Date of Award

January 2023

Document Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Nicola Hawley

Second Advisor

Courtney Choy

Abstract

Background: Childhood obesity is a pressing issue requiring a reliable tool for assessing health-related eating behaviors. The Child Eating Behavior Questionnaire (CEBQ) is a parent-reporting measure designed to assess multiple dimensions of children's eating behavior. This study aimed to assess CEBQ factor structure with data collected from Ola Tuputupua's Cohort and analyze the association between children's eating behavior and weight.

Methods: The confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) were conducted. Multinominal logistic regression analyses were conducted to examine associations between the CEBQ subscales with children's weight (healthy weight/overweight/obesity) as the dependent variable.

Results: The original eight-factor CEBQ model was not replicated, so EFA of the data eventually revealed a 14-item three-factor structure (Enjoyment of Food, Emotional Undereating and Emotional Overeating). For the Enjoyment of Food subscale, after adjustment, in the second tertile, the odds of having obesity were 7.95 times higher (95% CI: 4.38, 14.41) than the healthy weight children in the first tertile. For the third tertile, the odds of having overweight were 1.85 times higher (95% CI: 1.02, 3.35) than the healthy weight children in the first tertile, and the odds of having obesity were 18.66 times higher (95% CI: 8.27, 42.09) than the healthy weight children in the first tertile. These associations were statistically significant. However, Emotional Undereating and Emotional Overeating subscales were not significantly associated with children's weight status.

Conclusions: CEBQ may be affected by demographic and cultural differences. Further qualitative studies are needed to validate the three-factor model in other populations to investigate its generality. Primary caregivers need to be aware of the impact of a child's enjoyment of food on promoting healthy eating and designing effective interventions.

Comments

This thesis is restricted to Yale network users only. It will be made publicly available on 05/10/2025

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