![]() ![]() ![]() The first measure relied on the well-validated snack delay task, 22 in which toddlers are presented with an M&M in 4 separate trials and asked to wait 5, 15, 30, and 60 seconds before eating it, with scores ranging from 0 = ate the M&M before time was up to 2 = waited the entire time (Cronbach’s α = 0.76). Toddlers’ self-regulation was assessed with 3 measures tapping different dimensions of the umbrella construct: delay of gratification, task orientation, and emotional and/or behavioral control. ![]() (Even the youngest toddlers could place a piece of cheese on a tortilla, stir dry ingredients in a bowl, or peel a banana.) As part of each lesson, home visitors helped parents identify opportunities for skill generalization in other contexts. Lessons were tailored to toddlers’ skill levels. 19 In addition, food preparation provides multiple opportunities for toddlers to practice self-regulation, such as waiting patiently while ingredients cook, and for parents to practice sensitive scaffolding based on techniques used in parent-child interaction therapy, 20 such as behavior descriptions and specific praise. Toddlers are more likely to eat something they help make. However, most of each lesson was focused on active coaching of carefully structured and sequenced food preparation activities involving 3 to 6 ingredients we provided (adjusted as necessary to accommodate food allergies or limited cooking equipment and/or facilities). 17 From the beginning, this randomized controlled clinical trial was designed to test whether Recipe 4 Success would result in posttreatment differences in its 4 primary outcomes: toddlers’ healthy eating habits, toddlers’ self-regulation, parents’ responsive feeding practices, and parents’ sensitive scaffolding.Įach Recipe 4 Success lesson included some didactic information, such as how toddlers often need to be exposed to a new food 10 to 20 times before they will eat it or how poor sleep can undermine emotional and/or behavioral control and lead to weight gain. Given the extensive involvement of Early Head Start in developing the intervention (and given the team of investigators’ experience conducting basic research on toddlers’ healthy eating habits and self-regulation and clinical trials of preventive interventions for families in community settings), no initial pilot study of feasibility, process, or description was planned. Recipe 4 Success was cocreated by administrators and home visitors from Early Head Start to enhance the efficacy of that evidence-based program and to take advantage of its preexisting national infrastructure for dissemination. As depicted in Fig 1, with Recipe 4 Success, we assumed an integrated approach to promoting toddlers’ healthy eating habits and self-regulation and parents’ responsive feeding practices and sensitive scaffolding among families living in poverty. ![]()
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