A Home-based Video and Motivational Interviewing Intervention to Improve Preschoolers Diet Quality and Parental Food Parenting Practices
Phase: NA
Conditions: Diet Modification
Sponsor: University of Rhode Island

 
Strong Families Start at Home/ Familias Fuertes Comienza en Casa 
Full Protocol for Data Collection, Processing and Management  
 
A Home-based Video and Motivational Interviewing Intervention to Improve 
Preschoolers Diet Quality and Parent 
 
 
Protocol Revision History  
Version Number: 1 
Version Date:02/26/2021 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Table of Contents 
 
 
 
 
 
 
 

 
1 
Study Team Roster 
2 
Participating WIC Sites 
3 
Study Abstract 
3 
Study Objectives 
4 
Overview of Study Timeline and Evaluation 
5 
Recruitment 
6 
Screening, Eligibility and Enrollment: 
9 
Possible Questions that may come up during Recruitment/Enrollment 
10 
Home Visitation Guide 
11 
Interview Guide 
13 
Overview of data collection visit 
13 
Introduction Script for Data Collection Team 
15 
Interviewer Administered Questionnaire 
13 
Forms to be Completed 
16 
Anthropometrics 
17 
Height: 
17 
For the child : 
17 
Weight: 
19 
Video Set Up 
20 
Schedule recall & First Home Visit 
21 
Potential Questions/Scenarios During BL Visit 
18 
Second Dietary Recall & Randomization 
24 
Data Management & QA 
26 
Coding and Feedback 
27 
CEBQ Coding 
27 
Feedback 
30 
 

 
2 
Study Team Roster 
Alison Tovar 
PI 
alison_tovar@uri.edu 
4018749855 
Patricia Risica 
Co-I 
patricia_risica@brown.edu 
Kim Gans 
Co-I 
Kim.Gans@chip.uconn.edu 
Karen McCurdy 
Co-I 
kmccurdy@uri.edu 
Ernestine Jenning 
CHW supervision, MI training, 
and adherence 
ernestine_jennings@brown.edu 
Katelyn Fox 
RA/ Project manager 
Recruitment calls 
In home data collection 
katelyn_fox@uri.edu 
401-787-0821- personal 
401-545-9105 - study 
Andrea Ramirez 
RA 
Recruitment calls 
In home data collection 
Video coding 
andrea_ramirez@uri.edu 
401-441-4812 
Amy Moore 
RA  
PRN 
amy_moore@uri.edu 
Maggi Samson 
RA  
Video coding 
margaret_samson@my.uri.edu  
Adam Brice 
UGRA 
Phone 24 hour recalls 
NDSR data management 
adam_brice@my.uri.edu  
Ivone Sical  
UGRA 
In home data collection 
NDSR data management 
ivone_sical@my.uri.edu  
401-500-9449 
Haley Blanchette 
JWU Intern 
hblanchette01@jwu.edu  
Rachel  
UGRA 
 
Patricia Castillo 
CHW 
401-771-5018 
Yesicca Cranshaw  
CHW 
401-300-2258 
Heidi Samayoa 
CHW 
401-248-5008 
Rede Reyes 
Data Collection 
401-835-7254 
Elka Arredondo 
 
elvarredondom@gmail.com 
 (401) 569-6616 

 
3 
 
 
Participating WIC Sites 
Meeting Street/St Josephs 
Megan Sheehy  
msheehy@meetingstreet.org, 
 
Tri County  
Isabella Fiore 
isabellefiore8@gmail.com 
ifiore@westelmwood.org 
 
 
 
 
 
 
 
 
 
Study Abstract  
There is an urgent need to create effective interventions to help parents establish a 
healthy diet among their children early in life, especially among low-income and 
ethnically diverse families. U.S. children eat too little fruits and vegetables and whole 
grains, and too many energy dense foods, dietary behaviors associated with increased 
morbidity from cardiovascular diseases. Contributing to this poor diet is consuming 
foods outside the home, having unhealthy foods available in the home and lack of 
home-prepared meals. Parents play a key role in shaping their child’s diet and best 
practices suggest that parents should involve children in food preparation, offer, model 
and encourage a variety of healthy foods. In addition, while parents help to shape food 
preferences, not all children respond in the same way and certain appetitive traits, such 
as satiety responsiveness (sensitivity to internal satiety signals), food responsiveness 
(sensitivity to external food cues), and enjoyment of food may help explain some of 
these differences. Prior interventions among preschool aged children to improve their 
diet have not used a holistic approach that fully targets the home food environment, by 
focusing on food quality, food preparation, and positive feeding practices while 
acknowledging a child’s appetitive traits. This proposal will build upon pre-pilot work to 
develop and pilot-test the feasibility, acceptability and preliminary efficacy of a novel 
home-based intervention with low-income ethnically diverse families of preschool 
children to inform a future fully powered randomized controlled trial. The proposed 6-
month intervention, will include 3 monthly home visits by a community health worker 
(CHW) trained in motivational interviewing, that include in-home cooking demos. In 
between visits, parents will receive tailored text-messages 2x/wk. and monthly mailed 
tailored materials.  During the last 3 months CHW phone calls will replace the home 
visits. The intervention will be tailored for individual families based on the child’s 
appetitive traits.  

 
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The aims are as follows: Aim 1. To conduct focus groups with 40 ethnically diverse 
parents of preschoolers to inform the development of and adaptation of the intervention 
components; Aim 2. To conduct a pilot RCT with 60 parent-child pairs (30 
intervention/30 control) to determine the feasibility and acceptability of the enhanced 
intervention and determine the preliminary efficacy on child diet quality, feeding 
practices and availability of healthy foods in the home. The proposed research will lay 
the groundwork for a larger RCT to educate, support, motivate, and empower low-
income parents to prepare healthy meals and use healthy feeding practices, which will 
improve children’s diets and ultimately their health. 
Study Objectives 
Aim 1: To conduct a pilot randomized controlled trial with 60 parent-child pairs (30 
intervention/30 control) from ethnically diverse, low-income families with preschoolers 
to: 
Aim 1.1: Determine the feasibility and acceptability of the enhanced intervention. Aim 
1.2 Determine the preliminary efficacy of the enhanced intervention on changes in 
children’s diet quality (primary outcome) and parental feeding practices and availability 
of healthy foods in the home (secondary outcomes) and calculate effect sizes for a 
future randomized controlled trial (RCT). 
We hypothesize that the intervention will be feasible and acceptable to parents and that 
parent-child pairs randomized to the intervention condition will demonstrate greater 
improvements in the outcomes after six months compared to the comparison condition 
(attention control of a school readiness intervention). 
Exploratory aim: Explore how parents’ skills, perceived competence and intrinsic 
motivation are related to changes in children’s diet quality and parental feeding 
practices. 
 
 
 
 
 
 
Overview of Study Timeline and Evaluation  
Data collectors will be involved primarily with recruitment, enrollment and data collection 
at baseline and 6 month follow up. All data collection and tracking will occur via RedCap 

 
5 
Software. Each data collector will have their own username and password to enter data 
into RedCap. 
 
Please view this video on the Basics of Redcap Data Entry  
https://redcap.vanderbilt.edu/consortium/videoplayer.php?video=data_entry_overview_02.mp4&
referer=redcap.uri.edu&title=Overview%20of%20Basic%20Data%20Entry 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Recruitment  

 
6 
Overview of Recruitment Plan: The goal is to recruit a total of 60 parent-child dyads. 
In order to do this we will use a variety of methods to reach low-income diverse 
participants in the community. The first will be via WIC nutritionists who have been CITI 
certified and can provide us with names and numbers of interested participants. If a 
WIC nutritionist has not been CITI certified they are not allowed to provide us with this 
information. NOTE: If you speak to someone who would like to gather names and 
numbers of interested parents, please speak to Katelyn Fox (see contact) and we can 
provide them with information on how to become CITI certified. We will also be placing 
flyers around the community including childcare centers, WIC offices, community 
centers, libraries etc. Research Assistants & Hilda Castillo will also be doing individual 
outreach in the community to recruit participants.  
 
Recruitment via WIC nutritionist: WIC nutritionists will provide study flyer and use the 
following script to describe the study to parents of children ages 2-5 years old. 
 
Information Script for WIC Nutritionist 
I would like to tell you about a study being led by Dr. Alison Tovar 
from the University of Rhode Island (WIC Nutritionist shows flyer to 
participant). This study is being done to help improve children’s 
wellness and development and is for parents who have a child 
between the ages of 2-5 years of age.  Parents will participate in one 
of two groups: a group to help families make mealtimes easier or a 
group to help children get ready to read.  As part of the six-month 
program, you will be working with a support coach,  who will come to 
your home for three home visits, call you over the phone for three 
calls and text messages. At the end of the program you can receive 
up to $150 for participating.  If you think you might be interested, I 
can write down your name and number and someone from the study 
will call you and check to see if you are eligible to participate. Would 
you be interested in learning more about this program and should I 
write down your name? 
If client says yes, then respond: Great! I will be giving them your name 
and number and they will be following up with you over the phone in 
the next couple of days.  
If client says no, then respond: No problem, thank you for listening.  
 
Please note that the project manager, will obtain names and contact 
information from WIC nutritionist weekly and store in secure excel 
file ‘SFSH Recruitment’ on the CNCOP team drive. 

 
7 
In-person Recruitment by Research Assistants: Study staff will recruit at the 
following locations (WIC offices, child care centers, summer kick off events).  RA will 
provide flyer and use the following script to describe the study to potential participants. 
The script can be found in the eligibility form on Redcap.  
 
 
 
 
Information Script for Recruiter 
Are you interested in hearing about a program to help improve 
children’s wellness and development and is for children ages 2-5 
years ? If caregiver says yes 
I would like to tell you about a study being led by Dr. Alison Tovar 
from the University of Rhode Island.This study is being done for 
parents who have a child between the ages of 2-5 years of age.  
Parents will participate in one of two groups: a group to help families 
make mealtimes easier or a group to help children get ready to read.  
As part of the six-month program, you will be working with a support 
coach,  who will come to your home for three home visits, call you 
over the phone for three phone calls and text messages. At the end 
of the program you can receive up to $150 for participating.   
 
Would you be interested in finding out if you are eligible for this  
program? If client says yes, then respond: Great, do you have 5 
minutes to see find out if you are eligible to participate? If yes, then 
proceed to screening and enrollment in Redcap. Fill out recruitment 
contact information form & give to project manager to enter data into 
‘SFSH Recruitment’ spreadsheet 
 
If no, say, Ok, when would be a good time to call you back to find out 
if you are eligible? Write down the date/time to call back.  
 
 
If client says not right now, then respond:  No problem, we are going to 
be recruiting over the next six months, do you think you would like 
us to call you back at another time?  
 
If client says yes, then respond: Great! We can take down your name 
and number and call you at a later date.  
 
If client says No, I am just not interested, then respond: No 
problem,thank you so much for your time, we appreciate you 
listening to us.  

 
8 
Covid Recruitment 
RA will share a study flyer via text message, email, or social media  and use the 
following script to describe the study to potential participants. The script can be found in 
the eligibility form on Redcap.  
 
 
 
 
 
Information Script for Recruiter 
Are you interested in hearing about a program to help improve 
children’s wellness and development and is for children ages 2-5 
years ? If caregiver says yes 
I would like to tell you about a study being led by Dr. Alison Tovar 
from the University of Rhode Island.This study is being done for 
parents who have a child between the ages of 2-5 years of age.  
Parents will participate in one of two groups: a group to help families 
make mealtimes easier or a group to help children get ready to read.  
As part of the six-month program, you will be working with a support 
coach,  who will video chat with you for three visits, call you over the 
phone for three phone calls and text messages. At the end of the 
program you can receive up to $150 for participating.   
 
Would you be interested in finding out if you are eligible for this  
program? If client says yes, then respond: Great, do you have 5 
minutes to see find out if you are eligible to participate? If yes, then 
proceed to screening and enrollment in Redcap. Fill out recruitment 
contact information form & give to project manager to enter data into 
‘SFSH Recruitment’ spreadsheet 
 
If no, say, Ok, when would be a good time to call you back to find out 
if you are eligible? Write down the date/time to call back.  
 
 
If client says not right now, then respond:  No problem, we are going to 
be recruiting over the next six months, do you think you would like 
us to call you back at another time?  
 
If client says yes, then respond: Great! We can take down your name 
and number and call you at a later date.  
 
If client says No, I am just not interested, then respond: No 
problem,thank you so much for your time, we appreciate you 
listening to us.  

 
9 
Screening, Eligibility and Enrollment: 
1. Access ‘SFSH Recruitment’ in CNCOP team drive for  contact information 
2. Contact weekly x 4 weeks, document all calls in ‘SFSH Recruitment’ 
3. Either in person or over the phone when screening: Begin Redcap Data 
Collection 
a. In Person: Log into Redcap app>Choose project based on preferred 
language> 
b. Over the phone : Log into online Redcap project. ADD/EDIT 
RECORDS>ADD A NEW RECORD >RECRUITMENT >ENROLLMENT 
c. Information Script for Recruiter 
Hello, my name is [name of RA] with the University of Rhode Island .  
You spoke to someone [date of recruitment] at [location of recruitment] 
about our study and mentioned that you may be interested.  As a 
reminder,  we are comparing two programs to improve children’s 
health and wellbeing, one that focuses on making healthy mealtimes 
easier and one that focuses on reading and  preparing for school.    If 
you choose to participate, each parent and their child will be 
“randomized” into one of the two groups. This means that you are 
put into a group by chance, like a lottery or by 
flipping a coin.  
As part of the six-month program, you will work with a support coach 
and  get three home visits, three phone calls and text messages.  For 
the healthy mealtime group you would also do a cooking activity in 
your home with a culinary student from Johnson & Wales University.  
At the beginning and end of the program we would ask you to fill out 
some surveys and we would measure height and weight of you and 
your child.  You will be given up to $150 for participating.  
Would you be interested in finding out if you are eligible for this  
program? 
If client says yes, then respond: Great! Proceed to eligibility questions 
in Redcap & Open SFSH Google calendar to schedule BL visit 
 
*Note use google calendar first to schedule based on data 
collection team availability. BL Assessment is entered afterward into 
redcap using year-month-day format. 
If client says no, then respond: No problem, thank you for listening.  
4. If participant does not answer the phone 
a. Information Script for Recruiter 
Hello, my name is [name of RA] with the University of Rhode Island .  
You spoke to someone [date of recruitment] at [location of recruitment] 
about our study and mentioned that you may be interested.  We are 
comparing two programs to improve children’s health and wellbeing, 
one that focuses on making healthy mealtimes easier and one that 

 
10 
focuses on reading and  preparing for school.    As part of the six-
month program, you will get three home visits, three phone calls and 
text messages and at the end of the program you can receive up to 
$150 for participating.   You will also receive a text and email 
regarding the study. If you are interested in participating in the study 
you can call us back at 401-542-9105 or respond to the email from 
strongfamilies@etal.uri.edu  
5. Text 
a. Hi, this is [name of RA] at the University of Rhode Island.  We want to 
know if you are interested in participating in our study to help improve 
children’s health and well being. 
b. Text flyer image. 
6. Email 
a. Hi, this is [name of RA] at the University of Rhode Island.  We want to 
know if you are interested in participating in our study to help improve 
children’s health and well being. We are comparing two programs to 
improve children’s health and wellbeing, one that focuses on making 
healthy mealtimes easier and one that focuses on reading and  preparing 
for school.    If you choose to participate, each parent and their child will 
be “randomized” into one of the two groups. This means that you are put 
into a group by chance, like a lottery or by flipping a coin.  
As part of the six-month program, you will get three home visits, 
three phone calls and text messages and at the end of the program 
you can receive up to $150 for participating.   You will also receive 
a text and email regarding the study. If you are interested in 
participating in the study you can call us back at 401-542-9105 or 
respond to the email from strongfamilies@etal.uri.edu  
 
b. Email flyer image. 
7. Project manager assigns and notifies data collection team of baseline visit once 
scheduled. 
 
 
Possible Questions that may come up during Recruitment/Enrollment 
Q. They want to participate but they want to choose what group they are in.  
Response: We are so excited that you are interested in participating. Because this is a 
research study we want to make sure that the group you fall into is random or by flipping 
a coin and unfortunately I cannot control that. The good news is that both groups will be 
working closely with a support coach and receiving important materials for your child’s 
health and development. Once the study is over, if you are interested, we would be 
happy to share the materials from the program you did not receive.  
 

 
11 
Q. Their child has allergies to foods.  
Response: Unless their child has a severe allergy, they may still participate.  
Q What is a diagnosed feeding disorder? 
Response: A diagnosis from a doctor or other medical provider (such as a dietitian, 
speech language pathologist or occupational therapist) that severely impacts how you 
feed your child. Children with a feeding disorder may have had weight loss, nutritional 
deficiencies, need for nutritional supplements or problems with functioning. 
 
Q Can multiple children participate. 
Response: The study will focus on one child between the ages 2-5 that the parent 
chooses for data collection purposes but the intervention material can and should be 
applied as a family so that all family members may benefit. 
 
NOTE: If other questions come up and you are not sure, please contact Katelyn 
Fox, Andrea Ramirez or Alison Tovar so that we can help you answer these 
questions and also add to our protocol.  
 
 
 
 
 
 
 
 
Baseline Data Collection: Now that participants have been enrolled in the study, we will 
need to consent them and collect the baseline data.  A reminder text / call for baseline 
visit will be sent via Mosio. 
Data collection team confirm & prepare for baseline visit.  
1. I-Pad (check that I-pad is charged)  
a. Note download participants record prior to visit while on wireless by 
logging into redcap app using your pin then select 
MyProjects>HomeVisitingR34Intervention (select correct 
language)>refresh setup and data (click proceed to clear project 
from i-pad)>get partial set of data> select records 
needed>download checked records> 
2. Charger 
3. Consent forms 
4. Paper survey copies 
5. Color copy of Townsend measure to show participant during interview 

 
12 
6. Stadiometer 
7. Height adjustment ruler  
8. Scale 
9. NDSR Laptop 
a. Note set up record prior to home entry so that you are ready to 
begin dietary recall as soon as the participant completes the 
consent process.Include: 
i. 
Participant ID  
ii. 
Child date of birth  
iii. 
Gender 
iv. 
Date of visit 
v. 
Visit number (1 for home baseline, 2 for phone baseline, 3 
for home follow up, 4 for phone follow up) 
vi. 
Interviewer ID- Your initials 
10. Charger 
11. 2 food amount booklets 
12. NDSR notebook 
13. measuring spoons/cups 
14. food models 
15. Incentive ($35) 
16. Coloring & crayons for kids 
17. Disinfectant wipes 
18. Antibacterial hand gel 
19. Tripod & instructions for google drive & video recording 
Covid Baseline Data Collection: Now that participants have been enrolled in the study, 
we will need to consent them and collect the baseline data.   
Following Enrollment in the study the research team will mail package including: 
1. One copy of the consent form in the preferred language. 
2. Food amounts booklet 
3. Instructions for sending the home video 
4. Sheet with survey responses  
5. Tripod 
6. Magnets 
Data collection team confirm & prepare for baseline visit.  
20. I-Pad (check that I-pad is charged)  
a. Note download participants record prior to visit while on wireless by 
logging into redcap app using your pin then select 
MyProjects>HomeVisitingR34Intervention (select correct 
language)>refresh setup and data (click proceed to clear project 

 
13 
from i-pad)>get partial set of data> select records 
needed>download checked records> 
21. Charger 
 
 
Home Visitation Guide 
Remember to:  
1. Ensure that you are dressed appropriately, you are entering their home as a 
research professional. Avoid clothing such as halter / tube tops, bare midriff, 
short skirts or dresses, see through or ripped clothing, or clothing that displays 
inappropriate messages or pictures. Pants/skirt and a shirt or dress are 
appropriate options. 
2. Be respectful of the home, follow the participants lead on where they would like 
the interview to take place and ask permission before placing belongings 
anywhere. If the participant is unsure about where to meet, you can let them 
know that you will be asking them questions, so if possible a quiet place would 
be great. 
3. Avoid using the families restroom. 
Safety: 
1. Stay alert entering neighborhoods, parking, and walking 
2. Identify safe areas (i.e. restaurants, telephones, rest rooms, police stations)  
3. Leave jewelry at home  
4. Leave purse at office or trunk  
5. Carry necessary cash, keys, study badge and driver's license on person  
6. If at anypoint you feel unsafe, remove yourself from the situation  
7. Travel in pairs when possible  
8. Trust your instincts  
9. Take universal precautions by washing hands before/after visit  
 
 
Interview Guide 
1. Make sure that your are thoroughly prepared prior to your visit.  Ensure you have 
all materials and have practiced the interview so that you are comfortable and 
confident with the material.  
2. Establish rapport with the participant.  Present in a confident and friendly 
manner. Remember how you introduce the study and how you answer questions 
will help the participants feel more comfortable and willing to participate. 
a. Establish trust. Follow the script to ensure that participants know who you 
are, that you are working for the University of Rhode Island, and why we 
are conducting this research. 

 
14 
b. Personalize the interaction. Ask what they would like to be called and what 
they call their child. Try to use their names throughout the interview.  
c. Listen actively- make eye contact, let the person know that you are 
listening for example by nodding/ using “mmhm” and be patient, allowing 
them to complete statements without interruption. Ask for clarification if 
necessary. 
d. Show empathy by putting yourself in the other person's shoes and 
validating their concern, ask for clarification when necessary, explain 
steps you will take to address their concerns, and provide rationale for 
what you are asking them to do. See “Potential Questions” for examples of 
how to respond to common concerns. 
 
3. Collect accurate and reliable data; this requires that every participant hears 
exactly the same questions read in exactly the same way. 
4. Remember that you are there to ask for and record respondent’s answers, not to 
influence or advise them in any way. 
5. Always remain neutral in your words and manner. Never express criticism, 
surprise, approval or disapproval of the questions you ask or of the answers 
respondents give. 
6. Ask all questions in a simple straightforward way. If you feel uncomfortable 
asking certain questions, such as about food security, practice them repeatedly 
until you are more comfortable stating them in a matter of fact way. 
7. Ask every question as written, do not simplify. If a participant asks for an 
explanation for a word or part of a question refers to “Possible Questions that 
may come up” for responses. If a question comes up during an interview please 
let Katelyn Fox know so that standard response can be added to protocol if 
needed. 
8. Discourage unrelated conversation. Maintain a businesslike attitude and 
acknowledge answers with comments such as “I see” or “OK”. If you must 
interrupt do so politely, such as “that sounds very interesting, but what I need to 
ask is.. “ or “I see what you mean, but let me repeat that last question” 
9. If a participant appears uncomfortable because of a personal question or does 
not want to answer take time to reassure the responded that he/she may speak 
freely, restate confidential nature of the interview and if the participant does not 
wish to answer the question take note in the comment section in Redcap. 
10. Remember that it is best not to know if they are in the intervention or control 
group. If at follow-up data collection, the participants tells you what group they 
are in, do not assume that this is correct and most importantly do not as the best 
to your ability let this influence how you collect the data.  
11. Remember you do not want to rush through data collection, obtaining as 
accurate data is possible is critical to the success of the project. Having said that 

 
15 
it is also important to not overextend your stay and be efficient in collecting the 
data. 
Overview of data collection visit  
Introduction Script for Data Collection Team 
Hello, my name is [name of RA’s] with the University of Rhode Island .  You spoke 
to someone [date of enrollment] to set up our visit today.  This is [name of 2nd 
RA] they will be helping me today.  First I will review the study and you will sign 
what is called an informed consent to make sure that you agree to participate. If 
at any time you have questions or concerns you may ask me at any time.  We will 
then ask you some survey questions. This visit should take about 1 hour to 
complete. At the end of our visit, I will be explaining what the next steps of the 
program will be as well as setting up your first visit with your support coach. I will 
also be providing you with your first gift card. Do you have any questions before 
we begin? 
*COVID- confirm that family has received baseline packet including copy of the 
consent form, food amounts booklet, magnet, instructions for taking home video 
and tripod 
 
Consent 
Participants will fill out parental consent form in their preferred language.Explain 
consent to participant describing the study and what to expect in the next 6 months. 
Signing the consent is a very important time to ensure that the participant knows and 
understands what they study is about. Make sure correct participant ID is written on the 
consent form in the top right corner. 
Covid-Consent 
Participants will have a copy of the consent form in their preferred language.Explain 
consent to participant describing the study and what to expect in the next 6 months.  
Verbally ask for consent for each portion (participation, video, and child participation) 
 
24-hr Dietary Recall 
Introduction to Dietary Recall 
First we will collect some information on what your child ate yesterday.  Here is a booklet 
that helps us estimate amounts of foods and beverages your child consumed along with 
some measuring cups and spoons, we will use this a little later.  
Follow prompts in NDSR for conducting 5-pass dietary recall.  
 

 
16 
Upon completion of the dietary recall the second data collector will begin the interviewer 
administered questionnaires. While survey is being completed complete first QA pass and set 
up stadiometer and scale for anthropometric measurements.  This way you are able to ask any 
necessary clarifying questions prior to leaving the home. 
Interviewer Administered Questionnaire  
Surveys will be completed in RedCap: The surveys will be interviewer administered. 
Remember to read the questions slowly and clearly and remind the participant that you 
are always happy to read the question again if they have concerns. Remind them that 
you are not looking for a “right” answer and that we are not judging them, we are 
simply learning from them and looking for them to be as open and honest as 
possible with their answers.  
To complete surveys enter Redcap App with your PIN>collect data>select participant> 
select baseline assessment>demographics (after each form select status unverified 
then select save and go to the next instrument) 
 
Forms to be Completed 
Demographics 
Feeding questions 
Child Eating Behavior Questionnaire (CEBQ) 
Household chaos 
Basic Psychological Needs Satisfaction and Frustration (BPNSF) 
14-item Diet Assessment Parent 
Healthy Kids (For this questionnaire please show the participant the printed color 
copy while you ask them the questions)  
Reading Readiness Checklist 
Self-regulation scale 
Perceived competence scale 
Home food environment & photo of kitchen/ cooking space for visit 
 
** note if over 1.5 hours for visit do not complete home food environment. 
 
 
 
 
 

 
17 
Anthropometrics (Not Collected During COVID) 
Anthropometrics will be obtained on both the child and the parent.  Recommend 
measuring the parent first then the child.  
Height:  
The stadiometer is used to measure stature.  
Height adjustment ruler: A 15-centimeter (cm) plastic ruler is used to correct stature 
measurements when participants hair styles that interfere with the stadiometer 
headpiece placement, or when they are unwilling to remove their shoes.  
 
1. Have the parent stand erect on the floorboard of the stadiometer with his or her 
back to the vertical backboard of the stadiometer. Make sure that the weight of 
the participant is evenly distributed on both feet.  
2. The heels of the feet are placed together with both heels touching the base of the 
vertical board. Place the feet pointed slightly outward at a 60 degree angle.  
3. If the participant has knock knees, the feet are separated so that the inside of the 
knees are in contact but not overlapping. 
4. The buttocks, scapulae, and head are positioned in contact with the vertical 
backboard. It may not be possible for some children and most adults to place 
their heels, buttocks, scapulae and the posterior aspect of the head against the 
backboard while maintaining normal stature. In that case participant should be 
positioned so that only the heels and buttocks are in contact with the vertical 
board, and the body is positioned vertically above the waist.  
5. The arms hang freely by the sides of the trunk with palms facing the thighs. 
6. The adult is asked to inhale deeply and to stand fully erect without altering the 
position of the heels.  
7. The head is maintained in the Frankfort Horizontal Plane position while the 
examiner lowers the horizontal bar snugly to the crown of the head with sufficient 
pressure to compress the hair.  
8. Hair ornaments, buns, braids, etc. must be removed to obtain an accurate 
measurement.The examiner needs to make sure that the hair of the participant  
does not obscure the scale.  
9. After the measurement is read from the by the examiner and recorded by the 
recorder to the nearest 0.1 cm. Repeat twice. Take a third measurement if the 
first two measurements are > 1 cm from each other 
 
For the child : 
1. Working with the caregiver, and kneeling in order to get down to the level of the 
child:  

 
18 
2. Help the child to stand on the baseboard with feet slightly apart.  
3. The back of the head, shoulder blades, buttocks, calves, and heels should all 
touch the vertical board. This alignment may be impossible for an obese child, in 
which case, help the child to stand on the board with one or more contact points 
touching the board.  
4. The trunk should be balanced over the waist, i.e., not leaning back or forward. 
Ask the mother to hold the child’s knees and ankles to help keep the legs straight 
and feet flat, with heels and calves touching the vertical board.  
5. Ask her to focus the child’s attention, soothe the child as needed, and inform you 
if the child moves out of position.  
6. Position the child’s head so that a horizontal line from the ear canal to the lower 
border of the eye socket runs parallel to the baseboard. To keep the head in this 
position, hold the bridge between your thumb and forefinger over the child’s chin. 
If necessary, push gently on the tummy to help the child stand to full height.  
7. Still keeping the head in position, use your other hand to pull down the 
headboard to rest firmly on top of the head and compress the hair. Read the 
measurement and record the child’s height in centimetres to the last completed 
0.1 cm (0.1 cm = 1 mm)  Repeat twice. Take a third measurement if the first two 
measurements are > 1 cm from each other 

 
19 
 
 
 
 
 
 
 
 
 
Weight: 
Digital scale (Seca  813) 

 
20 
 
1. Before beginning to weigh the participants, be sure that the scale is placed on a 
flat, hard, even surface. It should not be placed on a loose carpet or rug, but a 
firm carpet that is glued down is acceptable.  
2. If a child is 2 years old or older and will stand still, weigh the child alone.  
3. Ask the mother to help the child remove shoes and outer clothing. Talk with the 
child about the need to stand still. Communicate with the child in a sensitive, non-
frightening way.  
4. Turn on the scale. When the number 0.0 appears, the scale is ready.  
5. Ask the child to stand in the middle of the scale, feet slightly apart, and to remain 
still until the weight appears on the display. Record the child’s weight to the 
nearest 0.01 kg. If the child jumps on the scale or will not stand still, you will need 
to use the tared weighing procedure instead.  
 Weigh a child using tared weighing Check to see that the mother has removed her 
shoes. Ask the mother to stand in the middle of the scale, feet slightly apart, and remain 
still. The mother’s clothing must not cover the display or solar panel. Remind her to stay 
on the scale even after her weight appears, until the child has been weighed in her 
arms. With the mother still on the scale and her weight displayed. Gently hand the child 
to the mother and ask her to remain still. Record this weight in the Recap. Be careful to 
read the numbers in the correct order (as though you were viewing while standing on 
the scale rather than upside-down).  x2 
 
Repeat twice. Take a third measurement if the first two measurements are > 0.1kg from 
each other 
 
 
 
 
 
 
 
 
Video Set Up 
Provide Tripod, set up google drive, and review instructions. 
As part of the intervention we would like you to video record a time with 
you and your child at a meal if you are feeding your child group and a time when 
you read or tell stories if you are in the school readiness group. We will review 

 
21 
the video and provide some feedback on what is working well and tips to help 
you.  In order to do this you can film it on your cell phone. Here is a tripod that 
you can put your phone in and set it up nearby your child [demonstrate]. In order 
for you to send us the video securely we are using whatsapp or an app called 
google drive. Do you use Whatsapp? If not, would prefer to download it or use the 
google platform? Do you have a google email? Would you be willing to set one 
up? Now we can get the google photo app. [Have participant set up google photo 
app in visit, if they have an android phone they may already have it]] I will share a 
folder with you [If access to the internet can create folder with participant number in 
visit] . Now you can upload the video to this folder (demonstrate). 
 
Covid Video Set Up 
Parents should have received a tripod and instructions in the mail. Describe above and if 
possible offer to set up video chat to demonstrate if the family has any questions. 
Schedule recall & First Home Visit  
Just a reminder we are comparing two programs to improve children’s 
health and wellbeing, one that focuses on making healthy mealtimes easier and 
one that focuses on reading and  preparing for school.  You and your child will be 
“randomized” into one of the two groups. This means that you are put into a 
group by chance, by flipping a coin. This will be decided after you complete the 
next call over the phone next week where we ask you similar questions to what 
we did today to find out what your child ate. Let’s schedule the day for that call 
now.  
 
We would also like to take the time to schedule your first visit with the support 
coach.  
Refer to support coach calendar/times that are available and offer those times. Google 
Calendar “Strong Families Start at Home Study” with window of 3 weeks from baseline 
visit +/- 4 days. 
Enter date into redcap. 
Let parents know they will receive a $35 gift card & inform participants that they will 
receive an additional $15 at their first home visit if they complete the 2nd phone call to 
ask them about what their child ate. 
Ask preference for how they would like to receive gift card and include in notes section - 
can receive walmart (via email or mail) or target (via text, email, or mail). 
 
Upon returning to the office, complete the following:  

 
22 
1) Sync data to online project by RedCap app> my project (choose correct 
language project)> Send Data to Server 
2) Scan and upload a copy of the consent into Redcap  
3) Confirm that all data was entered and synced.  Review all dates and 
measurements for data entry errors.  Change status of form from 
Unverified to complete. 
4) Complete first QA pass 
5) Return all materials to room 119.  
6) If any questions came up during the data collection process please check 
as soon as possible with Katelyn/Alison about these issues.  
Potential Questions/Scenarios During BL Visit 
Consent 
Potential concerns & responses 
When addressing participants concerns or responses remember to show empathy by 
putting yourself in the other person's shoes and validating their concerns explain steps 
staff will take to minimize concern and provide rationale for what we are asking them to 
do. 
 Examples 
 
“I don’t think I would be comfortable with so my family meal/ reading” 
  
Validate their concern and ask for clarification (Note in the statement above the 
parent does not explain why they would not be comfortable so you can’t address their 
concern.) 
  
You could say: “I understand you may feel uncomfortable recording your family. What 
are your concerns about this”? 
 
 They may say 
“I worry about privacy 
 Or 
 “I worry it will be embarrassing” 
  
Explain steps to address concern 
“We understand that your family's privacy is extremely important. You will send us the 
video using an application. The study staff who review the video will not see your name 
or any identifying information. The videos will be stored in secure server. The only 
people that will see your video are yourself, the study staff, and the support coach who 
will come to your home, after 5 years the videos will be deleted” 
Or  

 
23 
“We understand that it may feel uncomfortable to film you and your child. The person 
reviewing the videos will not see your name or any identifying information The goal of 
the video is not to judge you or grade you on how well you interact with your child. We 
understand that children in this age range are very unpredictable and that is normal” 
  
Provide rationale for what you are asking them to do 
“The reason we have you provide the video is so that we can see if watching and 
receiving feedback on family videos can help parents find ways to improve their 
children’s health. We have tried something similar with other families and they found it 
very helpful. 
  
  
Parents: “I’m not sure about someone coming into my home” 
  
Validate their concern and ask for clarification if necessary 
Researcher: “We understand that having someone come to your home may be 
uncomfortable. Is there something specific that you are worried about? 
  
They may say 
“How will I know who they are” 
Or 
“I worry they would judge our family” 
Or 
“I wouldn’t be comfortable if it was a male” 
  
  
 
 
Explain steps to address concern 
It is important to us that you feel comfortable and safe. 
 Study personnel will have a badge with the URI logo & their name printed on it.  All 
study personnel are registered with our institutional review board, have completed 
several hours of training and have experience working in family’s homes.  Their role is 
to provide you information and help you set goals to improve your family’s health not to 
judge you in anyway. 
Or 
 We can ensure that you only have female personnel ** Please make a note of this in 
redcap and alert Katelyn so that all female data collection teams are assigned** 
 
 
Provide rationale for what you are asking them to do 

 
24 
We are conducting a home-based study because we understand families are busier 
than ever and want to ensure everyone has access regardless of transportation or 
schedule.  
 
Demographics 
Q. What is my race/ethnicity? 
Answer: Remember that you can not identify race/ethnicity just by looking at a person.  
Provide the following explanation and allow the participant to identify themselves.: 
 
Ethnicity 
Hispanic or Latino - A member of an ethnic group that traces its roots to 20 Spanish-
speaking nations from Latin America and Spain itself. 
 
Race 
White – A person having origins in any of the original peoples of Europe, the Middle 
East, or North Africa. 
Black or African American – A person having origins in any of the Black racial groups 
of Africa. 
American Indian or Alaska Native – A person having origins in any of the original 
peoples of North and South America (including Central America) and who maintain 
tribal affiliation or community attachment. 
Asian – A person having origins in any of the original peoples of the Far East, 
Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, 
India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam. 
Native Hawaiian or Other Pacific Islander – A person having origins in any of the 
original peoples of Hawaii, Guam, Samoa, or other Pacific Islands. 
 
 
  
 
Second Dietary Recall & Randomization 
1. Project manager will notify phone call recall team when recalls are scheduled. 
2. UGRA will log into redcap to obtain participant contact information & enter redcap 
form. Find participant record> event pre_visit1> Second Recall 

 
25 
3. Fill out header section in NDSR prior to beginning recall 
a. Participant ID  
b. Child date of birth  
c. Gender 
d. Date of visit 
e. Visit number (1 for home baseline, 2 for phone baseline, 3 for home follow 
up, 4 for phone follow up) 
f. Interviewer ID- Your initials 
4. If participant answers the phone.  
a. RA will complete 5 pass dietary recall per NDSR protocol 
5. After Foods have been entered into NDSR:  
a. Notify participants that incentive will be given to them at their first home 
visit when the support coach comes($15).  
b. Open randomization envelope and let participants know which group they 
are in and enter form in redcap 
i. 
Remind participants of the video recording.  
As part of this program we ask that you video record a time 
with your child. As you are in the (identify group assignment) we ask 
that you record a (meal with your child or a time that you read with your 
child). Do you have any questions about this? Do you remember how 
to use Google Photo to share your videos with us?  
 
  
 
6. If participant does not answer the phone leave message & document call attempt 
in RedCap.  Attempt x2 to get weekday weekend, if not 2 weekday.  
Hello, my name is [name of RA] with the University of Rhode Island . 
I am calling to complete the last part of the interview so that we can 
begin the program..  Please give us a call back at 401-542-9105. After 
the interview you will be given your study group and you will also 
receive a second gift card for your time. 
 
 
 
 
 
In the event that the second recall is not completed within two weeks of the baseline 
visit, the participants will then be randomized without completing that second recall. 
Since they have their home visit scheduled they will find out at that time.  

 
26 
 
Data Management  
NDSR Data Entry Rules & Assumptions 
1. Follow NDSR training data entry rules (Appendix 15 of the NDSR manual) unless 
otherwise noted.Ensure that there are complete and detailed notes for any 
items entered. This includes documenting what the participants said their child 
ate, what was used to estimate portion sizes and any other relevant information  
2. If no recipe exists for a food item, if standard recipes in NDSR do not suffice, and 
participant knows the ingredients  and amounts used create a user-recipe for the 
meal in NDSR.   
a. If recipe quantities are available: 
i. 
Create user recipes with the quantities and ingredients noted. 
ii. 
Be sure to keep recipe name in original language 
b. If recipe quantities are not available: 
i. 
Follow NDSR “Mixed Foods” protocol - follow the prompts on 
screen, and choose appropriate ingredient variables. 
ii. 
If mixed foods are not appropriate, make substitution based on 
best, most similar available food item in NDSR. 
iii. 
Priority note all recipes for review by CNCOP data management.  
3. QA of NDSR data entries - Recall  
a. Missing foods and substitutions protocol  
i. 
Missing foods are considered a last resort if no appropriate 
substitution is available for your food product in NDSR. appropriate 
substitutions are determined by the following nutrient tolerances: 
Nutrient tolerances per 100g of product 
Calories  
+/- 85.0 kcal 
Protein  
+/- 5.00g  
Total fat 
+/- 2.50 g 
Total carbohydrate  
+/- 10.00g  
Sodium  
+/- 100.00 mg  
 
b. If the nutrient values of the closest food substitute does not fall within the 
nutrient tolerance per 100g, then the product will be considered a missing 
food.  
 

 
27 
2. This will be determined after the 3rd QA pass - usually by the lead RDN whether 
or not a MF is appropriate. 
3. Missing foods will be resolved via NCC (Nutrition Coordinating Center).  
a. Submit a New Food request form (have nutrition facts for product 
available). 
b. The missing foods client number for URI is: 679 ir University of Rhode 
Island. 
4. Determine the appropriate substitution(s) for item(s) that are not found in NDSR.  
a. Print the Nutrients per Food report. 
i. 
NDSR R34 project >> Click on record ID that has the substitution 
>> Reports tab >> Nutrients per food.  
b. Compare the nutrients of the substitution to the actual food product. 
i. 
You will need to find the nutrition information from online or 
producer. 
 
 
 
 
 
 
 
 
 
 
 
 
 
Coding and Feedback  
CEBQ Coding 
Export CEBQ data into SAS by clicking Data Exports, Reports, and Stats> Selected 
instruments and or events> CEBQ and Baseline> export raw data without labels  
 
 
 Score CEBQ using code title “CEBQ_Score”. Enter category into redcap. 

 
28 
a) If CEBQ_SR=1 then participant is “low satiety responsiveness” 
b) If CEBQ_FF=1 then participant is “high food fussiness” 
c) If CEBQ_FR=1 then participant is “high food responsiveness”  
If participant is high in multiple traits, they will first get tailored information on the food 
fussiness, followed by satiety responsiveness and then food responsiveness. 
 
CEBQ_Score Code 
data redcap.CEBQ; 
SET redcap.CEBQ; 
reverse_cebq3= 6-cebq3_bigappetite; 
reverse_cebq4= 6-cebq4_finishesquickly; 
reverse_CEBQ10= 6-cebq10_enjoystasting; 
reverse_CEBQ16= 6-cebq16_enjoysvariety; 
reverse_CEBQ32= 6-cebq32_interestedtasting; 
Run; 
data redcap.CEBQ; 
set redcap.CEBQ; 
CEBQ_FF= (cebq7_refusesnew+reverse_CEBQ10+reverse_CEBQ16 + 
reverse_CEBQ32+cebq35_moreslowly)/6; 
CEBQ_FR= (cebq12_alwaysasking+ cebq14_eattoomuch+ cebq19_mostofthetime+ 
cebq28_favoritefoods+cebq34_alwaysfood)/5; 
CEBQ_SR= (REVERSE_CEBQ3+ cebq17_leavesfood+ cebq21_fullbefore+ 
cebq26_fulleasily+ cebq30_mealsnack)/ 5; 
Run; 
Data redcap.CEBQ; 
set redcap.CEBQ; 
if CEBQ_SR<2.8 then low_SR=1; 
if CEBQ_SR>=2.8 then low_SR=0; 
if cebq_sr=. then low_sr=.; 
if cebq_FF>3 then high_FF=1; 
if cebq_ff<=3 then high_FF=0; 
if cebq_ff=. then high_ff=.; 
if cebq_FR>2.8 then high_FR=1; 
if cebq_FR<=2.8 then high_FR=0; 
if cebq_fr=. then high_FR=.; 
run; 
 
Enter results in Final Baseline Checklist form of Baseline Visit in Redcap. 
 
Video Coding 

 
29 
Project manager will monitor study WhatsApp and Google account daily.  When video is 
received video coding staff will be notified and sent video. Video should be coded within 
one week of receiving. 
 
If video is not received within 1 week of randomization a text message will be generated 
to remind the participant.  
 
If the video is not received within 2 weeks of randomization a phone call and text 
message will be sent to remind the participant and answer any questions they may have 
about the purpose of the video or how to record/send the video.  
 
Protocol for video coding: 
1. Project manager will alert coders when a new video is uploaded to the server. 
2. Prior to watching the video, have Operational Definitions and Coding Tool readily 
accessible. While the coder will have the Operational Definitions available to 
them during the coding process, it is important that they are comfortable with 
identifying the different practices. 
3. Watch video and fill out coding sheet. It is likely that the video may need to be 
paused multiple times while coding, and certain clips may need to be re-watched 
if the parental practices seem ambiguous. For further directions on when to code, 
refer to the directions on the top of the Operational Definitions sheet. 
4. While watching the video, note if there is a specific interaction that stands out in a 
positive or negative way, or if a behavior occurs multiple times within a meal. If 
there is not a positive and negative clip that stands out, use best judgment to 
select a clip. 
5. Follow below protocol to edit the video so it contains only the “positive” and 
“negative” clips.  
6. Fill out the CHW Feedback Sheet by writing a quick overall description of the 
meal at the top of the sheet. Mention anything that may be beneficial for the 
CHW to know about the meal (Remember that the CHW will not be viewing the 
full video).  
7. Briefly describe what practice the video clip is showing. 
8. Copy and paste the appropriate sample feedback. Modify as necessary so that 
feedback is specific to what is observed in the video, and upload to the CHW’s 
folder on the Google Drive.  
9. Go onto RedCap application, and copy the information from coding tool onto the 
“Video Coding” tab.  
 

 
30 
Protocol for video editing using iMovie: 
1. In order to edit the video with the positive and negative clip, import the entire 
video into iMovie. 
2. Create a new project and name it StudyID_VideoClips_1 or 
StudyID_VideoClips_2. 
3. When in the “My Media” tab of the “Projects” section, drag the clip to the bottom 
half of the screen (it should be a lighter gray than the top). 
4. Trim the video so it only includes the desired positive clip by moving the 
bidirectional arrow cursor that will appear at the front and end of the clip. 
5. Add a title slide that says “Clip 1”  before the video clip. Find this by clicking the 
“Titles” tab, and dragging the desired title to the bottom half of the screen. 
6. Repeat Step 5 to create a title slide that says “Clip 2” following the first positive 
video clip. 
7. Repeat steps 3 and 4 to trim the clip to only include the desired negative video 
clip. 
8. Export the video by going to the “File” tab, then “Share”, then “File”. The video 
clips will then be downloaded as a .mov  
Feedback 
Project manager will upload video clips, feedback form, and CEBQ trait into CHW 
google drive folders. If the participant does not complete the video sample video and 
feedback sheet will be provided. 
CHW will be notified via email and text message when new materials are uploaded. 
 
 
 
 
 
 
NDSR QA protocol 
1. Open NDSR and select the project and the record. 
2. Review the Header tab 
○ Check to ensure that the record is entered into the correct project  
○ Check the participant ID & DOB with redcap ID and DOB 
○ Check the date of intake (typically the day before the date of entry).  
○ Check the interviewer ID 
○ Check the visit number (1 for home baseline, 2 for phone baseline, 3 for 
home follow up, 4 for phone follow up) 
3. Review the Food tab. 

 
31 
○ Review each food name for correctness. Visualize what is eaten. 
○ Review each amount. Visualize how much is eaten. Use the reference 
amount (in parenthesis) as another reality check.  
○ Use study approved amount estimation tools or ruler to “re-create” 
amounts. 
○ Are Food Amounts Booklet amounts entered correctly? 
○ Make sure Assembled Foods include a complete description of the food.  
○ Are all components of the food included? (e.g, bread for the sandwich)  
○ Are companion foods included? (e.g, spread for bread or toast, bread or 
rolls with a restaurant meal.  
○ Are amounts appropriately described and reasonable?  
○ Is a rationale documented for unusually small or large portions?  
○ Do Missing Foods include complete descriptions of food and amount 
eaten?  
4. Review the Trailer tab. 
○ Read Notes for completeness and accuracy.  
5. View the Quick List. Make sure foods entered correspond to the Quick List and 
account for all foods initially reported. Make notes for discrepancies. 
6. Generate and review the Nutrients per Food Report. 
○ Check the gram weight for unusual amounts 
■ 8 FO (fluid ounces of coffee) = 240g (beverages vary in density).  
■ 6 FO of wine = 176g (6 oz = 170.10g). 
■ 1 ¼ cup of frosted cheerios = 35g (8 ounces = 227g = 6.075 cp). 
■ 2 medium tomato slices = 40g ( 2 medium tomatoes = 123g)  
■ 1 medium brownie = 2” x 2” = 40g 
○ Other reference points include: 28g of cheese = 1oz; 454g of steak = 1 
pound; 250g of chili = 1 cup. 
○ Check individual food items that are >400kcal, >25g fat, >500g total 
weight.  
7. Generate the Missing Foods and Missing DSAM Products List Reports    
○ Select the sample project missing for the training project. 
○ From the Reports menu, select the Missing Foods List Report. 
○ When asked if you would like to open the Missing Foods List Report or 
save it, select Open. 
Note: This report opens as an excel file which can be formatted as desired. You may 
wish to document your QA decisions in an additional column on this report. It also may 

 
32 
be helpful to copy and paste the missing foods and decisions into a master list for use 
throughout your study.  
 
8. Generate and Review the Food and QA Report 
● Highlight the project and Your Name W001 in NDSR.  
● From the Reports menu, select the Quality Assurance Reports > Foods QA 
Report 
● When asked if you would like to open the Foods QA Report or save it, select 
Open. As you review the report, highlight items on the spreadsheet that may 
need editing.  
○ Check data for items that need to be fixed or require interviewer 
education.  
○ Sort by Note field. Review priority notes. Look for items that require 
editing, research, or data entry decisions. 
● Highlight Unit Selected column and search for OZ. Verify that beverages are 
entered with FO instead OZ.  
● For larger data-sets sort by Food ID to place like items together to check for the 
amount errors. 
9. Return to NC003 in your W001 project and make corrections to problems identified. 
10. Generate a new Foods QA Report. Review Food Detail Notes.   
Note: Use the Record Search to find a record during the QA report revi 
Data Backup 
All data (Redcap & NDSR) will be exported and backed up each Friday on the teams 
external hard drive in folder StrongFamilies_Backup. Please refer to NDSR Healthy 
Start protocol for more information on NDSR data entry and cleaning.  
 
 
Blinding 
Data collectors will be blinded to what arm the participant is in. You will not know if they 
are in the intervention or control group.  
 
Completion/Final Evaluation 
Final evaluations will be scheduled by the support coaches during their last visit. All 
data collection teams should have their availability entered in the google calendar  
Repeat all data collection procedures outlined above. 

 
33 
 
Reporting Procedures 
Injury 
In the event of any injury to the participant or to yourself, data collection staff should 
immediately  report to supervisor, Katlyn Fox or Alison Tovar. 
In consultation with the project manager, PI and co-I, if appropriate, unexpected 
problems/outcomes should be reported on Appendix S – Event Reporting. 
Management staff to report to IRB 
 
Child abuse 
Please immediately report to supervisor (Katelyn Fox and Alison Tovar)  if you have any 
concern that you have witnessed child abuse. 
A report is required when: 
● A person has reasonable cause to know or suspect that a child has been abused 
or neglected. 
● "Any recent act or failure to act on the part of a parent or caretaker which results 
in death, serious physical or emotional harm, sexual abuse or exploitation"; or 
● "An act or failure to act which presents an imminent risk of serious harm." 
If you are not sure, please discuss with Katelyn or Alison and a decision can be made. 
 
 
Study Discontinuation 
Lost to Follow Up. If a participant does not attend scheduled visit and team is unable 
to contact the participant protocol is to Contact by phone, text and email 2 x/week x 2 
weeks. 
Expresses desire to discontinue study. If a participant expresses desire to 
discontinue the study alert project manager. Thank them for participating and ask, if 
willing to share, the reason for discontinuation. Project manager will cancel all upcoming 
visits/ data collection time points. 
 
Data will be kept for all participants who have been randomized prior to discontinuation 
and analyzed with intention to treat . 
 
 

 
34 
Training 
All data collectors  
 
NDSR training binder 
Quality control  
 
 
Metrics 
 
 
Protocol deviations 
 
 
Monitoring 
 
IRB Review 
 
 
 
 
 
 
 
 
 
 
 
 
 
Measures & Coding 
 
 
Feeding Question Sub-
Scale & Coding 
 
 
FPI 
Question 
Variable 
Name 
Encourage Trying New 
Foods 
 
 
Offer New Foods 
I teach my child about new foods 
fpi_teach 
 
I offer new foods at mealtime 
fpi_offerm 
 
I offer new foods at snack 
fpi_offers 

 
35 
Encourage Exploration of 
New Foods 
I let my child explore new foods by smelling 
fpi_explores 
 
I let my child explore new foods by licking or touching 
the food to his/her lips 
fpi_explorel 
 
I let my child explore new foods by picking up and 
looking at the foods 
fpi_lookfood 
Urge Child to Eat New 
Foods (mean inter-item 
correlation = .33) 
When I offer new foods, I have my child eat at least one 
bite 
fpi_onebite 
 
I show my child how to try foods by taking a bite myself 
fpi_bitemyself 
 
I have my child try a new food before he/she eats sweet 
foods 
fpi_beforeswe
et 
 
If my child refused to eat a new food, or a food he/she 
does not like, I continue to offer that food 
fpi_continue 
Repeated Presentation of 
New Foods  
If my child does not eat a new food on one day, I offer it 
again on another day 
fpi_offeragain 
 
If my child does not eat a new food on one day, I offer it 
again and prepare it in a different way on another day 
fpi_offerprepa
re 
 
I offer foods for my child to try even if I don't like them 
myself 
fpi_dontlike 
Mealtime Structure 
 
Family Meals  
Our family regularly eats dinner together 
fpi_dinnert 
 
Everyone if our family is expected to be home for dinner 
fpi_homedinn
er 
 
People in our family feel strongly about eating dinner 
together 
fpi_together 

 
36 
 
People in our family sit in the same seats at every meal 
at home 
fpi_samesit 
Regular Timing of Meals 
and Snacks 
We have routine times for meals at our house 
fpi_routineme
al 
 
We have routine times for snacks at our house 
fpi_routinesna
ck 
 
Having a routine time for children to eat is important 
fpi_routine 
Inconsistent Mealtimes 
Adults in our house have separate mealtimes from 
children 
fpi_adultm 
 
Dinnertime in our family is flexible. People eat whenever 
they can. 
fpi_flexible 
 
In our family, there is little planning around dinnertime 
fpi_pland 
Indifferent Feeding  
An effective way to get an upset child to quit crying is to 
feed him/her 
fpi_crying 
 
My child can have juice when he/she asks for it 
fpi_juice 
 
Children should be able to eat foods they want to for 
snacks 
fpi_wantsnack
s 
 
I have bigger problems to worry about than which foods 
my child is eating 
fpi_biggerpro
blem 
Child Involvement in Food 
Preparation  
My child helps me prepare new foods 
fpi_helpprepa
re 
 
My child helps prepare part of the meal 
fpi_preparem 
 
My child helps prepare his/her snacks 
fpi_prepares 
Parent Decides Portion 
Sizes 
I put food on my child's plate 
fpi_childsplate 

 
37 
 
I serve the right amount so that my child can eat enough 
fpi_eatenough 
 
Are you responsible for the size of the portions your child 
receives? 
fpi_portionsiz
e 
 
Are you responsible for how many helpings your child 
gets? 
fpi_helpchild 
Serves Measured Portions  
I help my child use a tablespoon so that he or she knows 
how much food should go on the plate 
fpi_spoon 
 
I measure portions for myself based on food packaging 
guidelines 
fpi_portionm 
 
I measure portions for my child based on food packaging 
guidelines 
fpi_portiongui
des 
External Control 
 
Pressure to Eat 
If my child says “I'm not hungry,” I try to get him/her to 
eat anyway 
fpi_nothungry 
 
I have to be especially careful to make sure my child 
eats enough 
fpi_careful 
 
My child should always eat all of the food on his/her 
plate 
fpi_plate 
 
If I did not guide or regulate my child's eating, he/she 
would eat much less than he/she should 
fpi_eatless 
Restriction 
I have to make sure that my child does not eat too many 
sweets 
fpi_eatsweets 
 
I have to make sure that my child does not eat too many 
high fat foods 
fpi_highfats 
 
If I did not guide or regulate my child's eating, he/she 
would eat too many junk foods 
fpi_junkfood 
Food as a Reward  
I offer sweets to my child as a reward for good behavior 
fpi_offersweet
s 

 
38 
 
I offer my child his/her favorite foods as a reward for 
good behavior 
fpi_favoritef 
 
A favorite food is an effective way to reward children 
fpi_foodrewar
d 
Responsiveness to Child's 
Fullness Cues  
When my child resists eating, I ask him/her if he/she is 
hungry 
fpi_resisteatin
g 
 
During mealtime I ask my child is his/her stomach is full 
fpi_fullstomac
h 
 
During meals, I ask if my child is still hungry 
fpi_hungryd 
Monitoring  
Do you keep track of the sweets that your child eats? 
fpi_trackswee
ts 
 
Do you keep track of the snack foods that your child 
eats? 
fpi_tracksnac
ks 
 
Do you keep track of the high fat foods that your child 
eats? 
fpi_trackfat 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 
39 
Assumptions & Data Entry Rules 
 
Date Entered 
Data Entry Form 
Rule 
8/9/17 
NDSR 
If meat is fried and option not 
available in NDSR (ie for 
sausage) assume that fat 
absorbed by the meat is 1.5% 
of the total weight of the 
meat.  
For example:  
If 85g  sausage is fried in 
butter assume that 1.3 g of 
butter is absorbed (85g x 
0.015=1.3g) 
8/9/17 
Demographic Form & Healthy 
Kids Form  
If given a range of times 
choose the mean.  
For example if reports 
bedtime is between 20:00 
and 21:00 enter as 20:30. 
8/9/17 
Demographic Form  
Ages of children in the home 
Enter age as years. For 
example if parent reports 
child is 3 months enter as 
0.25 years. 
8/9/17 
14 Item Diet Screener 
If parent reports 1 tsp of 
cream/butter/ margarine per 
day enter. If >1.5 tsp count 
enter as 1 x/week 
8/9/17 
Healthy Kids 
Record fortified non-dairy 
milks as soy milk.  
8/9/17 
14 Item Diet Screener 
If eating red meat >3x/week 
enter 1 x/day. 
8/27/17 
NDSR 
1 bite of hamburger = 15 g 
(1/16th) 
9/3/19 
NDSR 
Breastfeed unknown volume 
assume 2 oz  per feeding 
https://jandonline.org/article/S
0002-8223(10)01481-1/pdf 

 
40 
9/3/19 
NDSR 
Every attempt to be made to 
quantify amount using FAB or 
measuring spoon/cup. 
However if only estimate 
provided is large serving 
spoon assume ½ cup. 
9/25 
NDSR 
If supplement n/a in NDSR 
Katelyn or Andrea will find 
similar supplement in NDSR. 
Please enter all supplement 
details in notes section so 
that in the future we request 
the supplement if necessary. 
10/23 
NDSR 
Dip with carrots is 1 Tbsp low 
fat ranch on CACFP menu 
11/13 
NDSR 
For pizza eaten without crust 
subtract 1” from radius of 
wedge. If wedge size N/A 
decrease portion by 20%. 
2/26 
NDSR 
½ CP milk per 1 CP cereal 
08/21 
NDSR 
1TB of oatmeal per 8 FO for 
oatmeal drink  
08/25 
NDSR 
If amount of water not 
provided, use amount from 
another day.  
8/31/20 
NDSR 
Sugar on cereal (included 
oatmeal)= 1 TS sugar per 1 
CP cereal  
9/2/2020 
NDSR 
Medium slice pizza:  7 D 
(FAB) 
09/04/2020 
NDSR 
For banana, a bite is an inch 
10/1/2020 
NDSR 
1 bite : 1 TB (M3) 
1 sip: 1 FO 
10/1/2020 
NDSR 
Dip from childcare menu: 
dips, unknown type, unknown 
if regular or fat-free 

 
41