Increasing vegetable consumption in early childhood: parents as facilitators

This thesis aimed to investigate the potential to increase young children s vegetable consumption by using caregivers as facilitators. This was achieved in two parts. Part I set out to investigate whether parent led interventions using three known successful methods of offering can be effective for increasing children s acceptance of a disliked vegetable. Three studies were conducted for Part I. The first tested the efficacy of these interventions, the second investigated the role of individual factors in intervention success, and the third examined the longitudinal efficacy of such interventions over two, six and 12 months. The findings suggested that parent led home-based interventions may be successful for increasing children s acceptance of disliked vegetables in the short-term, and that such interventions may be more successful for children who are more sociable and less fussy eaters. While these interventions may not be successful for sustained long-term changes, there was a lack of statistical power for these analyses and further studies with larger samples are required. Part II of the thesis sought to investigate the wider variety of methods which caregivers use to offer vegetables to their children, as well as the possible barriers to offering. These studies worked towards informing the design of future interventions as well as providing information for caregivers on achieving a healthful diet in their children. This was achieved via two studies which used qualitative and quantitative methods. One study used focus groups to gather a comprehensive report of caregivers methods of offering, as well as caregivers perceived influences on how and whether they offer their child vegetables. Methods of offering vegetables formed three main categories: active/behavioural methods, passive methods, and food manipulations. The influences on offering which caregivers perceived formed four categories: information, cost, caregiver factors, and child factors. These methods and influences were then assessed in a large scale cross-sectional study. This study examined which methods caregivers perceive as successful for encouraging consumption of vegetables, as well as assessing predictors of offering vegetables and children s vegetable consumption. Caregiver factors predicted reoffering of rejected vegetables while a combination of caregiver and child factors predicted children s consumption of vegetables. A number of discrepancies were found between methods caregivers perceived as successful and those which were associated with greater consumption of vegetables. As food fussiness was identified as a significant factor in children s consumption of vegetables, a final study investigated whether children categorised as fussy or not fussy with vegetables differed on a number of caregiver and child factors. Differences were found between these groups on both caregiver and child factors. Using a mixed methodology, the research in this thesis investigates possibilities for increasing vegetable consumption in early childhood and highlights the central role or caregivers in this process. Together, these findings suggest utility of whole family interventions aimed at increasing vegetable consumption, as well as providing caregivers with information on how best to offer vegetables to children of this age.