Mothers participated in a private interview with the PI. The semi-structured interview guide included eight open-ended questions developed from a review of the literature and identified gaps. Using the qualitative findings for Phase 2, the study team chose to adapt and test the Food Choice Questionnaire (FCQ) (Pollard et al., 1998) for parents of infants. English-speaking mothers of healthy infants (9-19 months old) self-selected from web-based platforms to complete a questionnaire that included the adapted Infant Food Choice Questionnaire (IFCQ). Exploratory factor analysis (principal components analysis with varimax rotation) was used to examine the IFCQ’s structure. Multiple linear and logistic regression analyses were used to examine the associations between IFCQ factors and CFPs. For Phase 3 validity testing, the team examined relationships among IFCQ factors and CFPs (e.g., timing/type of complementary food (CF) introduction, frequency of feeding method, usual texture intake, and allergenic food introduction (AFI)). Spearman’s Rho was used to examine associations between the IFCQ subscales with timing/type of complementary food introduction. Multiple linear and logistic regression analyses were used to examine associations among the IFCQ subscales with feeding method, usual texture intake, and AFI, controlling for infant age.

Results: For Phase 1, median maternal age was 29.8 years and infant age was 11.6 months (n = 27). Key themes of maternal priorities for CFP were nutrition/health, limiting unhealthy foods, natural/organic, convenience, liked by baby, supporting the emotional climate, and perceived threats. For Phase 2 and 3, mean maternal age was 30.4 years and infant age was 14.1 months (n = 381). The final structure of the IFCQ included 30 items and 7 factors: Behavioral Influence, Health Promotion, Ingredients, Affordability, Sensory Appeal, Convenience, and Perceived Threats (Cronbach’s α = 0.68-0.83) (See Table 1). Associations of factors with CFPs supported construct validity (See Table 2).

Discussion: The IFCQ was determined to have strong initial psychometric properties in a sample of mothers from the US. Additional psychometric testing in a larger and more heterogenous sample is needed. Mothers who rated Behavioral Influence as more important were more likely to report suboptimal CFPs (e.g., feeding CFs earlier than recommended, delaying AFI, and prolonged use of spoon-feeding method). Clinicians and interventionists could benefit from focusing on IFCQ factors, especially Behavioral Influence, to encourage optimal CFPs, growth and development.

Authors

• Michelle Graf, University of North Carolina at Chapel Hill
  Presenting Author

• Heather Wasser, University of North Carolina at Chapel Hill

• Mary Lynn, University of North Carolina at Chapel Hill

• Sharon Karp, Vanderbilt University

• Melanie Lutenbacher, Vanderbilt University

• Eric Hodges, University of North Carolina at Chapel Hill