Development of a Survey to Assess Latino Fathers’ Parenting Practices Regarding Energy Balance

Abstract

Latino adolescents face challenges to performing energy balance–related behaviors (EBRBs) to prevent childhood obesity, including healthy dietary intake, adequate physical activity, and limited screen time. Fathers are underrepresented in family-based obesity interventions but could be influential in shaping the EBRBs of Latino children. Three types of parenting practices (setting expectations/limits, role modeling, managing availability and accessibility) have shown relatively consistent positive relationships with children’s EBRBs in studies that have mostly involved mothers. The purpose of this study was to develop measures to assess Latino fathers’ parenting practices based on existing measurement instruments, focus groups and cognitive testing. Criterion validity of the measures (40 items) was examined with Latino fathers and their early adolescents (10-14 years old, n = 96 dyads) who were predominantly from low-income, two-parent households. Criterion validity was indicated by significantly higher intakes of fruit and vegetables; lower intakes of sugar-sweetened beverages, sweets/salty snacks and fast foods; more weekly physical activity hours; and fewer daily screen time hours among adolescents who reported high versus low levels/frequencies of supportive parenting practices. In addition, nearly all scales of adolescent-reported paternal behavioral modeling and availability/accessibility practices were significantly correlated with adolescents’ corresponding EBRBs (r = 0.22 to 0.54). However, poor validity and agreement with early adolescents’ reports were found for most father-reported parenting practices. Overall, this study indicated that the measures were acceptable for assessing adolescents’ report of Latino fathers’ parenting practices around EBRBs. The findings also indicate the importance of including early adolescents’ reports in measuring paternal parenting practices.

Keywords

adolescents dietary intake Latino fathers parenting practices physical activity screen time

This study provided valid measures of Latino fathers’ parenting practices specific to seven energy balance–related behaviors (EBRBs) and highlighted the importance of measuring adolescents’ perceptions and experiences. Further application of these measures would contribute to understanding the potential influence of Latino fathers on the prevention of excess weight gain during adolescence.

Latino children and adolescents experience a greater burden of overweight/obesity compared to other ethnic/racial groups with nearly half of the population having a body mass index at or above the 85th percentile (Skinner, Ravanbakht, Skelton, Perrin, & Armstrong, 2018). Studies have found that Latino children and adolescents from immigrant families tend to adopt a “Western” diet pattern and have less active transport, inadequate leisure-time exercise, and increased screen time than those from less acculturated families (Ayala, Baquero, & Klinger, 2008; Echeverría, Ohri-Vachaspati, & Yedidia, 2015; Gordon-Larsen, Harris, Ward, & Popkin, 2003; Unger et al., 2004). EBRBs influence calorie intake and expenditure and are behavioral risk factors for unhealthy weight gain (Han, Lawlor, & Kimm, 2010). EBRBs include intake of fruits, vegetables, sweets/salty snacks, sugar-sweetened beverages (SSBs), and fast food, and physical activity and screen time. Adverse changes in these behaviors need to be addressed by effective intervention strategies.

Existing family-based behavioral interventions to prevent pediatric obesity demonstrated only modest effects on improving children’s EBRBs (Brown et al., 2016; Marsh, Foley, Wilks, & Maddison, 2014; Schlechter, Rosenkranz, Guagliano, & Dzewaltowski, 2016). These programs frequently applied indirect strategies to involve parents as change agents and did not directly address important parenting practices to improve child EBRBs. Moreover, fathers have an important and unique influence on children’s health and weight status (Freeman et al., 2012; Yogman & Garfield, 2016) but have been underrepresented in family interventions to prevent childhood obesity (Davison et al., 2018).

In Latino families, cultural values of “familism” and “respeto” along with the gender roles of “machismo” and “marianismo” indicate that Latino fathers are influential household figures in charge of major decisions with caregiving roles and parenting practices that may differ from mothers’ (O’Connor, Perez, Garcia, & Gallagher, 2018). Several qualitative studies have documented Latino fathers’ EBRB-related parenting practices that may reflect some of these cultural values (Davis, Cole, Blake, McKenney-Shubert, & Peterson, 2016; Evans et al., 2011; Lindsay, Wallington, Muñoz, & Greaney, 2018; Lora, Cheney, & Branscum, 2016; Mena, Gorman, Dickin, Greene, & Tovar, 2015). For example, these studies indicated that Latino fathers were generally less engaged in food parenting practices than mothers who have a traditional cultural role in food acquisition and preparation. But fathers’ food preferences and permissiveness regarding children’s diets influenced the dietary intake of the family. These studies also found that Latino fathers were more involved in children’s physical activity and screen time than mothers. The disproportionately high obesity rate among Latino children and adolescents and the potentially important role of fathers indicate a need for further research regarding Latino fathers’ parenting practices around EBRBs.

However, validated instruments for assessing fathers’ parenting practices around EBRBs are lacking. Existing measures have primarily been developed based on research with mothers of young children (Davison et al., 2016; Vaughn, Tabak, Bryant, & Ward, 2013). Fathers and mothers may differ in their perceived responsibilities for food and activity parenting (Blissett, Meyer, & Haycraft, 2006; Zhang, Hurtado, Flores, Alba-Meraz, & Reicks, 2018), especially among Latino families based on traditional gender roles. For Latino families, Larios, Ayala, Arredondo, Baquero, and Elder (2009) designed the Parenting Strategies for Eating and Activity Scale based on focus group findings from Latino mothers of 5- to 8-year-old children. This scale was tested among mothers of adolescent girls but showed limited validity (Matthews-Ewald, Posada, Wiesner, & Olvera, 2015). Moreover, an application of the Parenting Strategies for Eating and Activity Scale found significant differences between fathers and mothers in three out of five constructs of parenting practices (Lloyd, Lubans, Plotnikoff, Collins, & Morgan, 2014). Better instruments that incorporate Latino fathers’ perceptions are needed to investigate paternal parenting practices around adolescents’ EBRBs.

In addition, multiple studies have reported discrepancies between parents’ and children’s report of parenting practices, possibly influenced by parent social desirability bias and parent–child relationships (Korelitz & Garber, 2016; Rebholz et al., 2014; Tak, te Velde, de Vries, & Brug, 2006; van Assema, Glanz, Martens, & Brug, 2007). These studies indicated that parents may feel a need to represent their parenting practices positively. Also, if parents and children do not have close relationships, children may not be aware of expectations or be exposed to modeling. Therefore, including both children’s and fathers’ reports is important for assessing parenting practices. Comparing agreement between children’s and fathers’ reports would shed light on future studies of paternal parenting practices.

According to the contextual model of parenting style, parenting practices are goal-directed behaviors that have direct effects on the development of specific child behaviors (Darling & Steinberg, 1993). This definition indicates that the relationship between parenting practices and specific behavioral outcomes of children is an important criterion of construct validity for assessing parenting practices. This criterion should be applied to validate measures assessing paternal parenting practices specific to children’s EBRBs. Based on available studies, three types of parenting practices have shown relatively consistent positive relationships with children’s EBRBs, including setting expectations/limits, behavioral modeling, and managing availability and accessibility (Edwardson & Gorely, 2010; Xu, Wen, & Rissel, 2015; Yee, Lwin, & Ho, 2017). A recent focus group study confirmed the application of these parenting practices among Latino fathers of early adolescents (Zhang et al., 2018). This study also indicated the importance of including separate measures of these parenting practices around dietary intake, physical activity, and screen time because Latino fathers reported behaviors that differed by domain. An instrument incorporating these parenting practices related to specific EBRBs would be beneficial for advancing the research on Latino fathers’ involvement in promoting healthy lifestyle among children and adolescents.

Therefore, the present study aimed to examine the criterion validity of Latino father- and adolescent-reported paternal parenting practices (40 items) against adolescents’ corresponding EBRBs and the agreement between father-reported and adolescent-reported paternal parenting practices. This study was an essential part of a formative process to develop the Padres Preparados, Jóvenes Saludables program (Zhang et al., in press). This program is a community-based, healthy lifestyle intervention program that provides a series of eight weekly classes with an emphasis on father involvement for Latino early adolescents.

Method

Participants and Study Design

Latino father–adolescent dyads were recruited from community centers serving low-income Latinos in the Minneapolis/St. Paul metropolitan area and surrounding suburbs using flyers, word of mouth, and social media. Inclusion criterion for adolescents was being 10 to 14 years of age. Inclusion criteria for fathers were having meals with the early adolescent at least three times in a week, self-identifying as Latino, and speaking Spanish. Survey data about paternal parenting practices and EBRBs were collected from a total of 96 Latino father–adolescent dyads; 71% of the sample (n = 68) were enrolled in the Padres Preparados, Jóvenes Saludables program and their survey data were collected prior to the first class session. The other 29% (n = 28) participated in a separate study where they only completed the survey. Parents and adolescents provided consent and assent, respectively. Fathers completed the parent survey and adolescents completed the youth survey in separate groups taking about 20 to 30 minutes. The surveys were self-administered with assistance from research staff if needed. Parents and adolescents received cash compensation for their participation. The study was approved by the Institutional Review Board Human Subjects Committee at the University of Minnesota.

Development of Measures of EBRB-Related Parenting Practices Reported by Fathers and Adolescents

Survey items to assess the frequency of three key parenting practices (setting expectations/limits, behavioral modeling, and managing availability and accessibility) were developed based on existing instruments (Matthews-Ewald et al., 2015; Pinard et al., 2014; Singh et al., 2012) and findings from focus groups with Latino fathers (Zhang et al., 2018). Level or frequency of parenting practices was assessed with regard to intake of fruit, vegetables, SSBs, sweets/salty snacks, and fast food as well as physical activity and screen time. The adolescent and parent versions of the survey addressing parenting around the seven EBRBs were first written in a parallel form in English. The parent survey was translated into Spanish and then translated back into English to confirm that the meaning of the survey items was similar in both languages. Cognitive testing of newly developed survey items was conducted with five Latino fathers in Spanish and four Latino adolescents in English during individual interviews using the think-aloud method (Ericsson & Simon, 1993). These interviews were conducted in part to ensure that both fathers and adolescents interpreted the parallel items in the same manner. Participants were asked to (1) repeat the survey questions using their own words, (2) explain how they selected their response from the options provided, (3) indicate how difficult each question was to answer, and (4) indicate how sure they were of their answer for each question. The research team revised the survey items based on a discussion of interview responses. The final version of the questions is shown in Figure 1. Adolescents completed the youth survey in English, and fathers completed the parent survey in Spanish. Cronbach’s α coefficients of the paternal availability/accessibility scales ranged from .62 to .84 for adolescents’ reports and from .54 to .86 for fathers’ reports.

Figure 1.

Measures to assess Latino fathers’ parenting practices related to early adolescents’ energy balance–related behaviors (fathers responded to the same set of questions reworded to reflect their perceptions).

Adolescent-Reported Dietary Intake

Adolescents’ intake frequencies of fruit, vegetables, SSBs, sweets/salty snacks, and fast food were assessed by asking how often typical food/drinks from each food group were consumed. The list of typical food/drinks in each food group (Figure 2) was adapted from the Block Kids food frequency questionnaire (Hunsberger, O’Malley, Block, & Norris, 2015). Response options (never, less than once a week, 1-3 times per week, 4-6 times per week, once a day or more) were recoded to 0, 0.11, 0.29, 0.71, and 1, respectively, to estimate daily intake frequency. The daily intake frequency score was the sum score of the converted daily intake frequency scores of items in each food group. Outliers were identified as ≥ upper quartile plus 1.5 times the interquartile range (IQR) and were excluded from the analysis involving corresponding variables.

Figure 2.

Food and drink items assessed in the early adolescent-reported Food Frequency Questionnaire.

Adolescent-Reported Physical Activity

Adolescents responded to two survey questions assessing hours spent in a usual week on vigorous and moderate exercises with examples provided for each level (Godin & Shephard, 1985; McGuire, Hannan, Neumark-Sztainer, Cossrow, & Story, 2002). Response options (0, <30 minutes, 0.5-2 hours, 2.5-4 hours, 4.5-6 hours, and >6 hours) were recoded to 0, 0.3, 1.3, 3.3, 5.3, and 8, respectively, to estimate hours of physical activity per week. Responses to the two questions were summed to create a score representing total time spent in moderate to vigorous physical activity in a usual week.

Adolescent-Reported Screen Time

Adolescents reported screen time in response to questions from Project EAT regarding media use (Utter, Neumark-Sztainer, Jeffery, & Story, 2003). The questions assessed daily hours spent watching TV/DVDs/videos, using a computer (not for homework or work), and playing electronic games while sitting on a typical weekday and weekend day. Adolescents also reported daily hours spent using smartphones and tablets. Seven response categories ranged from 0 hours to >5 hours for each type of screen time. Hours of total screen time per day were calculated using a weighted sum of weekday and weekend day responses divided by 7 days (Utter et al., 2003). Adolescents who reported >10 hours of recreational screen time per day were excluded from the analysis. This cutoff point was determined by examining the distribution of participants’ responses as well as consideration of responses indicating implausible reporting and/or multi-tasking.

Adolescent- and Father-Reported Demographic Characteristics

Adolescents reported their age and sex. Fathers reported their age, marital status, highest level of education, household income, food security status, years lived in the United States, and language spoken at home. Food insecurity was determined using a two-item screener (Hager et al., 2010).

Statistical Analysis

Statistical analysis was performed using SAS 9.4 (Cary, NC, USA, 2002-2012). Descriptive analyses (count, frequency, mean, standard deviation, median, and/or IQR) were performed on sociodemographic variables as well as father- and adolescent-reported paternal parenting practices and adolescent-reported EBRB variables. The normality of data distribution was examined based on the Kolmogorov–Smirnov test. Internal consistency of scales of paternal availability/accessibility practices was determined based on Cronbach’s alpha coefficients. Correlations between adolescents’ EBRBs and paternal behavioral modeling and availability/accessibility practices were examined as continuous scores using Spearman rank correlation analyses. To assess criterion validity, paternal parenting practices were dichotomized into high and low levels or frequencies based on the nature of the response options and distribution of the data. Adolescents’ EBRBs were compared using the Wilcoxon rank sum test by high and low levels or frequencies of parenting practices. Agreement between adolescent-reported and father-reported paternal parenting practices was assessed based on percentage of agreement and simple kappa statistics of the dichotomized responses. The agreement between adolescent-reported and father-reported paternal availability/accessibility scales was assessed by intraclass correlation coefficient. Differences between adolescent- and father-reported scores for paternal parenting practices were compared using Student’s t test.

Results

Participant Characteristics

For the 96 adolescent–father dyads, mean age was 11.7 ± 1.3 for adolescents and 40.2 ± 6.5 for fathers (Table 1). About half of the adolescents were boys. Most fathers were married or lived with a partner (91%), reported their highest educational attainment as high school or lower (79%), and reported an annual household income ≤$49,999 (85%). Nearly half of fathers reported food insecurity in their households. Mean length of U.S. residence for fathers was 18.8 ± 6.2 years. Most fathers primarily or only spoke (68%) their native language (e.g., Spanish) at home.

Table 1.

Demographic Characteristics of Latino Adolescent–Father Dyads (n = 96).

Characteristics	n (%) or M ± SD
Adolescent age, years	11.7 ± 1.3
10-12	68 (71%)
13-14	28 (29%)
Adolescent sex
Boy	50 (52%)
Girl	46 (48%)
Fathers’ age, years	40.2 ± 6.5
≤40	45 (47%)
>40	48 (50%)
Missing	3 (3%)
Marital status
Married or with a partner	87 (91%)
Single	7 (7%)
Missing	2 (2%)
Education attainment
Middle school or less	36 (38%)
High school or GED	39 (41%)
Some college or more	19 (20%)
Missing	2 (2%)
Household income, $
≤24,999	37 (39%)
25,000-49,999	45 (47%)
≥50,000	8 (8%)
Missing	6 (6%)
Food insecure
Yes	44 (46%)
No	51 (53%)
Missing	1 (1%)
Years lived in the United States	18.8 ± 6.2
Language spoken at home
Primarily native language (e.g., Spanish)	65 (68%)
Equally or primarily English	27 (28%)
Missing	4 (4%)

Paternal Expectations/Limits on Adolescents’ EBRBs

Adolescents who reported relatively high EBRB-specific paternal expectations and limits had significantly higher intakes of fruit and vegetables and higher weekly MVPA and lower intakes of SSBs, sweets/salty snacks, and fast food, and less recreational screen time compared to those who reported low or no paternal expectations/limits (Table 2). However, adolescent EBRBs were not significantly different based on high and low levels of father-reported expectations and limits except for screen time (Mdn, IQR: 23.5, 14.0-33.5 vs. 41.5, 25.5-54.0; p = .005, data not shown in Table 2).

Table 2.

Differences in Latino Adolescents’ EBRBs by Their Perceived High or Low Paternal Expectations or Limits.

Adolescents’ EBRBs	Paternal expectations/limits^a				p ^b
	High		Low
	n	Mdn (IQR)	n	Mdn (IQR)
Fruit (times/day)	47	3.3 (1.8-4.6)	38	2.2 (1.1-3.8)	.02
Vegetables (times/day)	53	1.2 (0.8-1.8)	37	0.8 (0.3-1.7)	.01
SSBs (times/day)	66	0.9 (0.4-1.6)	24	1.4 (0.6-2.5)	.04
Sweets/salty snacks (times/day)	56	0.9 (0.5-1.5)	23	1.2 (1.0-1.7)	.03
Fast food (times/week)	42	0.4 (0.2-0.7)	40	0.7 (0.5-0.8)	.004
MVPA (hours/week)	58	2.6 (1.6-2.6)	38	1.6 (0.6-2.6)	.03
Screen time (hours/week)	47	23.0 (14.0-30.5)	32	40.0 (25.0-55.3)	.0001

Note. EBRB = energy balance–related behavior; IQR = interquartile range; SSB = sweets and salty snacks; MVPA = moderate to vigorous physical activity.

High and low levels of paternal expectation: ≥2 and ≤1 time per day (fruit and vegetable), ≥0.5 hour per day and <0.5 hour per day (physical activity); high and low levels paternal limits: ≤1-3 and ≥ 4-6 times per week (sugary drinks and sweets/salty snacks), ≤1 and ≥1-3 time per week (fast food), ≤2 and >2 hours per day (screen time). ^bWilcoxon rank sum test, p < .05, two-tailed.

Paternal Behavioral Modeling of EBRBs

Adolescent-reported frequencies of EBRB-specific paternal behavioral modeling were positively correlated with five of the seven EBRBs (Table 3). The correlation coefficients ranged from .22 (SSB intake) to .54 (vegetable intake). Adolescents who perceived high frequency of paternal behavioral modeling of fruit intake, vegetable intake, and SSB intake reported higher intakes than those who perceived low frequency of paternal behavioral modeling. Father-reported frequencies of behavioral modeling of fast food intake and physical activity were positively correlated with adolescents’ fast food intake (r = .23, p = .04) and physical activity (r = .26, p =.01). None of the adolescent EBRBs differed by father-reported high or low frequency of the corresponding behavioral modeling (data not shown in Table 3).

Table 3.

Differences in Latino adolescents’ EBRBs by their perceptions of the frequency of paternal behavioral modeling.

Adolescents’ EBRBs	Scale		Paternal behavioral modeling^a				p ^c
	Scale		High		Low
	n	r _s ^b	n	Mdn (IQR)	n	Mdn (IQR)
Fruit (times/day)	78	.35**	26	3.0 (1.9-5.7)	52	2.1 (1.0-3.6)	.02
Vegetables (times/day)	87	.54***	39	1.5 (0.9-2.1)	48	0.8 (0.3-1.1)	<.001
SSBs (times/day)	89	.22*	20	1.5 (0.9-2.7)	69	0.8 (0.4-1.7)	.03
Sweets/salty snacks (times/day)	76	.17	15	1.4 (0.7-1.8)	61	1.0 (0.6-1.4)	.17
Fast food (times/week)	81	.27*	22	0.6 (0.4-1.0)	59	0.5 (0.2-0.7)	.09
MVPA (hours/week)	90	.30**	46	2.6 (1.6-2.6)	44	1.6 (0.6-2.6)	.10
Screen time (hours/week)	78	.10	29	28.3 (17.0-53.0)	49	24.5 (14.5-38.5)	.17

Note. EBRB = energy balance–related behavior; IQR = interquartile range; SB = sweets and salty snacks; MVPA = moderate to vigorous physical activity.

High and low frequencies of paternal behavioral modeling: mean frequency score >3 and ≤3 (fruit, vegetables, SSBs, physical activity, and screen time); mean frequency score >2 and ≤2 (sweets/salty snacks and fast food). ^br_s = Spearman rank correlation coefficient, *p < .05, **p < .01, ***p < .0001.

Between-group comparisons by Wilcoxon rank sum test, p < .05, two-tailed.

Paternal EBRB-Related Availability/Accessibility Practices

Adolescent-reported frequencies of paternal availability/accessibility practices were correlated with all seven adolescent EBRBs (Table 4). The correlation coefficients ranged from .29 (MVPA) to .44 (screen time). Adolescents who reported high frequency of paternal availability/accessibility practices reported significantly higher scores for all seven EBRBs, respectively, than those who reported low frequency of paternal availability/accessibility practices (Table 4). However, father-reported frequencies of availability/accessibility practices were only correlated with adolescents’ vegetable intake (r = .23, p = .04), SSB intake (r = .23, p = .03) and fast food intake (r = .33, p = 0.003). Adolescents whose fathers reported high frequency of availability/accessibility practices for SSBs or fast food had higher SSB intake or fast food intake than those whose fathers reported low frequency of these availability/accessibility practices (Mdn, IQR for SSB: 1.4, 0.8-2.6 vs. 0.7, 0.4-1.5, p = .002; Mdn, IQR for fast food: 0.7, 0.4-1.0 vs. 0.4, 0.2-0.7, p = .008, data not shown in Table 4).

Table 4.

Adolescent-Reported Paternal Availability Practice Scales and Correlations Between Paternal Availability Practices and Corresponding EBRB.

Adolescents’ EBRBs	Scale		Paternal availability practice^a				p ^c
	Scale		High		Low
	n	r _s ^b	n	Mdn (IQR)	n	Mdn (IQR)
Fruit (times/day)	78	.32**	23	3.5 (2.1-5.7)	55	2.3 (1.2-3.6)	.02
Vegetables (times/day)	84	.42***	23	1.7 (1.0-2.6)	61	0.8 (0.5-1.5)	.003
SSBs (times/day)	85	.36***	26	1.5 (1.1-2.3)	59	0.8 (0.4-1.3)	<.001
Sweets/salty snacks (times/day)	77	.29*	28	1.1 (0.8-1.8)	49	0.9 (0.4-1.4)	.04
Fast food (times/week)	78	.42***	30	0.8 (0.6-1.0)	48	0.4 (0.2-0.7)	<.001
MVPA (hours/week)	93	.29**	34	2.6 (1.6-4.6)	59	1.6 (0.6-2.6)	.005
Screen time (hours/week)	79	.44***	25	44.5 (28.5-56.5)	54	23.0 (14.0-31.0)	<.001

Note. EBRB: energy balance–related behavior; IQR = interquartile range; SSB: sweets and salty snacks; MVPA: moderate to vigorous physical activity.

High and low frequencies of paternal availability practice: mean frequency score ≥4 and <4 (fruit, vegetables, physical activity, and screen time); mean frequency score >2 and ≤2 (SSBs, sweets/salty snacks and fast food). ^br_s = Spearman rank correlation coefficient, *p < .05, **p < .01, ***p < .0001.

Between-group comparisons by Wilcoxon rank sum test, p < 0.05, two-tailed.

Congruence Between Adolescent-Reported and Father-Reported Parenting Practices

The percentage agreement between adolescent- and father-reported dichotomized responses for paternal expectations/limits ranged from 49% to 68% (Table 5), with only one significantly positive but weak kappa coefficient for paternal limits on screen time. In addition, adolescents reported significantly greater paternal allowances for sweets/salty snacks (2.3 ± 1.2 vs. 1.8 ± 1.1, p < .001) and fast food (1.9 ± 1.2 vs. 1.3 ± 0.9, p < .001) than fathers (data not shown in Table 5). The percentage agreement between adolescent- and father-reported dichotomized frequencies for paternal behavioral modeling ranged from 51% to 70%, with only two positive but weak kappa coefficients for paternal behavioral modeling of fruit intake and physical activity. Adolescents reported significantly higher frequency of paternal behavioral modeling for physical activity (3.0 ± 1.0 vs. 2.6 ± 1.1, p = .005) than fathers. The percentage agreement between adolescent- and father-reported dichotomized scores for paternal availability/accessibility practices ranged from 52% to 70%, with only one positive but weak kappa coefficient for paternal availability/accessibility practices for physical activity. The scales for paternal availability/accessibility practices also yielded poor intraclass correlation coefficients ranging from −.06 to .40. Adolescents reported significantly lower frequencies of paternal availability/accessibility practices related to fruits (3.1 ± 1.0 vs. 3.8 ± 0.8, p < .0001), vegetables (3.0 ± 1.2 vs. 3.6 ± 1.0, p < .0001), fast food (2.0 ± 0.7 vs. 2.1 ± 0.7, 0.02), and physical activity (3.4 ± 1.1 vs. 3.6 ± 0.9, p = .03) than fathers’ report (data not shown in Table 5).

Table 5.

Agreements Between Adolescent-Reported and Father-Reported Parenting Practices.

EBRBs	Expectation			Behavioral modeling			Availability practice
EBRBs	n	%^a	Kappa^b	n	%a	Kappa^b	n	%^a	Kappa^b	ICC^c
Fruit	94	51	0.01 (−0.19, 0.21)	82	70	0.26 (0.03, 0.48)*	80	58	0.17 (−0.02, 0.36)	.05
Vegetables	92	51	0.01 (−0.19, 0.22)	86	51	0.006 (−0.19, 0.21)	84	56	0.12 (−0.07, 0.31)	.20
SSBs	91	68	0.03 (−0.18, 0.23)	95	72	0.04 (−0.16, 0.24)	86	62	0.14 (−0.08, 0.35)	.25
Sweets/salty snacks	92	55	−0.07 (−0.24, 0.11)	93	59	−0.005 (−0.20, 0.19)	90	59	0.06 (−0.14, 0.27)	.08
Fast food	93	49	−0.003 (−0.20, 0.19)	94	60	0.05 (−0.15, 0.26)	88	55	0.10 (−0.09, 0.30)	.30
MVPA^c	91	52	−0.03 (−0.23, 0.17)	85	62	0.25 (0.08, 0.42)*	92	70	0.36 (0.17, 0.56)*	.40
Screen time	92	62	0.23 (0.04, 0.42)*	92	57	0.10 (−0.11, 0.30)	95	52	−0.01 (−0.21, 0.19)	−.06

Note. EBRB = energy balance–related behavior; SSB = sweets and salty snacks; MVPA = moderate to vigorous physical activity.

%: percentage of agreement of dichotomized responses from adolescents and fathers. ^bKappa statistics compared agreement of dichotomized responses from adolescents and fathers. ^cIntraclass correlation coefficients assessed the resemblance of adolescent-reported and father-reported paternal availability practices.

Discussion

Based on the current sample of Latino adolescents, all measures of fathers’ expectations/limits and availability/accessibility practices and most measures of behavioral modeling showed criterion validity. Similar validation methods have been applied in previous studies testing measures of parenting practices (Cullen et al., 2001; De Bourdeaudhuij et al., 2005; Pinard et al., 2014). In the present study, the valid measures of Latino fathers’ parenting practices related to EBRBs were developed with clear conceptualization and consistent operationalization based on the contextual model of parenting style (Darling & Steinberg, 1993). A systematic review conducted by Vaughn et al. (2013) found that less than half of the existing measures of food-related parenting practices defined constructs or used theory to guide instrument development. The application of theory-based measures contributes to the ability to evaluate the influence of food- and activity-related parenting practices on adolescent behaviors.

The current study demonstrated consistent validity across seven specific EBRBs for parental expectations/limits and availability/accessibility practices. In comparison, previous studies have tended to assess parenting practices generally and not for specific EBRBs and therefore could not show validity against specific EBRBs. For example, the “food policies” and “media policies” measures in the Comprehensive Home Environment Survey assessed parental expectations and limits with several items related to a variety of food and activity behaviors (Pinard et al., 2014). However, these measures showed validity only with children’s SSB intake and screen time and not with fruit and vegetable intake and physical activity. Therefore, specificity in the operationalization and validation of parenting practices is important.

Adolescent-reported paternal behavioral modeling of intake of sweets/salty snacks and screen time were not correlated with adolescents’ behaviors in the current study. In this sample, only 15 early adolescents reported a relatively high frequency of paternal behavioral modeling of sweets/salty snacks intake, indicating that few adolescents were exposed to their fathers’ modeling influence regarding these foods and therefore the opportunity to observe correlations was limited. The lack of correlation between adolescent-reported paternal behavioral modeling of screen time and adolescents’ daily screen time hours was unexpected because qualitative studies have reported Latino fathers’ involvement in children’s screen time activities, and correlations have been found between fathers’ and children’s screen time in other studies (Davis et al., 2016; Davison, Francis, & Birch, 2005; Fuemmeler, Anderson, & Mâsse, 2011; Lindsay, Salkeld, Greaney, & Sands, 2015). The lack of validity for these two measures calls for more sensitive measures of Latino fathers’ behavioral modeling of intake of sweets/salty snacks and screen time. Future studies may also need to consider the potential powerful effect of peer influence on certain adolescent EBRBs, such as intake of sweets/salty snacks and screen time.

The current study developed and tested measures of father-reported parenting practices in parallel with adolescent-reported measures and compared the congruence between adolescent and father reports. The results indicated limited criterion validity for father-reported parenting practices and substantial discrepancies between adolescents’ and fathers’ reports of parenting practices. This phenomenon has been reported in previous studies (Rebholz et al., 2014; Tak et al., 2006; Taylor, Wilson, Slater, & Mohr, 2011; van Assema et al., 2007) with the suggestion that parents were more likely than adolescents to respond to parenting-related questions in a socially desirable direction (Rebholz et al., 2014; Taylor et al., 2011). Findings from the current study indicated that adolescents reported significantly lower frequency of fathers making fruits, vegetables, and physical activity opportunities available than the more favorable higher frequency reported by fathers. Others have suggested that the congruence between adolescents’ and fathers’ reports of parenting practices may be influenced by child–parent relationships (Korelitz & Garber, 2016). In the current study, results regarding the incongruence of adolescents’ and fathers’ reports of paternal expectations/limits indicated that fathers may not adequately communicate their expectations/limits regarding EBRBs to their adolescents except for screen time. These findings support the importance of including adolescents’ reports in the assessment of parenting practices. Examining changes in agreement between adolescents’ and fathers’ reports of parenting practices would also serve as an indicator of effectiveness of programs designed to improve adolescent–father communication.

This study has several limitations. The instrument validation was conducted among a small sample of Latino father–early adolescent dyads primarily in two-parent families with about two thirds indicating interest in participating in a childhood obesity prevention program. Therefore, due to the potential for self-selection bias, caution should be used in generalizing the study results to other groups of Latino fathers of early adolescents. The small sample size also limited further stratified analysis based on adolescents’ sex and fathers’ acculturation status. Adolescents self-reported their dietary intake, physical activity, and screen time; therefore, these data were subject to response error or bias. In addition, the current study did not examine test–retest reliability and sensitivity to change. A controlled study design with intention-to-treat analysis should be applied to eliminate potential biases if these measures are to be used as outcome evaluation instruments for intervention programs. This study focused on a selected set of EBRB-related parenting practices that were relevant to the design of an ongoing family-centered healthy lifestyle intervention program. There may be other important parenting practices that need to be measured.

In summary, criterion validity was established for all adolescent-reported paternal parenting practices except for paternal behavioral modeling of sweets/salty snacks and screen time. In contrast, criterion validity was shown only for several father-reported parenting practices (paternal limits of screen time and parenting practices of making sugary drinks and fast food available). This may be explained by the poor agreement between father- and adolescent-reported parenting practices.

Future Implications

A recent systematic review found that only 1% of studies exclusively focused on the father’s role in pediatric obesity and when both parents were included, most studies (84%) reported results without specifying whether they pertained to female or male caregivers (Davison et al., 2018). This underrepresentation of fathers in research studies indicated that extra efforts are needed to improve paternal involvement and that findings generated from predominantly female caregivers may not be applicable to male caregivers. Only measures that demonstrated criterion validity in the current study should be used in longitudinal studies to examine causal relationships between parenting practices and early adolescents’ food and activity behavioral outcomes. The measures could also be used to identify key areas of improvement and as outcome evaluation instruments for Latino fathers participating in parenting skills programs that focus on healthy adolescent lifestyle behaviors. These applications could improve the understanding of Latino fathers’ influence on early adolescents’ dietary intake, physical activity, and screen time, and support effective intervention strategies to involve Latino fathers in promoting healthy lifestyle behaviors for their adolescents.

Footnotes

Acknowledgements

The authors would like to acknowledge Gabriela Burk, Giannina Posner, Jose Rivera, Linda Olson, and Eric Elton for their support in participant recruitment and Cynthia Davey for her statistical advice.

Authors’ Note

Y. Zhang was a doctoral student at University of Minnesota at the time this study was conducted.

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This project was supported by the Agriculture and Food Research Initiative (Grant no. 2016-68001-24921) from the U.S. Department of Agriculture National Institute of Food and Agriculture.

ORCID iD

Youjie Zhang

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Development of a Survey to Assess Latino Fathers’ Parenting Practices Regarding Energy Balance–Related Behaviors of Early Adolescents

Abstract

Keywords

Method

Participants and Study Design

Development of Measures of EBRB-Related Parenting Practices Reported by Fathers and Adolescents

Adolescent-Reported Dietary Intake

Adolescent-Reported Physical Activity

Adolescent-Reported Screen Time

Adolescent- and Father-Reported Demographic Characteristics

Statistical Analysis

Results

Participant Characteristics

Paternal Expectations/Limits on Adolescents’ EBRBs

Paternal Behavioral Modeling of EBRBs

Paternal EBRB-Related Availability/Accessibility Practices

Congruence Between Adolescent-Reported and Father-Reported Parenting Practices

Discussion

Future Implications

Footnotes

Acknowledgements

Authors’ Note

Declaration of Conflicting Interests

Funding

ORCID iD

References