title: Validation of the Comprehensive Feeding Practices Questionnaire among Brazilian Families of School-Aged Children.
abstract: BACKGROUND
  Children's eating behaviors are influenced by parents, who are the first nutritional educators. The comprehensive feeding practices questionnaire (CFPQ) was developed to measure feeding practices among parents, but has not yet been validated in Brazil, where child obesity rates are steeply increasing. The aim of the study was to test the validity of the CFPQ among Brazilian parents of school-aged children and propose a new version of the instrument.
  
  
  METHODS
  Transcultural adaptation included translation into Portuguese, back translation, content validity, testing for semantic equivalence, and piloting. Questionnaire data were obtained for 659 parents of 5- to 9-year olds. Confirmatory and exploratory factor analyses and psychometric analyses (tests for internal consistency, factor correlations, item-discriminant and convergent validity, and test-retest reliability) were conducted.
  
  
  RESULTS
  Confirmatory factor analysis demonstrated a poor fit of the data to the original 12-factor model. Exploratory factor analysis generated a 6-factor model composed of 42 items: healthy eating guidance, monitoring, restriction for weight control, restriction for health, emotion regulation/food as reward, and pressure. This factor solution was supported by internal consistency tests (α = 0.71-0.91) and factor correlations (ρ = -0.16 to 0.32). Item-discriminant and convergent validity tests showed that parents who used coercive practices had more overweight children and were more concerned about their child's weight (ρ = 0.09-0.40). Test-retest reliability was acceptable (intraclass correlation coefficient = 0.45-0.77).
  
  
  CONCLUSIONS
  Since parental practices are highly culturally and age group sensitive, it is essential to conduct careful evaluations of questionnaires when introduced into specific age groups within new cultural settings. This modified six-factor model of the CFPQ is valid to measure parental feeding behaviors of school-aged children in urban Brazilian settings.
authors.affiliation: Department of Pediatrics, Discipline of Nutrology, Federal University of São Paulo (UNIFESP) , São Paulo , Brazil.
authors.forename: Laís Amaral
authors.initials: LA
authors.lastname: Mais
authors.affiliation: Department of Pediatrics, Discipline of Nutrology, Federal University of São Paulo (UNIFESP) , São Paulo , Brazil.
authors.forename: Sarah
authors.initials: S
authors.lastname: Warkentin
authors.affiliation: Department of Epidemiology, School of Public Health, University of São Paulo (USP) , São Paulo , Brazil.
authors.forename: Maria do Rosário Dias de Oliveira
authors.initials: Mdo R
authors.lastname: Latorre
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine , Baltimore, MD , USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Carnell
authors.affiliation: Department of Pediatrics, Discipline of Nutrology, Federal University of São Paulo (UNIFESP) , São Paulo , Brazil.
authors.forename: José Augusto de Aguiar Carrazedo
authors.initials: JA
authors.lastname: Taddei
keywords: child; child nutrition; feeding behavior; parent–child relations; validation studies