Influential factors of caregiver behavior at mealtime: a study of 24 child-care programs.

OBJECTIVE: To measure the nutrition knowledge and attitudes of caregivers in child-care programs and to observe the behaviors of caregivers as they interact with children at mealtime.
DESIGN: A nonexperimental research design. Nutrition knowledge and attitudes toward nutrition were measured using survey methodology designed for this study. Observers measured caregiver behavior by means of observation and quantified it using a behavior checklist. Interrater reliability was 98%. Instruments were piloted and content validity was established. Using Cronbach's alpha, reliability was .69 and .67, respectively. SUBJECTS/
SETTING: Participants were 113 caregivers in 24 licensed child-care programs in three counties in Illinois. STATISTICAL ANALYSES PERFORMED: The independent variables (caregiver nutrition knowledge, caregiver nutrition attitudes, years of teaching, prior nutrition training, and education level) were correlated to the dependent variable (caregiver behavior), using the Pearson product moment correlation. The combination of variance from all independent variables was analyzed using the general linear regression model.
RESULTS: Although caregivers held beliefs that should have a positive influence on children's eating behaviors, they demonstrated low knowledge of nutrition and displayed behaviors at mealtimes that were inconsistent with their beliefs and expert recommendations. Positive correlations were found between nutrition knowledge and behavior at mealtime, nutrition knowledge and attitudes, and attitudes and caregiver behavior. APPLICATIONS: These instruments can be used to assess and teach nutrition practices through self-assessment, training, and coursework. Results also begin to define the role of the caregiver in children's nutrition practices. Results demonstrate that caregiver behavior can be enhanced by addressing nutrition knowledge and attitudes.