Table 1 Exposure, outcome, and moderation variables used in analyses
Construct | When Assessed | Question | Response Option | How Responses were Operationalized | Response Mean or Percent |
|---|---|---|---|---|---|
Collection of Ecological Momentary Assessment (EMA) Measures | |||||
An automated EMA survey schedule was created so that signal-contingent surveys were sent to parents’ phones randomly throughout the day using the following criteria: (a) the first signal-contingent survey was sent at least an hour after the parent’s reported wake time; (b) the third signal-contingent survey was sent at least an hour after the parent’s reported dinner time; (c) the three signal-contingent surveys were spaced so that a minimum of one hour occurred between surveys. Parents were sent a text when signal-contingent surveys were available and had an hour to complete them, with reminders every 15 min. | |||||
End-of-day EMA surveys were sent to parents’ phones 90 min after their reported dinner time. Parents were sent a text when the end-of-day survey was available and had four hours to complete the survey. Parents completed seven days of EMA at each wave of data collection. A “complete” day for this study was defined as finishing at least 2 out of 3 signal-contingent surveys and the end-of-day survey. If parents did not finish a complete day, an extra day was added to their observation period. Once parents completed 7 days of EMA, they were automatically deactivated from the EMA system and were sent a $75 gift card by study staff. As a result of this protocol, all participants in the Family Matters EMA sample have 7 complete days of EMA surveys each wave of data collection. | |||||
Exposure Variables | |||||
Parent stress [35] | Signal contingent EMA surveys time-stamped before 12 p.m | On a scale from 0–10, with 0 being not stressed at all and 10 being very stressed, how would you rate your level of stress right now? | 0, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 | Parent stress, sources of stress, depressed mood, and depressive symptoms were summed. Multiple morning observations on the same day were averaged. To ease comparability across measures, all four measures were rescaled to range between 0 and 5 and were analyzed as continuous random variables | Mean = 1.20; SD = 1.32, n = 5,642 days 40.5% days had a morning stress rating of 0 25.1% days: 1–2 17.8% days: 3–4 9.4% days: 5–6 4.6% days: 7- 8 2.6% days: 8 + |
Sources of stress (asked if parent stress was > 0) [36] | Since you woke up/since the last survey, have you experienced any of the following (select all that apply)? | Conflicts or arguments with family members or others | Demands from my family | Traffic/transportation problems | Concerns about news events | Problems with one's children| Concerns about medical treatment or health conditions (your own or other's) | Feeling conflicted over what to do | Worries about having enough money for the things I need or want | Too many things to do | Job dissatisfaction | Worries about upcoming family events (e.g., holidays, family vacation) | Unexpected change in plans | Childcare issues | Body image/weight concerns | Fatigue from lack of sleep | Some other problem or worry | Mean = 1.07; SD = 1.21, n = 5,642 days Frequency of Sources of Stress Endorsed: 41.5% of days no sources of stress were endorsed 30.2% days: 1–2 15.5% days: 3–4 7.5% days: 5–6 3.4% days: 7–8 1.8% days 8 + Type of Stress Endorsed: 9.7% of days “Conflicts or arguments with family members or others” was endorsed” 19.7% of days: “Demands from my family” 7.4% of days: “Traffic/transportation problems” 8.4% of days: “Concerns about news events” 8.0% of days: “Problems with one's children” 12.8% of days: “Concerns about medical treatment or health conditions (your own or other's)” 13.0% of days: “Feeling conflicted over what to do” 17.0% of days: “Worries about having enough money for the things I need or want” 24.5% of days: “Too many things to do” 6.7% of days: “Job dissatisfaction” 9.8% of days: “Worries about upcoming family events (e.g., holidays, family vacation)” 6.8% of days: “Unexpected change in plans” 4.1% of days: “Childcare issues” 10.8% of days: “Body image/weight concerns” 15.8% of days: “Fatigue from lack of sleep” 3.4% of days: “Some other problem or worry” | ||
Parent depressed mood [32] | On a scale from 0–10, with 0 being not sad or depressed at all and 10 being very sad or depressed, how would you rate your level of sadness or depression RIGHT NOW? | 0, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 | Mean = 0.74; SD = 1.14, n = 5,642 days 59.6% days had a morning depressed mood rating of 0 21.4% days: 1–2 10.0% days: 3–4 5.4% days: 5–6 1.9% days: 7–8 1.8% days: 8 + | ||
Parent depressive symptoms [37] | Since you woke up/since the last survey, have you felt: *Nervous? *Hopeless? *Restless or fidgety? *So depressed that nothing could cheer you up? *That everything was an effort? *Worthless? | Yes/No to each option | Mean = 0.35; SD = 0.94; n = 5,642 days Frequency of Depressive Symptom Endorsed: 82.6% of days no symptoms were endorsed 9.0% days: 1 4.0% days: 2 1.7% days: 3 0.8% days: 4 2.0% days: 5–6 Type of Depressive Symptom Endorsed: 9.4% of days: nervous was endorsed 4.5% of days: hopeless 7.7% of days: restless or fidgety 2.7% of days: depressed 7.5% of days: everything was an effort 3.7% of days: worthless | ||
Outcome Variables | |||||
Pressure-to-eat [38] | End-of-day EMA surveys time-stamped after 4 p.m | Did you have to encourage [child] to eat more food at this meal? Did you encourage [child] to eat more after s/he told you s/he was done? Did you make sure [child] ate all of the food on his/her plate before you let him/her stop? | Yes/No to each option | A positive answer to any of the three questions was coded as having engaged in pressuring practices that evening | 24.9% of days; n = 5,642 days 14.8% encourage food 8.0% encourage after done 12.2% make sure clean plate |
Food restriction [38] | Did you have to make sure [child] didn’t eat too much food at this meal? Did you have to make sure [child] didn’t eat too much of a certain food? | Yes/No to each option | If the respondent answered yes to either question, they were coded as having engaged in restrictive practices at that evening meal | 6.2% of days; n = 5,642 days 3.3% restrict food 4.8% restrict specific food | |
Instrumental feeding [38] | Did you require [child] to finish certain foods before s/he could have other foods (e.g., dessert)? | Yes/No | A positive response was coded as having engaged in instrumental practices at that evening meal | 12.5% of days; n = 5,642 days | |
Foods served at dinner [39] | Which best describes the type of food served? (Select all that apply) | Fast food / take-out (eaten at home or at a restaurant) | Pre-prepared foods (e.g. macaroni and cheese, frozen meals, cereal, chips) | Homemade / freshly prepared (include fresh fruits or vegetables here) | Three binary variables were created to capture foods served: fast food only, homemade only, or pre-prepared foods only | n = 5,642 days 14.9% of days served fast food/take out only 13.8% of days served pre-prepared meals only 63.1% of days served homemade meals only | |
Child food fussiness [40] | Did the child refuse to eat any of the food you offered him/her? | Yes/No | If the responded answered yes, the child was coded as having exhibited food fussiness that evening | 9.0% of days; n = 5,642 days | |
Moderation Variablesa,b | |||||
Food Insecurity [41] | At baseline or follow-up survey | In the last 12 months, did you (or other adults in your household) ever cut the size of your meals or skip meals because there wasn't enough money for food? | Yes/No | A household was categorized as food secure if they had 0 or 1 affirmative responses to these 6 questions and households were classified as food insecure if they answered yes to two or more questions. Almost every month and some months but not every month was coded as an affirmative response to the one frequency question. Often or sometimes true was coded as an affirmative response to the last two questions | 26.7% of households were food insecure; n = 618 households 14.2% of respondents/ adults cut the size or skipped meals; n = 618 households |
How often did this happen? | Almost every month | Some months but not every month | Only 1 or 2 months | 69.3% of households that cut the size or skipped meals did so more than only 1 or 2 months; n = 88 households | |||
In the last 12 months, did you ever eat less than you felt you should because there wasn't enough money to buy food? | Yes/No | 17.2% of households; n = 618 households | |||
In the last 12 months, were you ever hungry but didn't eat because you couldn't afford enough food? | Yes/No | 11.2% of households; n = 618 | |||
In the last 12 months, the food that we bought just didn't last, and we didn't have money to get more | Often true | Sometimes true | Never true | 29.1% of households report sometimes or often; n = 618 | |||
In the last 12 months, we couldn't afford to eat balanced meals | Often true | Sometimes true | Never true | 29.3% of households report sometimes or often; n = 618 | |||
Household race/ethnicity [32] | At recruitment, to ensure we had equal representation across race/ethnicity by household type | Please select the race/ethnicity that best characterizes your household (e.g., the foods you cook for your family, the language you speak at home, the holidays you celebrate) | White | Black/African American | Latinx | Hmong | Native American | Somali | 28.2% White; 23.5% Black/African-American 13.4% Latinx 15.9% Hmong 16.2% Native American 2.9% Somali | |
Race, Parent and child [42] | At baseline survey | Do you think of yourself/your child as…(you may chose more than one) | White | Black or African American | Hispanic or Latinx | Asian American | Native Hawaiian or other Pacific Islander | American Indian or Native American | Other | Using these two question individuals were categorized as White if race is white only and ethnicity is none; African American if race is Black/African-American only and ethnicity is none; Latinx if race is Hispanic/Latinx only and ethnicity is none; Hmong if race is Asian only and ethnicity is Hmong; Somali/Ethiopian if ethnicity is Somali or Ethiopian; Native American if race is American Indian or Native American only and ethnicity is none; Multi-racial if more than one race was selected or if race selected does not match household race/ethnicity | 27.2% children and 27.5% parents were White 17.5% children and 18.6% parents were African American 9.5% children and parents were Latinx 15.0% children and 15.2% parents were Hmong 2.4% children and 2.3% parents were Somali/Ethiopian 8.9% children and 11.7% parents were Native American 19.4% children and 15.2% parents were Multiracial |
Ethnicity, Parent and child [42] | Is your/your child’s background any of the following? | Hmong | Cambodian | Vietnamese | Laotian | Somali | Ethiopian | Other | None of the above | |||
Child sex [42] | At recruitment | Does your child in the study identify as… | Female | Male | 52.4% of children are female | |