The effectiveness of interventions on changing caregivers' feeding practices with preschool children: A systematic review and meta-analysis

Caregivers' feeding practices are critical in shaping preschool children's eating habits and preventing childhood obesity. We conducted a systematic review and meta-analysis to evaluate the effectiveness of existing interventions targeting caregivers of preschool children, which aimed to promote child healthy eating and/or manage child weight and/or prevent child nutrition-related problems and included feeding practices as one of the outcomes. Eighteen studies with 18 intervention programs and 3887 respondents that completed baseline evaluations were eligible for data synthesis. Behavior change techniques (BCTs) frequently used included the following: instruction on how to perform the behavior and demonstration of the behavior. The pooled effects of randomized controlled trials (RCTs) on pressure to eat (pooled standardized mean difference [SMD] = 0.61; 95%CI: -1.16, -0.06), use of food as a reward (pooled SMD = -0.31; 95%CI: -0.61, -0.01), and emotional feeding (pooled SMD = -0.36; 95%CI: -0.66, -0.06) were found statistically significant compared with control groups at post-intervention. However, there were no pooled effects on restrictive feeding and pressure to eat at other follow-ups or on other feeding practices at post-intervention. Interventions may have short-term effects on decreasing the adoption of coercive control. Future interventions should directly and adequately optimize feeding practices, include components of individual support, and contribute to the maintenance of the effects over the long term.