This study examined the relations between independent eating and communicative development, both concurrently and longitudinally, using observational methods. In total, 182 Italian mother-infant pairs (Mage = 12.33; 48% females; 100% White) participated from 2020 to 2023. Infants' gestures, vocalizations, and self-feeding episodes were coded during mealtimes at 12 months. Mothers reported on language development at 12, 18, and 24 months. Self-feeding was concurrently and positively associated with infants' use of deictic gestures and simple vocalizations during the meal. Notably, self-feeding at 12 months was positively related to sentence production reported by mothers at 24 months (but not to parent-reported vocabulary size at 12, 18, or 24 months). The results suggest potential language benefits from allowing infants an active role during the mealtime.

Objective: In democratic societies, public opinion influences government policy. The urgency of global climate action highlights the importance of understanding public support towards environmental policies. The Value-Belief-Norm theory offers a model for understanding psychological processes underlying pro-environmental policy support. This study aims to evaluate the Value-Belief-Norm theory as an explanatory model of policy support. Method: We searched Web of Science, Scopus, MEDLINE, PsycINFO and three registries. We included 23 cross-sectional survey studies testing the Value-Belief-Norm model to explain support for environmental public policies, nine of which were eligible for random-effects meta-analysis of correlations. Results: Model-explained variance in policy support ranged from 2% to 72%, with substantial variation in the Value-Belief-Norm theory application across studies. Policy support was positively associated with Ascription of responsibility (r = .39, p < .001), Awareness of consequences (r = .37, p < .001), Pro-environmental personal norms (r = .36, p < .001), Ecological worldview (r = .28, p < .001) and Altruistic values (r = .13, p < .01). The strongest correlations were between policy support and policy-specific beliefs, specifically Perceived fairness (r = .77, p < .001) and Perceived effectiveness (r = .59, p < .001), which are not part of the Value-Belief-Norm theory. Conclusions: The Value-Belief-Norm theory performs adequately at explaining public support for environmental policies but it does not include beliefs about policy fairness and effectiveness, which are the main reasons why the public support and oppose environmental policies.

CONTEXT:In 2022, less than 18% of UK children aged 5-7 years consumed 5 portions of fruit and vegetables, with an average intake of 3 portions per day. Group settings (eg, schools or nurseries) present an opportunity to apply policies to encourage children's consumption of novel and healthy foods. OBJECTIVE:The extent and types of evidence regarding efforts to increase the consumption of fruits and vegetables by young children in group settings who reside in high-income countries was investigated in this scoping review. DATA SOURCES:A systematic scoping review was conducted that followed the JBI guidelines and included articles, published from 2012 onward, about methods to increase consumption of novel and/or healthy foods by children aged 3-7 years in settings within local government control and who were residing in high-income countries. DATA EXTRACTION:A total of 7000 articles were initially identified, of which 114 were included in this review after screening. DATA ANALYSIS:Intervention methods included an array of different techniques from educational programs to repeated exposure, food modification, and behavioral modeling approaches. CONCLUSION:Interventions administered to children aged between 3 and 7 years in group-based settings have been shown to improve the consumption of healthy foods, specifically fruits and vegetables. Behavioral modeling and sensory play interventions, in particular, present the highest level of success.

Most international and national feeding recommendations highlight the role of parental responsiveness for shaping infants’ self-regulation when feeding and eating, with research suggesting that a more infant-led approach to complementary feeding is associated with greater parental responsiveness. Infant temperament can shape both approach to complementary feeding and parental responsiveness, and may moderate the relationship between them. For example, more surgent infants might initiate more self-feeding attempts which prompt increased parental responsiveness, whereas infants with more negative affect might show more frustration when self-feeding which may increase uncertainty and lower parental responsiveness. However, the role of infant temperament in these interactions has not yet been empirically explored. Furthermore, most research in this area is questionnaire-based. In this study we utilised home-based mealtime observations to examine the relationship between the proportion of infant self-feeding, parental responsiveness and infant temperament. Fifty-one parent-infant dyads (infants aged 6-18 months) were video recorded during typical mealtime interactions, and we coded infant self-feeding and parental responsiveness. Parents also completed questionnaires regarding their infants’ temperament. Observed parental responsiveness to infant fullness was positively associated with the proportion of infant self-feeding. Infant surgency was associated with observed parental responsiveness to fullness but no aspects of infant temperament moderated the relationship between self-feeding and responsiveness. These findings suggest that infant temperament and self-feeding are related to parental responsiveness, although the relationship between responsiveness and infant independence during mealtimes may not depend on temperament.

When children transition from home to school settings and are ready to engage in school tasks, they are more likely to succeed, not only in school but also in their work and social life later on. Studies have, however, indicated that many children in lowand middle-income countries (LMICs), particularly in African contexts, enter school without the requisite school-readiness skills. Not much attention has been given to sibling caregiving within family systems as a potential resource for supporting school readiness among younger siblings. In many LMICs, it is common for older children in families to care for younger siblings, where they act, for instance, as teachers, caregivers, and playmates among other roles. In these roles, they support younger siblings with various tasks. This qualitative observational study aimed to explore strategies older siblings use to support younger children in acquiring school-readiness skills, which are very important for successful engagement in school settings. This study used a naturalistic design, which allowed investigators to observe participating children as they interacted with each other in their typical environments at school and at home. Sixteen sibling dyads were recruited from rural African communities (10 from Kenya and 6 from Ethiopia). Data were collected through observation and video recording. The study data were analyzed thematically in an iterative process to develop codes and themes, with related illustrations. The study found that older siblings are effective “teachers” for their younger brothers and sisters, as well as for siblings in the locality. The older siblings spontaneously used strategies such as play, scaffolding, helping, modeling, and direct instruction and supervision to teach the younger siblings important school-readiness skills, including managing frustration by offering scaffolding for joint activities and turn-taking through collaborative play. These findings provide an initial, community-embedded perspective that may help inform interventions to support children in navigating the often challenging transition from home to school in rural Africa and similar contexts.

The reliability and validity of children's eating behaviour trait questionnaires is critical for accurately measuring and understanding children's eating behaviours among diverse populations and for developing targeted nutritional and behavioural interventions, especially in low- and middle-income countries. This review was conducted with the aim of investigating current evidence on the validity and reliability of child eating behaviour trait questionnaires, initially developed or used in high-income countries, when adapted for use among children aged 2 to 12 years in low- and middle-income countries. Systematic literature searches were conducted in MEDLINE Complete, Scopus, Embase, Web of Science, Global Health, and PsycINFO. Studies investigating the validity and reliability of the most commonly used children's eating behaviour questionnaire tools in low- and middle-income countries, and conducted from January 2001 were considered for inclusion in the review. Title and abstract screening of the studies was followed by full text screening by two independent reviewers. 24 studies were included in the review. A majority of the studies (n = 13 studies) examined the Children's Eating Behaviour Questionnaire, with fewer studies investigating the psychometric properties of the other child eating behaviour trait questionnaire tools. The evidence for the validity and reliability of the questionnaires in low- and middle-income countries was mostly limited to construct validity (n = 18 studies) and internal reliability (n = 24 studies) analysis. Future studies should conduct more comprehensive psychometric evaluations of other adapted questionnaires and develop new instruments tailored to assessing children's eating behaviour traits in low- and middle-income countries.

Background: Early language development is critical for literacy acquisition and academic success. However, children in rural Africa often face challenges such as limited access to literacy resources and minimal shared reading experiences at home, which can hinder their language skills. While wordless picture books (WPBs) are known to enhance narrative abilities, scant research has examined their effectiveness in rural African contexts. Objectives: This study explored how WPBs support narrative development among preschool children in rural Kenya. It examined the relationship between home literacy environments, parental involvement, and children’s storytelling abilities. Method: A mixed-methods approach was used, combining qualitative thematic analysis of children’s storytelling with quantitative data on family reading practices. Forty preschool children participated in WPB-based storytelling sessions, while parents completed structured interviews on home literacy practices. Data were analysed thematically and statistically to identify patterns in children’s narrative responses. Results: Children from homes with shared reading experiences produced longer and more detailed narratives than those without book access. Guided questioning further enhanced children’s storytelling by encouraging richer descriptions. Children who were unfamiliar with books often listed objects rather than producing constructing coherent narratives. Conclusion: Limited access to literacy resources contributes to disparities in early language development. Wordless picture books, combined with guided questioning, can be an effective tool to support emergent literacy in under-resourced communities. Contribution: Our work provides insights into how WPBs can foster language skills in rural African settings, emphasising the value of WPBs for enhancing literacy and facilitating parental engagement in early education.

We investigated the relationship between the complementary feeding approach (Baby-Led Weaning, Parent-Led Weaning or a mixed approach) and maternal responsiveness to child feeding cues in 166 children using mealtime observations at 8, 12, 18 and 24 months of age. We also explored whether maternally reported child linguistic proficiency was related to observed maternal responsiveness during mealtimes. Results suggest that mothers were more responsive to child receptiveness to eat when their children were 12 and 18 months old compared to when they were 8 months old. Mothers were increasingly responsive to their child's fullness cues at 8, 12, and 18 months. Mothers were less responsive to fullness when children were 24 months compared to 18 months old; although not assessed directly this may reflect a developmentally expected increase in child neophobia and picky eating as children age. Maternal responsiveness to fullness was positively correlated with child consumption of fruit and vegetables, which are usually among the least consumed food categories by neophobic and picky children. Furthermore, mothers who were more responsive to their infants' receptiveness to eat reported significantly lower levels of child verbal production at 12 months. In contrast, mothers who were more responsive to child fullness cues reported higher levels of infant verbal production, regardless of child age. Responsiveness to fullness was also positively related to proportion of self-feeding, which is a key feature of Baby-Led Weaning. In conclusion, in the first 18 months of life maternal responsiveness during mealtimes increased over time and was related to child language proficiency and ability to eat independently. These findings may extend to maternal responsiveness in contexts other than mealtimes with potential implications for the child socio-emotional development.

Recent evidence has identified four distinct eating profiles in 3-5-year-old children in the UK: avid, happy, typical, and avoidant. Among these profiles, children with avid eating behaviour exhibit high responsiveness to food cues, emotional eating, fast eating speed, and low responsiveness to fullness, posing risks for overeating and higher adiposity. Despite the implications, there is limited research on how avid eating manifests and impacts parents' behaviour and wellbeing. This study aimed to report the frequency of children's avid eating behaviour and explore its associations with child demographics, child temperament, home environment, parental feeding practices, and parental wellbeing. This study collected data via Ecological Momentary Assessment from 109 parents of a 3-5-year-old child identified as having an avid eating profile through a latent profile analysis of parents' reports of their children's eating behaviour. Using baseline and momentary data, the novel findings revealed that children with avid eating frequently requested food, especially snacks, with higher occurrences during weekends. Older children and boys showed higher probabilities of avid eating. High surgency in children correlated with more frequent food requests, while greater effortful control in children related to fewer eating occasions. Parents of children with higher probability of avid eating reported higher stress, depression, and anxiety, as well as frequent food requests from their child. Additionally, food insecurity was linked to increased food requests, suggesting a complex interplay between food availability and eating behaviour. The study underscores the need for targeted interventions to support parents in managing children's avid eating behaviour and improving overall family wellbeing.

Background: The wide use of smartphones offers large-scale opportunities for real-time data collection methods such as ecological momentary assessment (EMA) to assess how fluctuations in contextual and psychosocial factors influence parents' feeding practices and feeding goals, particularly when feeding children with high food approaches. Objective: The main objectives of this study were to (1) assess parents/caregivers' compliance with EMA procedures administered through a smartphone app and (2) estimate the criterion validity of the EMA to capture children's eating occasions and parents' feeding practices. Participant adherence, technological challenges, and data quality were used to provide an overview of the real-time dynamics of parental mood, feeding goals, and contextual factors during eating occasions. Methods: Parents in the United Kingdom with a child aged 3 to 5 years who exhibit avid eating behavior were invited to participate in a 10-day EMA study using a smartphone app. Of the 312 invited participants, 122 (39%) parents initiated the EMA study, of which 118 (96.7%) completed the full EMA period and the follow-up feasibility and acceptability survey. Results: Of those parents who completed the EMA study, 104 (87.4%) parents provided at least 7 "full" days of data (2 signal surveys and 1 event survey), despite 51 parents (43.2%) experiencing technical difficulties. The parents received notifications for morning surveys (69.9% response rate), 3 daily mood surveys (78.7% response rate), and an end-of-day survey (84.6% response rate) on each of the 10 days. Over the EMA period, a total of 2524 child eating/food request surveys were self-initiated by the participants on their smartphones, an average of 2.1 times per day per parent (SD 0.18; min=1.7, max=2.3). The majority of parents felt that the surveys made them more aware of their feelings (105/118, 89%) and activities (93/118, 79%). The frequency of daily food requests estimated by parents at baseline was significantly correlated with the frequency of food requests reported daily during the EMA period (r=0.483, P<.001). However, the number of daily food requests per day estimated at baseline (mean 4.5, SD 1.5) was significantly higher than the number of food requests reported per day during the EMA period (mean 3.7, SD 1.1), (t116=18.8, P<.001). Conclusions: This paper demonstrates the feasibility of employing EMA to investigate the intricate interplay between parental mood, feeding goals, contextual factors, and feeding practices with children exhibiting an avid eating behavior profile. However, the use of EMA needs to be carefully developed and tested with parents' involvement to ensure successful data collection.

The aim of this systematic review is to assess the relationship between two complementary feeding features (diet quality and feeding approach) and some aspects of infant development (cognitive development, social cognition, and language). Recent reviews have explored many aspects of complementary feeding, such as the age at which first foods are introduced, child’s micronutrient status, weight and health outcomes. However, there appears to be a knowledge gap in two areas that are potentially relevant for developing a healthy diet: the quality of the diet and the type of complementary feeding approach. Furthermore, reviews on complementary feeding tends to rely heavily on research from Western countries (also known as WEIRD countries), failing to provide a global perspective on infant development. Positive significant relationships were found between diet quality and (i) cognitive development (five studies), (ii) language development (six studies), (iii) social cognition (three studies), (iv) general development (six studies), and between approach and language development (two studies). Although a substantial number of findings suggest a significant relationship between diet quality and child development (20), some findings were non-significant (17), signaling that more research is needed in this field.

BACKGROUND:Children with avid eating behaviour display high food responsiveness, high emotional overeating and low sensitivity to fullness; behaviours which may increase the risk of obesity and are challenging for parents to manage. This study explores the situational predictors of coercive or indulgent feeding practices among parents of children with avid eating behaviours using Ecological Momentary Assessment (EMA). METHODS:The study involved 109 parents of 3-5-year-old children exhibiting avid eating behaviour. Over 10 days, participants completed EMA surveys via a mobile app to report on their mood, stress, feeding goals, and feeding practices during eating occasions. Multilevel modelling was used to assess how parental mood, goals, and the eating context (e.g., meal versus snack, public versus private setting) influenced feeding practices. RESULTS:Parents were more likely to use specific coercive or indulgent feeding practices when experiencing higher stress, when aiming to avoid mealtime conflict, and during meals versus snacks. A negative meal atmosphere and a public setting also increased the likelihood of certain indulgent practices. Notably, parents were more likely to report giving their child food to calm them down or help manage their behaviour when the meal atmosphere was perceived as negative and if they aimed to reduce conflict at the meal. The findings highlight that the context of feeding occasions significantly drives the use of coercive or indulgent feeding practices. CONCLUSIONS:Parental stress, goals, and the eating context are key determinants of coercive or indulgent feeding practices with children exhibiting avid eating behaviours. Interventions to support parents should consider these dynamic factors, promoting healthier feeding strategies tailored to real-life contexts.

Children’s avid eating behaviour is characterised by frequent snacking and food responsiveness. Parents need evidence-based advice on specific feeding practices, such as distraction techniques and portioning, that can be used to reduce children’s intake of high energy-dense snacks. This experimental laboratory study tested the effectiveness of these feeding practices. Parents and children (3-5 years; N=129) who were identified as having an avid or typical eating profile were recruited and randomly allocated to one of three conditions. Following a standardised meal, children’s energy intake (measured in kilocalories) in the absence of hunger was assessed. While children had access to a snack buffet, parents were asked to use one of the following feeding practices: (1) Distract – using distraction techniques to delay children’s snack intake; (2) Portion – allowing children to have snacks from pre-portioned pots; or (3) Control – allowing children to eat the type and number of snacks that their child wanted to. Results showed that children in the distraction condition consumed significantly less energy from snacks compared to children in the portion or control conditions. Energy intake in the portion and control conditions was not significantly different. There was also no difference in energy intake between children with avid versus typical eating profiles. These findings suggest that parental use of distraction techniques may be effective for reducing children’s intake of high energy-dense snacks and could be recommended for use to support the development of children’s healthy eating behaviour. Further research to examine the effectiveness of distraction in real-world settings is now needed.

A variety of parent psychological characteristics (e.g., wellbeing) have been related to children’s eating behaviour. However, parent-child feeding interactions are reciprocal and complex, including relationships between parental cognitions, emotions, as well as the influence of children's varying appetitive traits. Using a person-centred approach, children’s appetitive traits can be clustered into meaningful eating profiles. To date, no research has examined whether parental behaviours, emotions, and cognitions differ depending on a child’s eating profile. Hence, this study recruited parents/primary caregivers from the APPETItE project, whose child had previously been identified as having an avoidant, typical, happy, or avid eating profile. Parents/primary caregivers of children (3-6 years; N = 632) completed online questionnaires examining broader parenting behaviour (parenting styles), parental emotions (stress, wellbeing), and parental cognitions (goals, self-efficacy, time and energy for meal planning and preparation, and perceptions about children’s body size). Findings showed significant differences in parent responses to the questionnaires based on children’s eating profiles. Parents of children with a happy eating profile reported better psychological wellbeing and greater parenting time and energy for meal planning and preparation, as well as being less likely to report goals of avoiding mealtime stress and conflict. In contrast, parents of children with an avoidant eating profile reported poorer psychological wellbeing. Children with an avid eating profile were perceived by parents as having a higher body weight, whereas children with an avoidant eating profile were perceived as having a lower body weight. Overall, these findings demonstrate that differences in parental characteristics and perceptions exist between children’s eating profiles and thus should be considered in the development of tailored interventions to support children’s healthy eating.

Background Black ethnic groups are disproportionately affected by sexually transmitted infections (STIs). This review aimed to identify interventions designed to increase engagement with sexual healthcare among people of Black ethnicity as determined by rates of STI testing, adherence to sexual health treatment, and attendance at sexual healthcare consultations. The behaviour change techniques (BCTs) used within identified interventions were evaluated. Method Four electronic databases (Web of science; ProQuest; Scopus; PubMed) were systematically searched to identify eligible articles published between 2000 and 2022. Studies were critically appraised using the Mixed Methods Appraisal Tool. Findings were narratively synthesised. Results Twenty one studies across two countries were included. Studies included randomised controlled trials and non-randomised designs. Behavioural interventions had the potential to increase STI/HIV testing, sexual healthcare consultation attendance and adherence to sexual health treatment. Behavioural theory underpinned 16 interventions which addressed barriers to engaging with sexual healthcare. Intervention facilitators’ demographics and lived experience were frequently matched to those of recipients. The most frequently identified novel BCTs in effective interventions included information about health consequences, instruction on how to perform behaviour, information about social and environmental consequences, framing/reframing, problem solving, and review behavioural goal(s). Discussion Our findings highlight the importance of considering sociocultural, structural and socio-economic barriers to increasing engagement with sexual healthcare. Matching the intervention facilitators’ demographics and lived experience to intervention recipients may further increase engagement. Examination of different BCT combinations would benefit future sexual health interventions in Black ethnic groups.

Background The Black Caribbean population have a disproportionately high burden of sexually transmitted infections (STIs) compared with other ethnic groups. The aim of this study was to explore barriers to engagement with STI testing within a UK-based young adult Black Caribbean community. Methods Semi-structured interviews were carried out with 14 young adults from the Black Caribbean community and six sexual healthcare professionals. Data were analysed thematically. A focus group of five young adults was conducted to refine themes. Results Data analysis generated three themes: (1) culturally embedded stigma; (2) historically embedded mistrust; and (3) lack of knowledge. Perceived as ‘dirty’, particularly for females, infection with STIs was stigmatised by religious conceptions of ‘purity’ and shame. This presented challenges in terms of cultural acceptability of talking about STI testing with partners, friends, and family. Legacies of colonialism, medical racism and malpractice compromised young people’s trust in medical intervention and confidentiality of data management. A lack of knowledge related to STIs and their treatment, and in how to access and perform STI tests further served as a barrier. Culturally tailored interventions targeting these factors and delivered by radio, podcasts and social media were highlighted as having potential to improve engagement with STI testing. Discussion Engagement with STI testing by young adults from the Black Caribbean community is impacted by historically and culturally embedded teachings, practices and beliefs inherited through generations. Targeting these factors within culturally tailored interventions may be effective for increasing STI-testing, and thus reducing rates of STI-infection in this population.