Papers by Janice Fletcher
Journal of Nutrition Education and Behavior, Jul 1, 2021
Background: In 2019, the Society of Nutrition Education and Behavior recommitted to representing ... more Background: In 2019, the Society of Nutrition Education and Behavior recommitted to representing the growing demographic of older adults. One metric to assess this commitment may be an equitable representation of articles published in the Society's journal. Objective: The aim of this retrospective study was to determine the historic representation of the older adult life stage in articles published in the Journal of Nutrition Education and Behavior (JNEB). Study Design, Setting, Participants: Research, research briefs, and report articles published in JNEB from 1969 to December 2020 were examined to determine the targeted life stage, including older adults (>65 years), adults, young adults (college-age), and infants, children and adolescents. Articles, in which older adults were included as part of a greater population, were also quantified. An "other" category included articles that did not target or state a life stage. Measurable Outcomes/Analysis: The percentage of research articles, research briefs and reports targeting the older adult life stage published in JNEB. Results: Of the 2,454 articles reviewed, 39% of research articles, 51% of research briefs, and 29% of reports targeted infants, children and adolescents. Articles specifically addressing older adults had the least representation and included only 4% of research articles, 3% of research briefs, and 4% of reports. Older adults as part of a greater population, were represented by 8% of research articles, 9% of research briefs, and 5% of reports. Of note, 37% of articles fell into the "other" category. Conclusion: Historically, the older adult life stage is underrepresented in articles published in JNEB. Given the Society's recent resolution to increase the focus on the educational needs of a growing aging population, an increase in journal publications targeting older adults is warranted, and thus equitably represent all life stages in future issues. Funding: None.
Journal of food, nutrition and dietetics, Jan 25, 2016
Background & Objectives: Childhood obesity is a health concern in Saudi Arabia. Further study of ... more Background & Objectives: Childhood obesity is a health concern in Saudi Arabia. Further study of parental feeding practices and concern about childhood weight in Saudi Arabia (SA) is needed. The purpose of the study was to: (1) Identify maternal feeing practices and concern about child weight using the Child Feeding Questionnaire (CFQ), (2) identify maternal Autonomy (A) and maternal report of children's Negative Reactions to Food (NRF) and (3) determine whether there is an association between CFQ scales and NRF and A. Subjects & Methods: A convenience sample of mothers from Saudi Arabia living in the US with children 2-6 years of age was contacted. Eligible mothers were sent a link to an online questionnaire Internal consistency for questions on the CFQ, NRF and A were computed using Cronbach's α. Spearman's correlation coefficient was used to test the association among CFQ scales, NRF, A and demographic factors. Results: Mothers (n=108) completed the questionnaire and internal consistency was 0.73 or above for general autonomy, concern about child weight, negative reactions to food and monitoring. The mean (SD) for concern about child weight were 1.8 (1.2). Mothers' with a lower-income had a greater concern about child weight (r=-0.20, P=0.04) and mothers who had greater concern about child's weight and who used more restrictive feeding practices reported NRF in their children (r=0.19, P=0.05; r=0.20, P=0.04, respectively). The more feeding autonomy mothers had, the greater responsibility they reported about feeding their children (r=0.20, P=0.04). Conclusion: While few mothers reported concern about weight, they reported frequent use of inappropriate restrictive and pressuring feeding practices. Understanding mothers feeding practices is important to identify children's eating habits and prevent childhood obesity. Since a little is known about feeding practices among Saudi mothers, further study is needed to verify the differences in child feeding practices and concern about child weight in mothers who only live in Saudi Arabia.
Journal of Food, Nutrition and Dietetics, 2016
Background & Objectives: Childhood obesity is a health concern in Saudi Arabia. Further study of ... more Background & Objectives: Childhood obesity is a health concern in Saudi Arabia. Further study of parental feeding practices and concern about childhood weight in Saudi Arabia (SA) is needed. The purpose of the study was to: (1) Identify maternal feeing practices and concern about child weight using the Child Feeding Questionnaire (CFQ), (2) identify maternal Autonomy (A) and maternal report of children's Negative Reactions to Food (NRF) and (3) determine whether there is an association between CFQ scales and NRF and A. Subjects & Methods: A convenience sample of mothers from Saudi Arabia living in the US with children 2-6 years of age was contacted. Eligible mothers were sent a link to an online questionnaire Internal consistency for questions on the CFQ, NRF and A were computed using Cronbach's α. Spearman's correlation coefficient was used to test the association among CFQ scales, NRF, A and demographic factors. Results: Mothers (n=108) completed the questionnaire and internal consistency was 0.73 or above for general autonomy, concern about child weight, negative reactions to food and monitoring. The mean (SD) for concern about child weight were 1.8 (1.2). Mothers' with a lower-income had a greater concern about child weight (r=-0.20, P=0.04) and mothers who had greater concern about child's weight and who used more restrictive feeding practices reported NRF in their children (r=0.19, P=0.05; r=0.20, P=0.04, respectively). The more feeding autonomy mothers had, the greater responsibility they reported about feeding their children (r=0.20, P=0.04). Conclusion: While few mothers reported concern about weight, they reported frequent use of inappropriate restrictive and pressuring feeding practices. Understanding mothers feeding practices is important to identify children's eating habits and prevent childhood obesity. Since a little is known about feeding practices among Saudi mothers, further study is needed to verify the differences in child feeding practices and concern about child weight in mothers who only live in Saudi Arabia.
International Journal of Behavioral Nutrition and Physical Activity, 2018
Background: Children spend a substantial amount of time in early care and education (ECE) setting... more Background: Children spend a substantial amount of time in early care and education (ECE) settings and may eat a majority of their diet in this setting. While there are several instruments focused on measuring factors of the ECE environment that may influence diet and weight outcomes, there are few comprehensive, valid, and reliable measures for collecting self-report of ECE providers' feeding practices. The purpose of this study was to establish the factor structure and internal reliability of a survey developed to measure practices and beliefs of ECE providers relative to feeding children. Methods: Licensed ECE centers from CA, CO, ID and NV were included in this cross-sectional survey study. The sample was stratified by states and census regions to yield equal numbers of centers from each category. The total sample distribution included 1600 randomly selected centers and up to 8000 staff members (who represented teachers, aides, assistants, or cooks); 1178 surveys were completed. We conducted an exploratory, unrestricted factor analysis as well as parallel analyses to inform the number of factors to be extracted. Results: Factors within Structural Mealtime Strategies included Adult Control of Foods Consumed (Kuder-Richardson [KR] = 0.67), Bribing with Sweet Foods (KR = 0.70), and Supportive Adult Roles at Mealtime (KR = 0.55). Factors in Verbal Mealtime Strategies included Supporting Children's Eating Self-regulation (KR =0.61), Pressure to Eat (KR = 0.58), and Social Comparisons (KR = 0.59). Beliefs about Mealtime factors were Autonomy Promoting (α = 0.64), Coercive Beliefs (α = 0.77), and Concern-Based Control (α = 0.60). Conclusions: The AFC Strategies and Beliefs Survey provides a promising self-report instrument with a strong factor structure consistent with the extant literature to measure practices and beliefs related to feeding and mealtimes in the ECE setting. Feeding young children in group settings differs in many ways from feeding in a family setting; hence it is important that measures such as the AFC Strategies and Beliefs Survey capture unique aspects of the ECE feeding environment.
International Journal of Behavioral Nutrition and Physical Activity, 2018
Background: Children spend a substantial amount of time in early care and education (ECE) setting... more Background: Children spend a substantial amount of time in early care and education (ECE) settings and may eat a majority of their diet in this setting. While there are several instruments focused on measuring factors of the ECE environment that may influence diet and weight outcomes, there are few comprehensive, valid, and reliable measures for collecting self-report of ECE providers' feeding practices. The purpose of this study was to establish the factor structure and internal reliability of a survey developed to measure practices and beliefs of ECE providers relative to feeding children. Methods: Licensed ECE centers from CA, CO, ID and NV were included in this cross-sectional survey study. The sample was stratified by states and census regions to yield equal numbers of centers from each category. The total sample distribution included 1600 randomly selected centers and up to 8000 staff members (who represented teachers, aides, assistants, or cooks); 1178 surveys were completed. We conducted an exploratory, unrestricted factor analysis as well as parallel analyses to inform the number of factors to be extracted. Results: Factors within Structural Mealtime Strategies included Adult Control of Foods Consumed (Kuder-Richardson [KR] = 0.67), Bribing with Sweet Foods (KR = 0.70), and Supportive Adult Roles at Mealtime (KR = 0.55). Factors in Verbal Mealtime Strategies included Supporting Children's Eating Self-regulation (KR =0.61), Pressure to Eat (KR = 0.58), and Social Comparisons (KR = 0.59). Beliefs about Mealtime factors were Autonomy Promoting (α = 0.64), Coercive Beliefs (α = 0.77), and Concern-Based Control (α = 0.60). Conclusions: The AFC Strategies and Beliefs Survey provides a promising self-report instrument with a strong factor structure consistent with the extant literature to measure practices and beliefs related to feeding and mealtimes in the ECE setting. Feeding young children in group settings differs in many ways from feeding in a family setting; hence it is important that measures such as the AFC Strategies and Beliefs Survey capture unique aspects of the ECE feeding environment.
As one of USDA’s food assistance entitlement programs, the Child and Adult Care Food Program (CAC... more As one of USDA’s food assistance entitlement programs, the Child and Adult Care Food Program (CACFP) provides nutritious meals and snacks to 2.9 million low-income American children, by reimbursing eligible childcare providers. CACFP also has suggested written feeding guideline policies to foster a supportive feeding environment, including allowing children to serve themselves. Interestingly, these guidelines are congruent with recommendations to prevent childhood overweight. Moreover, they support the concept of Satter’s division of responsibility. This concept assumes adults are responsible for selecting, preparing and offering healthful foods as well as determining when and where meals and snacks are served. On the other hand, children are responsible for how much they eat, or whether they eat at all— control of food intake.
Journal of Research in Childhood Education, 1997
Many child care food program guidelines recommend family-style food service as a best practice fo... more Many child care food program guidelines recommend family-style food service as a best practice for feeding young children in group settings. However, some child care providers resist these guidelines, expressing concerns about convenience, food waste, and time constraints. This study was conducted to determine if there are differences in food intake, waste, and time required for eating when young children
Journal of Nutrition Education and Behavior, 2012
Objective: To identify characteristics in nutrition education video vignettes that support learni... more Objective: To identify characteristics in nutrition education video vignettes that support learning and motivation to learn about feeding children. Methods: Nine focus group interviews were conducted with child care providers in child care settings from 4 states in the western United States: California, Idaho, Oregon, and Washington. At each focus group interview, 3-8 participants (n ¼ 37) viewed video vignettes and participated in a facilitated focus group discussion that was audiorecorded, transcribed, and analyzed. Results: Primary characteristics of video vignettes child care providers perceived as supporting learning and motivation to learn about feeding young children were identified: (1) use real scenarios; (2) provide short segments; (3) present simple, single messages; (4) convey a skill-inaction ; (5) develop the videos so participants can relate to the settings; and (6) support participants' ability to conceptualize the information. Conclusions and Implications: These 6 characteristics can be used by nutrition educators in selecting and developing videos in nutrition education.
Journal of Nutrition Education and Behavior, 2010
Journal of Nutrition Education and Behavior, 2010
Objective: To explore the verbal communication of child care providers regarding preschool childr... more Objective: To explore the verbal communication of child care providers regarding preschool children's internal and non-internal hunger and satiation cues. Methods: Video observation transcripts of Head Start staff (n ¼ 29) at licensed child care centers in Colorado, Idaho, and Nevada were analyzed for common themes. Results: Adults' verbal communication with children at mealtimes emphasized non-internal cues: (1) cueing children to amounts without referencing children's internal cues; (2) meal termination time; (3) asking children if they wanted more without referencing their internal cues; (4) asking children if they were done without referencing their internal cues; (5) telling children to take, try, eat, or finish food; (6) praising children for eating; and (7) telling children about food being good for you. Adults demonstrated an overriding effort to get children to eat. Conclusions and Implications: Training needs to be developed that gives specifics on verbally cueing young children to their internal hunger and satiation cues.
Journal of Hunger & Environmental Nutrition, 2008
ABSTRACT The Child and Adult Care Food Program (CACFP) plays a critical role by providing food to... more ABSTRACT The Child and Adult Care Food Program (CACFP) plays a critical role by providing food to children from low-income families while they are enrolled in licensed childcare or attending approved after-school programs. There is little documentation about ...
Family & Community Health, 2011
For obesity prevention planning in early childhood programs, attitudes and actions of staff relat... more For obesity prevention planning in early childhood programs, attitudes and actions of staff related to communicating with parents about young children's eating and weight need to be assessed. Early childhood program teachers (n = 271) working with children aged 3 to 5 years were surveyed by mail. Factor analysis provided patterns of response for multi-item questions. Respondents reported different levels of agreement and comfort regarding communicating concerns to parents about their child's weight and eating versus observations about the child's daily eating. Feelings about parent communication varied (worried, hesitant, responsible, and willing). Findings suggest opportunities for communication between program staff and parents.
Day Care & Early Education, 1994
Providing young children with food is simple, as we observed in one childcare center where snack ... more Providing young children with food is simple, as we observed in one childcare center where snack time was made quite easy. Slices of white bread were handed out from a bag to each child and milk was poured from a gallon jug into their paper cups. Children were seated on picnic-style tables, eight to a side. Little planning or adult participation was required. The children talked and admonished each other as they jockeyed in the close space for position to eat and drink. The inevitable spills and conflicts were handled by removing the offending child from the snacktime. The snacktime was quick, efficient, and easy. But what opportunity was lost to nurture growth and development of the children! Mealtime for young children in group settings can be planned with as much developmental awareness as
Contemporary Issues in Early Childhood, 2010
With increasing accessibility to quality video recording technology, researchers and trainers can... more With increasing accessibility to quality video recording technology, researchers and trainers can create data sets that are rich in content and application. Practical and ethical aspects of videotaping children and staff for research and teaching purposes are critical to successful use of videotaping. Taping and equipment strategies for achieving high-quality footage of children and teachers are shared, and ethical practices are described. Videotape data of child behaviors and child-staff interactions provide comprehensive observations for researchers, and real-life vignettes for developing instructional materials for human services professionals. Collection of video data is successful when equipment, videographers, and the environment are well organized and prepared for data collection. Selecting quality equipment, ensuring that videographers understand the target, and partnering with staff in the videotaping setting, all work together to assure success. Before Going to the Site for the Observation Ethical Behavior Ethical treatment of subjects is essential and expected in videotape data collection (see Figure 1). Written consent must be obtained from 100% of the people whose images or voices appear in the videotapes (Columbia University, 2000; University of California, 2001). Development of a subject consent protocol is a part of assuring ethical behavior. See sample forms at http://www.ag.uidaho.edu/feeding (Fletcher & Branen, 2010).
Journal of Nutrition Education and Behavior, 2013
To explore child care staff and parent perspectives and communications about children&amp... more To explore child care staff and parent perspectives and communications about children's eating in child care. Focus groups (FGs) conducted with child care staff and parents. Four Western states in the United States. Thirty-nine child care staff in 7 FGs and 25 parents in 6 FGs. Thoughts and concerns about children's eating and opportunities to improve communication between staff and parents. Content analysis (FG coding inter-rater reliability: staff = 0.74; parents = 0.81) and identification of meta-themes. Three meta-themes were identified: (1) recognition of positive influences of the child care setting in children's development of healthy eating; (2) concerns about children's eating in child care and at home; and (3) strategies to improve communications and transactions related to children's eating. Staff reported that their roles included informing parents about food at mealtimes in child care (eg, menus, recipes) but also educating parents about child nutrition and feeding. Parents valued daily information about their child's eating to adjust home mealtimes and to feel connected to their child. Barriers to effective communication included limited time and concerns regarding parent reactions and defensiveness. Staff requested training about child nutrition and feeding and about sensitive communications with parents.
Journal of Nutrition Education, 1994
Regulating young children's food intake is common practice In child care facilities. Many caregiv... more Regulating young children's food intake is common practice In child care facilities. Many caregivers fear that children will overeat or waste food If allowed to select their own portions. The purpose of this study was to compare food intake and waste of preschool children at snacktime when given one portion of snack and when allowed to self-select their snack amount. Subjects were 20 3-year-olds and 20 4-year-olds enrolled in a university preschool. For the 29 days of restrictive feeding, children were offered only one portion of snack. For the 25 days of self-selected feeding, children could eat as many portions as they wanted. Based on a 2 X 2 factorial analysis of variance (ANOVA), there was a Significant Interaction of class and feeding method. During self-selected feeding, the 4-year-old group Increased their Intake to a greater extent than the 3-year-old group. The number of portIOns wasted was not significantly different for the two feeding methods; however, the younger children wasted significantly more than the older children. These results indicate that preschool children in group settings will eat more than one portion at snack time when they are allowed to self-select their Intake without Significantly Increasing the amount they waste.
Journal of the American Dietetic Association, 2008
This study was conducted to describe mealtimes and explore routines, policies, and training in ch... more This study was conducted to describe mealtimes and explore routines, policies, and training in childcare centers. Following an intensive review of mealtimes, staff and director questionnaires were created. Using a stratified random sampling protocol and following the Tailored Design Method, directors and staff from licensed childcare centers from California, Colorado, Idaho, and Nevada were surveyed. Center and staff characteristics were compared among the four states and three census areas using analysis of variance and 2 analyses, as appropriate. To adjust for multiple comparisons, a stringent P value of Ͻ0.001 was used for post hoc comparisons. Responses were received from 568 centers (representing 1,190 staff and 464 directors). Mealtimes generally occurred in the classroom, where an adult sat at the table with the children, served some food, poured the drinks, and ate some of the center-provided food. Less than half of centers reported using "family-style" service, although this style allows children the opportunity to self-serve food. Staff received substantially less training on feeding children (42%) than on nutrition (68%) and child development (95%). These findings bring focus to the need to educate childcare staff and directors about the impact of mealtime environments on child health and development.
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Papers by Janice Fletcher