This study type is a clinical trial (randomized controlled longitudinal study). The primary purpose is to determine whether an online occupational therapy-based parent training program can prevent or reduce feeding problems, improve parental attitudes, and decrease parenting stress in mothers of infants. The participant population includes female caregivers (mothers) of typically developing infants aged 18 to 24 months. All participants are healthy volunteers. The main research questions this study aims to answer are: Does online occupational therapy-based parent training reduce feeding problems in infants (e.g., food refusal, resistance, sensory-based rejection)? Does the training improve maternal attitudes related to feeding and reduce parenting-related stress? Comparison group: Researchers will compare the outcomes of mothers who receive the online training (intervention group) with those who receive no intervention (control group) to determine the effectiveness of the program. Participants will be asked to: Complete baseline assessment forms prior to randomization If in the intervention group: Attend a 4-week online group training program (one session per week) via a secure Zoom® platform Participate in follow-up assessments at 6 months and 12 months post-training All participants (in both groups) will: Complete standardized assessment tools at three time points (baseline, 6-month follow-up, 12-month follow-up), including: Sociodemographic Information Form Infant Adaptive Feeding Behavior Scale Feeding Process Parental Attitude Scale Parenting Stress Scale
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
32
The intervention is a 4-week online parent training program based on occupational therapy principles, delivered via secure Zoom sessions once per week. Each session lasts approximately 60-75 minutes and focuses on topics such as feeding skill development, sensory-based feeding difficulties, responsive parenting strategies, and stress management techniques. The training includes interactive discussions and practical suggestions for daily feeding routines. Supporting materials, such as PDF slides and short demonstration videos, are shared with participants after each session. Attendance in at least three sessions is required to remain in the study.
Ankara Medipol University
Ankara, Altındağ, Turkey (Türkiye)
Adaptive Eating Behavior in Infancy Scale
The Infant Adaptive Feeding Behavior Scale (IAFBS) was developed by Dilsiz and Dağ in 2018 to assess the eating behaviors of children aged 9 to 36 months. The scale consists of 20 items and four factors: "Reluctance," "Resistance," "Reaction to Main Meal Structure," and "Sensory-Related Food Refusal." Items 1-8 measure the reluctance factor; items 9-12 measure resistance; items 13-16 assess reactions to meal structure; and items 17-20 evaluate food refusal related to sensory issues. Items are rated on a 5-point Likert scale ranging from "Never" to "Always," scored as follows: never = 1, rarely = 2, sometimes = 3, usually = 4, always = 5. However, item 2 ("reaches spontaneously for food during meals") reflects a positive feeding behavior and is reverse-scored. All other items are scored in the standard direction. The total score ranges from 20 to 100. Higher total and subscale scores indicate more severe feeding behavior problems in infants aged 9 to 36 months.
Time frame: T₀ - Baseline: Pre-training, first assessment after randomization T₁ - Post-intervention: Immediately after training completion T₂ - 6-month follow-up T₃ - 12-month follow-up
Maternal Attitudes Scale in the Feeding Process
This scale was developed in 2018 by Dilsiz and Dağ with the aim of identifying problematic areas in maternal attitudes during the feeding process, based on the interactional dimension of feeding between the mother and child. The Feeding Process Parental Attitude Scale (FPPAS) is used to assess the feeding-related attitudes of mothers with children aged 9 to 72 months. It is a 5-point Likert-type scale with response options ranging from "Never" to "Always." The scale consists of 27 items and includes the following subscales: Negative Emotional State During Meals, Attitudes Toward Inadequate/Unbalanced Nutrition, Negative Feeding Strategies, Forceful Feeding, and Reaction to Others' Opinions. The total score ranges from 27 to 135. Higher scores on the total scale and subscales indicate a greater presence of problematic maternal attitudes regarding the feeding process.
Time frame: T₀ - Baseline: Pre-training, first assessment after randomization T₁ - Post-intervention: Immediately after training completion T₂ - 6-month follow-up T₃ - 12-month follow-up
Parental Stress Scale
The Parenting Stress Scale was developed by Aydoğan and Özbay in 2017 to measure the stress experienced by parents of typically developing children in relation to their parenting role. The scale consists of 18 items and has a single-factor structure that includes the parent, the parent-child relationship, and characteristics of the child. It is a Likert-type instrument rated from 0 ("Does not describe at all") to 4 ("Describes very well"). The total score ranges from 0 to 72, with higher scores indicating higher levels of parenting stress. The scale is easily applicable to parents who have at least one child and have completed primary education or higher.
Time frame: T₀ - Baseline: Pre-training, first assessment after randomization T₁ - Post-intervention: Immediately after training completion T₂ - 6-month follow-up T₃ - 12-month follow-up
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