Graduate Studies


First Advisor

Dipti A. Dev

Second Advisor

Lisa Franzen-Castle

Date of this Version


Document Type



A THESIS Presented to the Faculty of The Graduate College at the University of Nebraska In Partial Fulfillment of Requirements For the Degree of Master of Science, Major: Nutrition and Health Science, Under the Supervision of Professors Dipti Dev and Lisa Franzen-Castle. Lincoln, Nebraska: July, 2021

Copyright © 2021 Carly Hillburn


Background: Child care and early childhood education settings offer ideal settings for nutrition interventions to prevent childhood obesity. These interventions often address nutrition of foods served, the physical environment, and implementation of responsive feeding evidence-based practices (EBP). Despite these interventions, implementation of responsive feeding EBPs continues to be low, especially in rural family child care homes (FCCH). This warrants an adaptation of interventions to better meet the contextual needs of these providers and therefore increase relevance and applicability in these settings.

Methods: Six qualitative focus group interviews were conducted with 19 rural FCCH providers using Diffusion of Innovations Theory to better understand FCCH perceptions and experiences using responsive feeding EBPs. Interviews were analyzed using thematic analysis.

Results: Providers reported having knowledge regarding responsive feeding EBPs and had learned about them through various communication channels. Providers reported challenges to implementing responsive feeding related to the context of the FCCH settings, such as the mixed age groups of children and balancing multiple roles during mealtimes. Additionally, providers who were implementing responsive feeding EBPs provided strategies used to overcome these challenges. Finally, providers reported the benefits of using responsive feeding EBPs.

Conclusions and Implications: Professional development trainings and interventions should consider and address context related challenges when designing content and programming. Future research is needed to understand how cultural contexts and other child care contexts influence use of responsive feeding EBPs.

Advisers: Dipti Dev and Lisa Franzen-Castle

Context Matters - Defense v2.pdf (1725 kB)
Defense Presentation