Correspondence: Karen Campbell, Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Hwy, Burwood VIC 3125, Australia. Fax: 3 9244 6017. Email: karen.campbell@deakin.edu.au

(Received 15 July 2009; accepted 18 January 2010)

ORIGINAL ARTICLE

Maternal self-effi cacy regarding children ’ s eating and sedentary behaviours in the early years: Associations with children ’ s food intake and sedentary behaviours

KAREN CAMPBELL, KYLIE HESKETH, AMANDA SILVERII & GAVIN ABBOTT

Centre for Physical Activity and Nutrition Research, Deakin University, Burwood, Melbourne, Australia

Abstract Introduction. This cross-sectional study aimed to describe parents ’ views regarding self-effi cacy to infl uence children ’ s eating and sedentary behaviours at two time points in early childhood, and to examine associations between these views and children ’ s eating and sedentary behaviours. Methods. Mothers of 1-year (n � 60) and 5-year-old children (n � 80) were recruited through Maternal and Child Health Centres and kindergartens in Victoria, Australia. Mothers reported children ’ s dietary intake, television viewing and perceptions of their self-effi cacy regarding children ’ s eating and sedentary behaviours. Results. Overall, 5-year-old children consumed signifi cantly more energy-dense food and drink and spent signifi cantly more time viewing TV/DVD and video. Mothers of 1-year-olds were signifi cantly more likely to report they felt confi dent to limit child ’ s consumption of non-core foods/drinks, and to limit screen access (p � 0.001). Measures of maternal self-effi cacy were directly associated with 5-year-old children ’ s water (p � 0.05), and fruit and vegetable consumption (p � 0.005), and with 1-year-old children ’ s vegetable consumption (p � 0.05), and were inversely associated with cordial and cake consump-tion (p � 0.05). Maternal self-effi cacy to limit viewing time was inversely associated with screen-time exposure in both age groups (p � 0.01). Conclusion. This study suggests that mother ’ s self-effi cacy regarding limiting non-core foods/drinks and limiting screen-time exposures may decline during the fi rst few years of a child ’ s life. Higher maternal self-effi cacy was associated with children having more obesity protective eating and sedentary behaviours at both ages. Interventions to support the development of healthy lifestyle behaviours may be most effective if they target mothers ’ self-effi cacy in these domains early in their child ’ s life.

Key words: Parental self-effi cacy , early childhood , obesity prevention , diet , sedentary behaviours

Introduction

Opportunities for obesity prevention in early child-hood have only recently become a focus of research with the majority of studies in this area published since 2003 (1). While parents are acknowledged as key drivers of the development of early obesity pro-moting/protective behaviours (2), our understand-ing of parental perspectives regarding capacity to impact on these behaviours remains poor. Under-standing parental self-effi cacy in these domains is likely to be important in informing the development of parent-focussed obesity prevention interventions for children.

Self-effi cacy speaks to the confi dence with which we perform a particular behaviour, and is known to

be strongly predictive of the uptake and maintenance of health behaviours (3). Self-effi cacy is considered to be central to the understanding of an individual ’ s translation of knowledge to behaviour as conceptua-lised in Social Cognitive Theory (3). A small number of studies have explored associations between parental self-effi cacy regarding child diet, physical activity and sedentary behaviours in children, and associated child behaviours. Cullen et al. (4) report in a sample of 109 parents of fourth to sixth grade students that parental self-effi cacy concerned with planning and encouraging fruit and vegetable intake was directly associated with children ’ s fruit con-sumption (r � 0.23; p � 0.05). In the physical activity domain, Adkins et al. (5) report in a sample of

International Journal of Pediatric Obesity, 2010; 5: 501–508

ISSN Print 1747-7166 ISSN Online 1747-7174 © 2010 Informa HealthcareDOI: 10.3109/17477161003777425

502 K. Campbell et al.

52 parents of 8 – 10-year-olds, that parent ’ s self-effi cacy for supporting their daughters to be active was directly correlated with girls ’ engagement in physical activity (r � 0.45, p � 0.01). We are aware of no studies that have considered parental self-effi cacy as a predictor of children ’ s sedentary behaviours.

In addition to studies considering associations between parental self-effi cacy and child eating and activity/sedentary behaviours, one study describes how parental self-effi cacy changes as children move through early childhood. This qualitative work involving mothers of children aged 1 – 5 years (6) suggests that mothers believe their capacity to infl u-ence child ren’s eating and television viewing dimin-ishes during the fi rst few years of the child ’ s life. This apparent decline in parental self-effi cacy is likely to have important implications for the design and timing of the delivery of interventions, which aim to support parents to achieve obesity protective behaviours over the course of their children ’ s lives. Quantitatively documenting parental self-effi cacy in these domains and against measures of dietary intake and sedentary behaviours would substan-tially enrich our understanding of, and potential to infl uence, this important period in the evolution of parenting skills development and obesity protective behaviours in children.

This cross-sectional study aimed to describe dif-ferences in 1-year and 5-year-old children ’ s eating and sedentary behaviours, and parents ’ views regarding their capacity to infl uence these behav-iours during these two periods of early childhood. This study also examined associations between parental self-effi cacy and children ’ s eating and seden-tary behaviours.

Methods

Mother/child pairs were recruited from all Maternal and Child Health Centres and kindergartens in a rural region of Victoria, Australia. Research packages containing self-completion questionnaires, a plain language statement and a consent form were sent to all fi rst-time mothers (with children aged six to twenty months) registered with the participating Maternal and Child Health Nurses. These research packages, with text modifi ed to refl ect their distribu-tion to parents of older children, were also distrib-uted via all registered kindergartens in the area (n � 4) to all mothers of four to fi ve-year-old children (regardless of the number of previous children they had). Data were collected over a six-week period in July 2007.

Ethical approval for this study was granted by the Deakin University Research Ethics Committee and

the Victorian Department of Human Services Ethics Committee.

Measures

Self-effi cacy items . As there were no existing measures of self-effi cacy in these domains of par-enting, measures were developed using qualitative data collected by Campbell and Hesketh (unpub-lished) and by existing measures of personal self-effi cacy (7). Respondents rated their confi dence to infl uence or control children ’ s eating and sedentary behaviours on 12 questions. All items relating to mothers ’ self-effi cacy were scored on a fi ve-point Likert scale from 1 (not at all confi dent) to 5 (extremely confi dent).

Self-effi cacy for promoting healthy eating . Five of the self-effi cacy items related to the mother ’ s confi dence in their ability to get their child to eat healthily e.g., “ How confi dent are you that you could get your baby/child to eat enough fruit over the next year? ” The scores for each of these fi ve items (refl ecting confi dence to get a child to consume enough fruit, vegetables, plain water, enough food and a wide range of foods over the next year), were averaged to produce a scale that assessed mothers ’ self-effi cacy for promoting healthy eating ( α � 0.84).

Self-effi cacy for limiting non-core foods . Four items related to the mother ’ s confi dence that they could refuse their child ’ s requests for unhealthy foods, e.g., “ How confi dent are you that you could say no to your baby/child ’ s demands/fussing for sweet snacks, confectionary, lollies and/or ice cream? ” The scores for each of these four items (refl ecting confi dence to say no to requests for sweet snacks, confectionary, lollies or ice cream; potato crisps/salty snack foods and biscuits; soft drink, cordial and other sweetened drinks; energy dense foods/drinks when grocery shopping over the next year) were averaged to produce a scale measuring mothers ’ self-effi cacy for limiting non-core foods ( α � 0.86).

Self-effi cacy for promoting physical activity to displace viewing of TV/DVD/video . The item “ How confi dent are you that you could get your baby/child to do something physically active, like dancing, skipping, playing outside, when they want to watch TV/DVD or videos over the next year? ” , was used as a single-item measure of the perceived ability of mothers to promote physical activity when their child wanted to be sedentary.

Self-effi cacy, diet and sedentary behaviours 503

Self-effi cacy for limiting viewing . Mothers ’ ability to limit their children ’ s TV viewing was assessed by a single item asking mothers how confi dent they were that they could “ say ‘ no ’ to their baby/child ’ s requests to watch TV/videos/DVDs over the next year ” .

TV, DVD and video viewing time

Children ’ s TV, DVD and video viewing behaviour was measured by asking mothers how many hours their child spends watching TV or videos/DVDs on a usual weekday (weekday viewing) and on a usual weekend day (weekend day viewing). Mothers responded on a scale from 0 to 6 hours, with half-hour increments. Child ’ s average viewing per day was calculated by multiplying weekday viewing by fi ve (i.e., fi ve weekdays) and multiplying weekend day viewing by two (i.e. two weekend days), summing these two values together (giving the total number of minutes of weekly viewing), then dividing this num-ber by seven. Parental report of their child ’ s ‘ usual ’ television viewing has been shown to correlate with both videotaped observations of the child ’ s television viewing (8) and with parental diaries of viewing (9).

Children ’ s dietary intake

Children ’ s dietary intake was assessed using the short assessment tool for young children ’ s eating and physical activity known as EPAQ (Eating and Physical Activity Questionnaire) (10). The EPAQ was designed to characterise child consumption of non-core foods including packaged snacks, choco-late/confectionary, soft-drinks, fruit juice, cordial and cakes/sweet biscuits/doughnuts/muffi ns, and core foods including water, fruit and vegetables, full-cream milk and potatoes on the previous day. The EPAQ has been validated against a 24-hour recall in the same study population (n � 90) (10). In that study, the proportion of children (mean age 3.98 years, standard deviation [SD]: � /�0.98) con-suming any amount from a food/beverage group did not differ signifi cantly between the two dietary methods, and intakes for all foods/beverages were highly correlated. Correlations ranged from 0.57 for chocolate/confectionary to 0.88 for fruit juice (highest correlation).

The EPAQ asked mothers, “ Yesterday, how many servings of the following foods/beverages did your child eat/drink? ” Response categories were ‘ None ’ , ‘ 1 ’ , ‘ 2 ’ , ‘ 3 ’ , ‘ 4 ’ , ‘ 5 ’ , ‘ 6 or more ’ and ‘ Don ’ t know ’ . Colour photographs were used to help participants quantify one serve. Serve sizes were based on the recommended servings in the Australian Guide to Healthy Eating (11). For each item participants were

given a score corresponding to the number of serves the carer reported the child ate, with responses ‘ None ’ being given a score of 0, and ‘ 6 or more serves ’ being given a score of 6. ‘ Don ’ t know ’ responses were classifi ed as missing data.

Given that the children were too young to provide information on their own, parents were used as sur-rogates. The literature supports the accuracy of par-ent reports of usual child food intakes (12).

Demographic information

Standard socio-demographic information was col-lected, including child age and gender, and mother ’ s age, highest level of education, employment status, country of birth, and marital status.

Maternal weight

Evidence suggests that maternal weight is likely to infl uence the ways in which mothers feed their chil-dren (13). Given this, participants were asked to record their height and weight, and BMI was calcu-lated (weight [kg]/height [m] 2 ). Self-reports are known to provide a valid estimate of actual height and weight (correlations � 0.90). (14).

Statistical analyses

Preliminary analyses revealed that children who were reported as having an illness that affected their appetite for more than two days in the previous week differed signifi cantly from the remainder of the children with regards to dietary intake of several items. These children were therefore excluded from analyses. Further preliminary analyses were con-ducted to assess whether potential covariates, maternal BMI and maternal education, were associ-ated with the study ’ s behavioural (i.e., serves of food/drink items consumed, and minutes of TV/DVD/video watched per day) and self-effi cacy vari-ables. Maternal BMI and education were not associ-ated with the outcome or predictor variables, so these factors were not controlled for in subsequent analyses. Differences between the mothers/children from the two age groups with regards to sociodemo-graphic variables were examined using chi-square tests for categorical variables (e.g., maternal educa-tion) and t-tests for continuous variables (e.g., mother ’ s age). As the behavioural and self-effi cacy variables had distinctly non-normal distributions, non-parametric statistical techniques were employed to analyse them. Differences between the two age groups on the behavioural and self-effi cacy measures were tested for signifi cance with Mann-Whitney U

504 K. Campbell et al.

tests. Subsequently, associations between children ’ s behaviour and mothers ’ self-effi cacy with regard to regulating their child ’ s behaviour were examined for the two age groups separately using Spearman rank order correlations. All analyses were conducted using SPSS Statistics 17.0.

Results

Table I shows the sociodemographic characteristics of the two groups. Seventy-fi ve (35.0%) fi rst time mothers of infants and 84 (39.3%) mothers of 5-year-old children returned a completed survey. Exclusion of children who had had an illness affect-ing appetite for more than two days in the previous week left a fi nal sample of 60 mothers of 1-year-old and 80 mothers of 5-year-old children. The mean age of the younger and older children was 15 (3.9) months and 59 (3.9) months, respectively. Around half of children in both groups were male. The two groups of mothers were found only to differ signifi -cantly in terms of age. As expected, mothers of 5-year-old children were older (six years on average) than the mothers of 1-year-old children.

Table II shows the mean and median (IQR) num-ber of serves of foods and drinks, minutes of televi-sion viewing and maternal self-effi cacy in each of the two age groups. As expected, when compared with the 1-year-olds, the 5-year-old children generally consumed more. Specifi cally they consumed signifi -cantly more water, juice, cordial, reduced-fat milk, packaged snacks, chocolate and cake, and signifi -cantly less full cream milk. While we are unable to

calculate the relative proportion of energy provided by energy-dense foods and drinks, the fact that the number of serves of all energy dense foods and drinks increased suggests a trajectory of increased intake over early childhood. In addition, vegetable con-sumption (excluding potato) was signifi cantly greater in the 5-year-old children (p � 0.05).

Minutes of weekly television viewing was also sig-nifi cantly higher among the 5-year-olds with these children watching more than twice as many minutes of television per day than the 1-year-olds. On a typ-ical day 20% of younger children and 61% of older children watched more than the recommended max-imum of two hours of television per day (15) (not shown in Tables).

Finally, Table II shows that mothers of 1-year-old children indicated signifi cantly higher self-effi cacy for limiting non-core foods and for limiting televi-sion viewing when compared with mothers of 5-year-olds. Indeed around one-third of mothers of 5-year-olds reported that they were not at all or only slightly confi dent that they could limit their child ’ s television viewing over the next year (not presented in Tables). No differences were seen between the two groups of mothers for their perceptions of self-effi cacy regarding promotion of healthy eating or promotion of physical activity when the child wanted to watch television.

Table III shows the associations between mothers ’ self-effi cacy for promoting healthy eating and for limiting non-core foods/drinks, and children ’ s dietary intake for the two age groups. These data show that maternal self-effi cacy for promoting healthy eating,

Table I. Sociodemographic characteristics of mothers and children.

1-year-old children (n � 60) 5-year-old children (n � 80)

Characteristic n (%) n (%) p a

Child ’ s age, months: mean (SD) 15 (3.9) 59 (3.9) ∗ ∗ ∗ Child ’ s gender

Male 31 (51.7) 40 (50.0) nsFemale 29 (48.3) 40 (50.0)

Mother ’ s age: mean (SD) 29.8 (5.4) 36.1 (5.1) ∗ ∗ ∗ Mother ’ s BMI: mean (SD) 26.1 (5.5) 24.6 (4.6) nsMother ’ s education

Did not complete high school 7 (11.7) 14 (17.5) nsHigh school/technical or trade school 25 (41.7) 40 (50.0)University or tertiary education 28 (46.7) 26 (32.5)

Mother ’ s marital statusMarried/de facto 54 (90.0) 75 (93.8) nsSeparated/divorced/widowed 3 (5.0) 3 (3.8)Never married 3 (5.0) 2 (2.5)

Mother ’ s country of birthAustralia 59 (98.3) 75 (93.8) nsOther 1 (1.7) 5 (6.3)

a p-value for differences between age groups, tested using chi-square tests for categorical variables and t-tests for continuous variables. ∗ ∗ ∗ p � 0.005, ns: non-signifi cant, SD: Standard deviation, BMI: Body mass index.

Self-effi cacy, diet and sedentary behaviours 505

and for limiting non-core foods was signifi cantly inversely associated with 1-year-old children ’ s cake consumption. Self-effi cacy for limiting non-core foods was also signifi cantly inversely associated with cordial consumption in this younger group. Self-effi cacy for promoting healthy eating was signifi cantly directly associated with 1-year-old children ’ s vegetable con-sumption, and with 5-year-olds ’ water, fruit and vegetable consumption. In the 5-year-old children maternal self-effi cacy for promoting healthy eating was inversely associated with cordial consumption.

Maternal self-effi cacy for promoting physical activity to displace television viewing was signifi -cantly inversely associated with both groups of children ’ s total television viewing time (Spearman rank order correlation –0.28 [p � 0.05] and –0.27 [p � 0.05] for 1-year and 5-year-old children, respec-tively). Similarly, maternal self-effi cacy for limiting television viewing was signifi cantly inversely associ-ated with both groups of children ’ s total television viewing time (Spearman rank order correlation –0.38 [p � 0.005] and –0.31 [p � 0.01]) for 1-year

Table II. Characteristics and differences between 1-year and 5-year-old children with regard to child diet, child television viewing, and maternal self-effi cacy.

1-year-olds (n � 60) 5-year-olds (n � 80)

Characteristic Mean Median (IQR) Mean Median (IQR) p a

Dietary intake: serves foods/ drinks (range: 0 – 6 � s/day) Water 3.01 3.00 (2.25) 3.82 4.00 (2.25) ∗ ∗ Juice 0.41 0.00 (0.00) 0.51 0.00 (1.00) ∗ Cordial 0.07 0.00 (0.00) 0.49 0.00 (1.00) ∗ ∗ ∗ Soft drink 0.07 0.00 (0.00) 0.05 0.00 (0.00) nsFull cream milk 1.83 2.00 (3.00) 1.17 1.00 (2.00) ∗ Reduced fat milk 0.02 0.00 (0.00) 0.42 0.00 (0.00) ∗ ∗ ∗ Packaged snacks 0.09 0.00 (0.00) 0.32 0.00 (1.00) ∗ ∗ Chocolate 0.08 0.00 (0.00) 0.24 0.00 (0.00) ∗ Cake 0.27 0.00 (0.38) 0.68 1.00 (1.00) ∗ ∗ ∗ Fruit 2.05 2.00 (2.00) 2.36 2.00 (1.00) nsPotato 0.39 0.00 (1.00) 0.49 0.00 (1.00) nsVegetables 1.78 2.00 (1.00) 2.14 2.00 (2.00) ∗

Sedentary behaviour Daily viewing (minutes) 71.61 51.43 (92.14) 148.05 141.43 (77.14) ∗ ∗ ∗

Maternal self-effi cacy (range: 1 – 5) Promoting healthy eating 4.51 4.70 (0.80) 4.38 4.60 (1.00) nsLimiting non-core foods 4.30 4.50 (1.19) 3.84 4.00 (0.94) ∗ ∗ ∗ Promoting Physical Activity 4.43 5.00 (1.00) 4.25 4.00 (1.00) nsLimiting TV viewing 3.69 4.00 (2.00) 2.85 3.00 (2.00) ∗ ∗ ∗

a p-value for differences between age groups, tested with Mann-Whitney U test. ∗ p � 0.05, ∗ ∗ p � 0.01, ∗ ∗ ∗ p � 0.005, ns: non-signifi cant.

Table III. Associations between mothers ’ self-effi cacy regarding child diet and children’s dietary intake for the two age groups.

Dietary intake

Mothers of 1-year-olds (n � 60) Mothers of 5-year-olds (n � 80)

Self-effi cacy for promoting healthy eating

Self-effi cacy for limiting non-core foods

Self-effi cacy for promoting healthy eating

Self-effi cacy for limiting non-core foods

Water –0.19 –0.24 0.24 ∗ 0.18Juice –0.22 –0.20 –0.03 –0.19Cordial –0.23 –0.26 ∗ –0.24 ∗ –0.16Soft drink –0.12 –0.20 0.13 –0.04Full cream milk –0.05 –0.04 0.00 –0.07Reduced fat milk 0.14 –0.16 –0.04 –0.10Packaged snacks 0.09 –0.06 0.20 0.03Chocolate 0.12 –0.20 –0.06 –0.11Cake –0.26 ∗ –0.34 ∗ ∗ –0.02 0.08Fruit 0.17 –0.02 0.42 ∗ ∗ ∗ 0.08Potato 0.18 –0.16 –0.09 –0.07Vegetables 0.31 ∗ 0.17 0.34 ∗ ∗ ∗ 0.01

∗ p � 0.05, ∗ ∗ p � 0.01, ∗ ∗ ∗ p � 0.005. Associations examined using Spearman rank-order correlation.

506 K. Campbell et al.

and 5-year-old children, respectively). These results are not presented in the Tables.

Discussion

To the authors ’ knowledge, this is the fi rst study to assess associations between maternal self-effi cacy regarding capacity to infl uence young children ’ s eating and sedentary behaviours, and measures of children ’ s food intake and television viewing time. It is also the only quantitative study to consider mater-nal self-effi cacy in regard to these health behaviours at two time points in early childhood.

This study suggests that maternal self-effi cacy may be an important correlate of child eating and sedentary behaviours, and that self-effi cacy regarding these behaviours may decline as children age. Consistent with recent national data (16), these data indicate that children ’ s obesity promoting behaviours, specifi cally consumption of energy-dense foods and drinks, and increased engagement in TV/DVD/video viewing are signifi cantly more common in older children.

The fi nding that mother ’ s increased self-effi cacy across a range of children ’ s diet and physi-cal activity behaviours was directly associated with obesity protective behaviours in the children is noteworthy. Thus mother ’ s reporting of higher self-effi cacy to promote healthy eating was asso-ciated with signifi cantly higher consumption of vegetables in both age groups.

Higher self-effi cacy to promote healthy eating was also signifi cantly associated with increased reported consumption of fruits and water in the 5-year-old children, and with reduced consumption of cordial (5-year-olds) and cake (1-year-olds). The direct asso-ciation between maternal self-effi cacy and child fruit consumption is consistent with the fi ndings of Cullen et al. (17). Associations between maternal self-effi cacy and child diet are also documented in oral health literature. For example, Litt et al. (18) showed in a sample of 184 parents of 3 – 4-year-olds, that mothers who scored highly on self-effi cacy for oral health behaviours had children who consumed signifi cantly less sugar (and had less dental caries). Finally, in the current study mother ’ s self-effi cacy regarding pro-moting physical activity in place of television viewing and for limiting viewing was inversely related to the amount of viewing time all children engaged in. To our knowledge this is the fi rst study to assess the asso-ciation between self-effi cacy in this domain and child television viewing time.

While self-effi cacy is known to be important in facilitating personal health behaviours (3), the lit-erature linking parental self-effi cacy to obesity pro-tective behaviours in children is scant. This study

thus extends the understanding of the important role maternal self-effi cacy may play in promoting healthy weight in children and provides focus for childhood obesity prevention interventions. These fi ndings suggest that parental support around pro-moting healthy eating and reduced sedentariness will need to encompass more than the translation of knowledge. Rather, in supporting parents we must seek to strengthen and maintain parent ’ s self-effi cacy in these areas (3,19). Putting knowledge of the rec-ommendations that children should eat a range of vegetables every day into practice, involves many skills that will impact self-effi cacy, ranging from those needed to buy and prepare vegetables, to those parenting skills needed for negotiating the likely food refusal and demands for other foods that will occur when offering vegetables.

The fi nding that mothers of 5-year-olds were less confi dent (than mothers of 1-year-olds) regarding their capacity to effect healthy eating and reduced sedentary behaviours in their children is important. It seems likely that this refl ects a child ’ s increased autonomy and capacity to negotiate aspects of their environment, and may speak to the need for increased parental skills concerned with manage-ment of emerging child behaviours. The need for increased support of parents has been raised in qual-itative work (6), where parents of young children spoke of having desired more support and advice in the eating and sedentary behaviour domains in their child ’ s early years. In that study parents also dis-cussed the fact that once “ bad ” eating and television viewing habits were in place it was very diffi cult to change them. Those fi ndings refl ect the understand-ing that self-effi cacy decreases as the perceived num-ber of barriers to a task increases (20), and highlights the likely importance of providing parents with focussed knowledge and skills regarding how to promote these health behaviours from very early in their children ’ s life.

Several limitations of this study should be acknowl-edged. The response rate of 37 percent was relatively low. While this rate of response is typical of cross-sectional surveys (21), we acknowledge that it has implications for generalisibility. We know for example that this sample of mothers were more likely to be tertiary educated (38.5%) than the Australian popu-lation of women aged 26 – 35 years (32.2%) (22).

In addition, this sample was drawn from a rural population and may not be representative of the broader population. Further, as this study was cross-sectional, causality cannot be inferred. Therefore, we can ’ t be sure of the direction of the associations between parent ’ s self-effi cacy and children ’ s eating and sedentary behaviours; whether low maternal self-effi cacy promotes/enables increased viewing time

Self-effi cacy, diet and sedentary behaviours 507

and increased consumption of non-core foods and drinks; or whether child demands for engagement in these behaviours and parental inability to negotiate desired outcomes in turn promotes reduced mater-nal self-effi cacy. These associations could be further elucidated in longitudinal and intervention studies. Regardless of the direction, it seems reasonable to suggest that programs seeking to strengthen parental self-effi cacy would be likely to improve targeted behaviours in children.

Unfortunately the small sample size and non-parametric distribution of the self-effi cacy variable precluded investigation of the size of effect of the associations detected in this fi rst study of maternal feeding self-effi cacy. Now that an association between maternal self-effi cacy and child diet and sedentary behaviours has been established by this study, studies involving larger samples and longitu-dinal studies are warranted to further explore how much change in self-effi cacy is required to effect change in child diet.

The use of validated outcome measures for diet and screen time (8 – 10) and the development of self-effi cacy measures, which proved to have good reli-ability, are important strengths of this study. We do acknowledge; however, that the dietary tool used in this study has not been validated in the younger of the two populations studied and that this may have limited our capacity to characterise young children ’ s diets. We are aware of no short dietary tools that have been validated in children younger than two years. We also acknowledge, given the relatively small sam-ple size, that diet would have been more accurately characterised by the use of three days of 24-hour dietary recall.

In summary, these fi ndings speak to the possibil-ity that obesity promoting eating and sedentary behaviours are beginning to be established in early childhood. The fi ndings also prompt us to consider the role parents (in this case mothers) play in the promotion or limiting of these behaviours. It is likely that parental self-effi cacy regarding capacity to impact on children ’ s eating and sedentary behaviours may be enhanced if we engage with parents while their self-effi cacy is high. This study suggests that this may be early in the child ’ s life. Given that few stud-ies consider capacity to improve parental skills and self-effi cacy in eating and sedentary behaviours domains (1), this remains an important area for future research.

Acknowledgements

We would like to gratefully acknowledge the Maternal and Child Health Nurses, the Kindergarten teachers and of course the parents who participated in this

study. Financial support for this work was provided via Dr.Campbell ’ s Victorian Health Promotion Foundation Research Fellowship. Dr Hesketh is supported by a National Health and Medical Research Council/Heart Foundation Post-doctoral fellowship. This study was conceived by Drs Campbell and Hesketh and undertaken by honours student Amanda Silverii.

Declaration of interest : The authors report no confl icts of interest. The authors alone are respon-sible for the content and writing of the paper.

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