The feeding to Manage Child Behavior Questionnaire: Development of a tool to measure' non-nutritive feeding practices in low income families with preschool-aged children

The parent feeding literature has largely focused on the use of controlling, intrusive practices to manage children's food intake (e.g., restriction, pressure). Less research has been conducted on parents' use of food as a contingency to direct or motivate child behavior. The aim of this study was to develop and validate the Feeding to Manage Child Behavior Questionnaire (FMCBQ). A mixed-methods approach was used to develop the 10-item questionnaire. Cognitive interviews informed the modification, deletion and/or replacement of items. The survey was distributed to mothers of children aged 2-5 years participating in the Women, Infants, and Children program or Head Start (n = 334). Factor analysis was conducted to test our theoretical model and construct validity was assessed. Caregivers also completed the Structure and Control in Parenting Feeding (SCPF) questionnaire and Child Behavior Questionnaire (CBQ). Exploratory factor analysis revealed a 2-factor model; 5-item Food to Soothe (FTS) and 4-item Food as Reward (FAR) subscale. Internal consistencies were good (0.84, 0.70 respectively). Both subscales were weakly and negatively associated with maternal self-reported BMI. As predicted, both subscales were positively correlated with child negative affect and other control-based feeding practices, whereas only FTS was negatively associated with structure-based feeding. The FMCBQ provides a short, reliable, and valid tool to assess use of FAR and FTS in response to a variety of contexts to better understand how mothers feed their children.