Table 4 Characteristics of original qualitative studies synthesised in this review
From: Childhood fussy/picky eating behaviours: a systematic review and synthesis of qualitative studies
Study | Country and Author Disciplines | Age Group Targeted | Sample/Population | Aims/Objectives | Data Collection, Analysis, & Summary of Interview Guide | Quality Appraisala | Key Findings Reported by Primary Study Authors |
|---|---|---|---|---|---|---|---|
Study A Rubio et al. 2017 [29] | France Psychology | Pre-schoolers 18–38 months | 38 parents (35 mothers, 3 fathers) General community sample Low-moderate income Recruited through day care centres | To explore parental concerns about their toddler’s pickiness and its consequences for parent-child relationship and family meals. To understand parental attributions of food pickiness and to investigate how parents manage their children’s food refusals. | Focus groups Thematic analysis Interview guide: Onset of child’s eating difficulties, parental perceptions and beliefs, parental strategies and food practices. | Moderate | The majority of parents report changes in food behaviours. Parents feel responsible. Picky eating causes parental anxiety and guilt. Attributions include opposition. Variety of different practices including repeated exposure, modelling and rewards for eating. |
Study B Goodell et al., 2017 [55] | US Nutrition Sciences; Pediatrics; Human Development | Pre-schoolers 3–5 years | 111 primary caregivers (104 female, 6 male, 1 chose not to answer) Low-income African American and Hispanic parents Recruited from Head Start Centers | To determine parent feeding strategies used to influence child acceptance of previously rejected foods. | Focus groups Thematic analysis Interview guide: Several topics relating to child feeding and mealtimes including: what strategies do parents use to influence their children to like previously rejected foods? | High | Parents often do not serve previously rejected foods. Parents value their child eating over liking a food. Parents rarely use the same feeding strategy more than once for a previously rejected food. Parents wish to reduce waste, save time, and ensure children eat enough for adequate growth. |
Study C Jarman et al., 2015 [56] | UK Lifecourse Epidemiology; Nutrition Biomedical Research; Psychology; Musculoskeletal Biomedical Research | Pre-schoolers 18 months – 5 years | 29 mothers Socially deprived area Purposive sampling | To explore mothers’ use of overt and covert control practices (and relationship with neophobia). Specifically, what do mothers say about controlling their children’s eating habits? | Mixed method Focus groups Thematic analysis Interview guide: Not provided | High | Feeding young children is stressful. Parent control is often relinquished to reduce conflict at mealtimes. |
Study D Harris et al., 2018 [50] | Australia Children’s Health; Exercise & Nutrition Science; Social Science | Pre-schoolers 1–4 years | 6 parents of children > 1 year (5 female, 1 male) General sample, mix of low and high socio-economic status | To characterise parents’ presentation of fussy eating and mealtime interactions at a point of crisis. | Calls to a help-line Inductive thematic analysis Interview guide: n/a | Moderate | Parents of toddlers present emotional accounts of feeding, portrayed their child’s eating behaviours as a battle and child agency over intake/variety as ‘bad’ or ‘wrong’. Escalating concern evoked non-responsive feeding practices. |
Study E Russell et al., 2013 [33] | Australia Exercise & Nutrition Sciences | Pre-schoolers 2–5 years | 57 parents (49 female, 8 male) General community sample recruited from a range of SES background Purposefully selected from survey participants | To describe parents’ beliefs (attributions and self-efficacy) about the origins of children’s food preferences that may influence parental feeding behaviours. To examine differences between parents of children with healthy preferences, unhealthy preferences and neophobia. | Interview Content analysis Interview guide: describe child’s likes and dislikes, influences of preferences, how much preferences change over time, how much influence parents have over child preferences. | Moderate | Attributions of food preferences include child characteristics, sensory attributions, and socialisation experiences. Beliefs (and self-efficacy) differ between parents of children with healthy preferences, unhealthy preferences, and neophobia supporting the idea of causal links between parent beliefs, behaviours, and child characteristics. |
Study F Russell et al., 2015 [57] | Australia Health; Exercise & Nutrition Sciences | Pre-schoolers 2–5 years | 57 parents (49 female, 8 male) General community sample recruited from a range of SES background Purposefully selected from survey participants | To describe behaviours used by parents to influence children’s food preferences. To examine differences between parents of children with healthy preferences, unhealthy preferences and neophobia. | Interview Content analysis Interview guide: behaviours used to influence children’s preferences (likes and dislikes), whether methods were effective and why. | Moderate | Parents used diverse behaviours to influence their child’s food preferences. Parents of children with healthy preferences appeared to use more effective feeding behaviours. Parents of children with unhealthy and neophobic preferences appeared to use more ineffective behaviours. |
Study G Norton et al., 2016 [58] | Australia Business | Pre-schoolers 1–2.5 years | 24 parents (23 female, 1 male) General community sample recruited from range of socio-economic areas Snowball sampling and purposeful selection | To explore primary caregivers’ awareness of food neophobia and how food preferences develop in young children. | Interview and projective technique drawings Cross case analysis Interview guide: history of child’s eating, foods that should be provided to a child on an everyday basis, other foods. Drawings of crying child in a trolley and child making a mess in a highchair. | Moderate | Primary caregivers are unaware of food neophobia and food preference development in young children. |
Study H Boquin et al., 2014 [35] | US Food Science & Human Nutrition; Market Research | Children 18 months – 21 years | 19 parents (14 female, 5 male) General sample | To investigate perceptions of picky eating. To determine the most predictive elements that people use to describe a picky eater. | Mixed method Focus groups Analysis method described but not specified Interview guide: describe mealtimes, picky eating perceptions, definitions and characterisations. | Moderate | Fussy eaters display before mealtime behaviours (being uninterested or avoidant), during mealtime behaviours (being disengaged, uninvolved, distracted, carefully inspecting food, having strong physical reactions to foods), general mealtime preferences, and food sensory-dependent preferences. Top two perceptions of picky eating: 1) unwilling to try new things, 2) consuming limited type and amount of food. |
Study I Trofholz et al., 2017 [34] | US Family Medicine & Community Health | Children 2–18 years | 88 parents (83 female, 5 male) Racially and ethnically diverse Low-income sample Recruited from previous study | How do parents describe child picky eating? How do parents perceive picky eating to impact the family meal? How do parents report responding to picky eating in the family meal? | Interview Content analysis Interview guide: what kind of eater child is, how eating impacts meal, how picky eating affects the family, what happens if child doesn’t want to eat what is prepared, how parents influence what child eats. | High | Children are frequently described as picky eaters, parents define picky eating in a variety of ways, picky eating impacts the family meal (stress, meal preparation), parents respond in a variety of ways. |
Study J Berge et al., 2016 [36] | US Family Medicine & Community Health; Human Development & Family Studies; Epidemiology & Community Health | Target children 6–12 years Siblings 2–18 years | 88 parents (83 female, 5 male) Racially and ethnically diverse Low-income sample Recruited from previous study | How do parents describe their approach to feeding siblings? Do parents engage in different feeding practices based on child-specific characteristics (weight, picky eating, age, sex, temperament)? | Interview Content analysis Interview guide: what it is like to be a parent of two (or more), how you decide what to feed your children, how do you feed them (similarly and differently), role as a parent during mealtimes, how you influence what siblings eat (child characteristics)? | High | Food preferences, in-the-moment decisions and planned meals influence decisions about what to feed siblings. Picky eating is managed by making one meal or by giving leeway to siblings about having other food options. Parents used different feeding practices. |