Validation of 5 stage-of-change measures for parental support of healthy eating and activity

Abstract

Objective: To assess the validity of 5 parental stage-of-change (SOC) measures: (1) providing 5 servings/d of fruits and vegetables (FV), (2) limiting television (TV) to 2 h/d, (3) helping children achieve 1 h/d physical activity (PA), (4) limiting sugary drinks (SD) to 1 serving/wk, and (5) limiting fruit juice (FJ) to 4-6 oz/d.

Design: Cross-sectional instrument development study. Construct validity was evaluated by examining whether parental self-efficacy, parental readiness ladder (ladder), and child's behavioral levels (eg, FV consumption) exhibited a theoretically consistent pattern across the SOC.

Setting/participants: Convenience sample (n = 283) of parents of children aged 4-10 years.

Measures: Survey assessed SOC, ladder, and child's behavioral level score for each topic (FV, TV, PA, SD, and FJ), and parental self-efficacy for measure except TV.

Analysis: Analysis of variance with Tukey-Kramer post hoc tests examined whether variables differed by SOC.

Results: Percentages of parents in the pre-action SOC were 34% (PA), 39% (FV), 42% (SD), 45% (TV), and 63% (FJ). Parental self-efficacy, ladder, and child's behavioral level differed significantly by SOC for each topic area (P < .001). Maintenance SOC was significantly higher than pre-action SOC.

Conclusions and implications: Measured variables exhibited a theoretically consistent pattern across SOC, suggesting construct validity and potential usefulness for obesity prevention efforts.

Keywords: measures; nutrition; obesity; parents; readiness; stages of change; sugar-sweetened beverage; television.