Abstract/Summary

Unhealthy eating in children is a widespread problem, associated with poor cognitive and physical development. Increasingly, evidence indicates that poor eating habits in children track into adulthood. Parents’ feeding practices are consistently found to predict children’s eating behaviours and many interventions have been developed to target parents as the main agents of change in family eating interventions. However, parents cite time, stress and convenience as barriers both to implementing positive feeding practices and to participating in healthy eating intervention studies. The research described in this thesis sought to investigate the effectiveness of interventions aimed at improving family eating behaviours, with a particular focus on enjoyment and stress reduction. The first paper is a comprehensive Systematic Review of family eating interventions delivered in the family home. The Review found that, in order to be effective, interventions should be robustly theory and evidence driven as well as engaging and burden-free for parents. The second paper describes the detailed development of a healthy eating intervention, the Healthy Happy Family Eating programme, which was delivered online and emphasised implementing enjoyable mealtimes. The design of a Randomised Controlled Trial is described in the subsequent three chapters. These describe measure selection and design, including the third paper which identifies the lack of and reports the design of a parental feeding goal measure; a report of the trial itself (the fourth paper) and supplementary analyses and information about the trial. Throughout these studies, attention is given to parents’ goals, motivations and engagement. Collectively, the studies indicate that future intervention studies should prioritise stress-reduction at mealtimes as well as paying careful attention to the theory and evidence base; parents’ preferences for the type of help they receive with their children’s eating should be given more attention, as well as their feeding goals and the potential conflicts between these.