Skip to main content
Journal cover image

Modifying the Environment and Policy Assessment and Observation (EPAO) to better capture feeding practices of family childcare home providers.

Publication ,  Journal Article
Tovar, A; Vaughn, AE; Fisher, JO; Benjamin Neelon, SE; Burney, R; Webster, K; Liu, T; Ostbye, T; Ward, DS
Published in: Public health nutrition
February 2019

To describe the modification and validation of an existing instrument, the Environment and Policy Assessment and Observation (EPAO), to better capture provider feeding practices.Modifications to the EPAO were made, validity assessed through expert review, pilot tested and then used to collect follow-up data during a two-day home visit from an ongoing cluster-randomized trial. Exploratory factor analysis investigated the underlying factor structure of the feeding practices. To test predictive validity of the factors, multilevel mixed models examined associations between factors and child's diet quality as captured by the Healthy Eating Index-2010 (HEI-2010) score (measured via the Dietary Observation in Childcare Protocol).Family childcare homes (FCCH) in Rhode Island and North Carolina, USA.ParticipantsThe modified EPAO was pilot tested with fifty-three FCCH and then used to collect data in 133 FCCH.The final three-factor solution ('coercive control and indulgent feeding practices', 'autonomy support practices', 'negative role modelling') captured 43 % of total variance. In multilevel mixed models adjusted for covariates, 'autonomy support practices' was positively associated with children's diet quality. A 1-unit increase in the use of 'autonomy support practices' was associated with a 9·4-unit increase in child HEI-2010 score (P=0·001).Similar to the parenting literature, constructs which describe coercive controlling practices and those which describe autonomy-supportive practices emerged. Given that diets of pre-schoolers in the USA remain suboptimal, teaching childcare providers about supportive feeding practices may help improve children's diet quality.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Public health nutrition

DOI

EISSN

1475-2727

ISSN

1368-9800

Publication Date

February 2019

Volume

22

Issue

2

Start / End Page

223 / 234

Related Subject Headings

  • Rhode Island
  • Reproducibility of Results
  • Process Assessment, Health Care
  • Pilot Projects
  • Nutrition Surveys
  • Nutrition & Dietetics
  • North Carolina
  • Multilevel Analysis
  • Male
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Tovar, A., Vaughn, A. E., Fisher, J. O., Benjamin Neelon, S. E., Burney, R., Webster, K., … Ward, D. S. (2019). Modifying the Environment and Policy Assessment and Observation (EPAO) to better capture feeding practices of family childcare home providers. Public Health Nutrition, 22(2), 223–234. https://doi.org/10.1017/s1368980018002665
Tovar, Alison, Amber E. Vaughn, Jennifer Orlet Fisher, Sara E. Benjamin Neelon, Regan Burney, Kathleen Webster, Tao Liu, Truls Ostbye, and Dianne S. Ward. “Modifying the Environment and Policy Assessment and Observation (EPAO) to better capture feeding practices of family childcare home providers.Public Health Nutrition 22, no. 2 (February 2019): 223–34. https://doi.org/10.1017/s1368980018002665.
Tovar A, Vaughn AE, Fisher JO, Benjamin Neelon SE, Burney R, Webster K, et al. Modifying the Environment and Policy Assessment and Observation (EPAO) to better capture feeding practices of family childcare home providers. Public health nutrition. 2019 Feb;22(2):223–34.
Tovar, Alison, et al. “Modifying the Environment and Policy Assessment and Observation (EPAO) to better capture feeding practices of family childcare home providers.Public Health Nutrition, vol. 22, no. 2, Feb. 2019, pp. 223–34. Epmc, doi:10.1017/s1368980018002665.
Tovar A, Vaughn AE, Fisher JO, Benjamin Neelon SE, Burney R, Webster K, Liu T, Ostbye T, Ward DS. Modifying the Environment and Policy Assessment and Observation (EPAO) to better capture feeding practices of family childcare home providers. Public health nutrition. 2019 Feb;22(2):223–234.
Journal cover image

Published In

Public health nutrition

DOI

EISSN

1475-2727

ISSN

1368-9800

Publication Date

February 2019

Volume

22

Issue

2

Start / End Page

223 / 234

Related Subject Headings

  • Rhode Island
  • Reproducibility of Results
  • Process Assessment, Health Care
  • Pilot Projects
  • Nutrition Surveys
  • Nutrition & Dietetics
  • North Carolina
  • Multilevel Analysis
  • Male
  • Humans