To Identify Differences in Feeding Practices Between Parents and Family Child Care Home Providers for Children Aged 3–5 Years and Their Associations with Child Dietary Intake, Skin Carotenoids, and Body Mass Index

Authors

• Charlene Maria Pereira, University of Nebraska-LincolnFollow

First Advisor

Dipti Dev

Second Advisor

Lisa Franzen-Castle

Committee Members

Sarah Hortman, Ann Rogers

Date of this Version

7-2026

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, July 2026

Comments

Copyright 2026, Charlene Maria Pereira. Used by permission

Abstract

Introduction: Childhood obesity remains a major public health concern in the United States (U.S.), and early childhood feeding environments may influence children’s dietary behaviors and health outcomes. Parents and family child care home (FCCH) providers both shape preschool aged children’s eating behaviors through their feeding practices. However, there is limited research about how these practices differ and their associations with children’s dietary intake, skin carotenoid levels, and body mass index percentile (BMI).

Methods: This cross-sectional study included 40 FCCH providers, 98 parents, and 98 preschool aged children enrolled in Child and Adult Care Food Program (CACFP) participating FCCHs in Nebraska. Online surveys assessed six feeding practice constructs: modeling, pressure to eat, food as a reward, balance and variety, child control, and teaching about nutrition. Children’s lunchtime dietary intake was assessed using the Dietary Observation for Child Care (DOCC) method, while height, weight, and skin carotenoid scores were objectively measured. Paired samples t-tests, Pearson correlations, and linear mixed-effects models examined differences in feeding practices and associations with child dietary intake, skin carotenoids, and BMI percentile.

Results: Results partially supported the hypotheses. Compared with parents, FCCH providers reported greater teaching about nutrition and lower use of food as a reward and pressure to eat, whereas parents reported higher modeling (all p ≤ 0.014). Provider encouragement of balance and variety was positively associated with child skin carotenoids (β = 280.37, p < 0.001) and BMI percentile (β = 11.40, p = 0.02). Parent modeling was positively associated with protein (oz) and dairy intake (cups), whereas provider modeling was negatively associated with protein intake. Parent feeding practices were not associated with child BMI or skin carotenoid levels.

Conclusion: These findings highlight differences in feeding strategies across home and FCCH settings and underscore the need for harmonized interventions and longitudinal research to better support healthy dietary behaviors and pediatric health.

Advisors: Dipti Dev and Lisa Franzen-Castle