Title: Maternal Attitudes, Subjective Norms and Feeding Practices of Young Children
Description: This exploratory study examined maternal attitudes, subjective norms and food selection behaviors of 31 mothers (mean age 29.6 years, 50% Hispanic, 34% Black, 47% ≤ high school, 31% marginal health literacy, 71% Women, Infants and Children program participants) for their 2 and 3-year-old children (n=32, 50% female, 34.4% overweight/obese, 72% breastfed during infancy) to identify factors associated with childhood overweight. The Theory of Reasoned Action was used to examine relationships between variables of interest. Subjects were recruited from two primary care sites. Measurements included 5 surveys, child anthropometric measures and a simulation exercise to identify types and quantities of food mothers offered to their child. Selected food items were weighed and organized by food group and compared to USDA recommendations by child's age, gender and activity level. Data were analyzed using descriptive statistics, Spearman's rho correlation coefficients, and multivariate linear regression modeling.

On average, mothers offered their children more fruit (237%) and meat (153%) but less vegetables (75%), dairy (79%) and grain (65%) than what is recommended. Mothers of 2 year olds selected greater quantity of food compared to mothers of 3 year old children for all food groups except dairy (p <0.05). Demographic, normative beliefs, maternal attitudes and health literacy meeting criteria were entered into multivariate regression models to predict behavioral intent. Final models explained 13% (dairy- restrictive attitude); 28% (grain- child's age, maternal BMI, physical activity); 40% (fruit-child's age, maternal education, normative belief, and health literacy); 44% (calories- child's age, normative beliefs for all food groups, restrictive attitude); 38% (meat- child's age, Hispanic ethnicity, normative belief) and 51% (vegetable- child's age, television viewing, normative belief and health literacy) of the variance of behavioral intent for the respective food groups. Normative beliefs and health literacy are potentially modifiable.

Therefore, appraisal of maternal normative beliefs about dietary recommendations for children and health literacy may identify children at risk for overweight and obesity.