P28 Validation of an Observational Measure to Capture Feeding Practices in Child Care Centers


      Current feeding practice measures are either not validated for use in childcare centers or do not include key constructs that influence children's eating.


      To describe the development and validation of the ‘Mealtime Observation in Child Care’ (MOCC) toolkit (manual, coding checklist, scoring sheet, training videos) to measure teachers’ feeding practices with preschool (3-5 years) children.

      Study Design, Setting, Participants

      An observational measure to assess mealtime environment and feeding practices was developed based on existing literature and measures, expert collaboration, and external reviews. Trained observers coded 41 lunchtime videos in 10 childcare centers.

      Measurable Outcome/Analysis

      Face validity of the tool was assessed by sending the toolkit to 4 external expert reviewers for feedback. Four trained coders watched and coded a video separately in order to assess inter-rater reliability calculating a Kappa statistic. Convergent validity was evaluated by relating the MOCC items to previously validated measures including EPAO-Extended Feeding Practices (EPAO-EFP), Table Talks (TT), and Feeding Behavior Coding System (FBCS). The same videos were coded with TT, EPAO-EFP and FBCS and the scores for relevant items were used for comparison with MOCC score. Pearson's, bivariate correlations were calculated between MOCC items and items matched with other measures.


      Expert reviewers provided feedback related to including additional verbal examples, clarifying the difference between unable to observe and not applicable and improving the formatting of the checklist. Interrater reliability was high (Fleiss's Kappa, K = 0.85). The convergent validity of the MOCC tool was high, among 9 subscales 8 were significantly associated to previous measures (r = 0.40 [P < .01] to 0.87 [P<.001] & β = 0.4; P = .001). Teachers’ response to food refusal subscale was not significantly related because children did not refuse foods in >50 lunchtimes.


      MOCC may be a comprehensive, valid and reliable tool to assess teacher feeding practices, informing professional development and evaluating intervention efforts.
      Funding: USDA.

      Appendix. Supplementary data