Exploring self-reported and observed feeding practices of Rhode Island head start teachers

Background: Head Start (HS) teachers care for low-income and ethnically diverse preschool-aged children who are disproportionately impacted by obesity. While it is known that parent feeding practices influence child weight status and eating behaviors, little is known about HS teacher feeding practices. The limited number of studies with HS teachers have been completed primarily with self-report measures, which has documented limitations such as response bias. Capturing HS teacher feeding practices through self-report and observations may provide valuable information needed to evaluate the inconsistencies of current findings. Methods: Rhode Island HS teachers (n=85) were observed and feeding behaviors coded using the Mealtime Behavior Observation Scale, adapted from the Environmental Policy Assessment and Observation (EPAO) tool. Post- observation, teachers completed the Children’s Eating Scale, adapted from the EPAO Self-Report (EPAO-SR), to capture self-reported feeding practices. Correlations (Spearman) were used to explore associations between self-reported and observed items (14) that were intended to measure the same feeding practice. Chi-square tests were also used to compare the level of consistency between measures and socio-educational factors. Results: Teachers were predominantly non-Hispanic White (89%) and female (98%). Not all self-reported and observed feeding practices were related. After aligning feeding practices on the self-report and observation scales, self-reported and observed “use of food as a reward” was the only significantly related feeding practice (r=22, p=.04). No significant associations were found with teachers’ self-reported years of experience, nutrition training, or desired weight status. Conclusions: Even though items on the self-report and observation measures were designed to capture identical feeding practices, most of them were not related. It is possible that because HS has such a clear policy with regards to the “use of food as a reward”, this practice was significantly related. Currently self-report measures are used to capture feeding practices, yet inconsistencies between measures of self-report and observation exist. Further understanding of these inconsistencies is needed to better capture teacher feeding practices