Investigating Parent-Provider Alignment of Feeding Practices for Children Aged 3–5 in Nebraska Family Childcare Homes: A Multi-Level Mixed Logistic Analysis of Cross-Sectional Survey Data

Authors

• Aya Abu Alrub, University of Nebraska-LincolnFollow

First Advisor

Dipti Dev

Second Advisor

Lisa Franzen-Castle

Committee Members

Sarah Hortman, Gilbert Parra

Date of this Version

4-2026

Document Type

Thesis

Citation

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 Sciences

Under the supervision of Professors Dipti Dev and Lisa Franzen-Castle

Lincoln, Nebraska, April 2026

Comments

Copyright 2026, Aya Abu Alrub. Used by permission

Abstract

This study investigated how feeding practices, focused on children aged 3-5, aligned between home and childcare settings in urban and rural Nebraska. Using a cross-sectional survey dataset from the 2021–2022 academic year in Nebraska, the study analyzed 83 children nested within 38 Family Childcare Homes (FCCH). The methodology utilized Bayesian multi-level mixed logistic regression with a random intercept for each provider to account for site-level clustering. The models investigated whether a significant positive association existed between the odds of a parent being in the high-practice [LF1.1] vs. low-practice group, and the provider’s practice score for the same construct [LF2.1]. Constructs included Modeling, Pressure, Child Control, Food as Reward and Teaching about Nutrition. Results indicated that alignment is practice-specific rather than uniform. Significant provider-parent alignment was found for Modeling, where the Odds Ratio (OR) was 2.6, Food as Reward (OR = 4.81), and Teaching about Nutrition (OR = 6.23). In contrast, Pressure and Child Control practices showed no evidence of association. Findings suggested that visible, verbal practices like Modeling and Teaching about Nutrition were more readily reinforced across settings. The high alignment and prevalence of Food as Reward highlights a need for targeted provider-focused efforts to discourage its use. Additionally, practices with low alignment, such as Pressure and Child Control, likely require context-specific and different education strategies across the two settings.

Advisors: Dipti Dev and Lisa Franzen-Castle